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types of nystagmus

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sensory defect

latent

latent latent

manifest

acquired

gaze paretic

pendular

jerk

convergence-retraction

vestibular

see saw

dissociated

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caused by co-contraction of medial recti, jerky stimulated by attempted up gaze in which fast phase brings the 2 eyes together in a convergence movement with retraction of the globe.

caused by cerebellar or brain stem disease, down beat is suggestive of arnold-chiari malformation where veritcal pursuit and vestibulo-ocular reflex is abnormal

jerky, appears on eccentric gaze, beats in direction of gaze, caused by cerebellar disorders, sedative or anti convulsant meds or alcohol

caused by cataracts, optic atrophy and aniridia . common form is albinism.

only present on occlusion

one eye elevates and usually intorts as the other depresses and extorts, caused by perasellar or chiasmal lesions, may be bitemporal hemianopia

present on monocular occlusion, fast phase beats towards the uncovered eye, so direction of nystagmus always reverses when the cover is moved from one eye to the other, with strabismus, cyclotorsion and vertical deviation

eye movements are dissimilar in direction, amplitude or speed, occurs in internuclear ophthalmoplegia

occurs after the first months of life, caused by lesion or trauma affecting motor pathways such as multiple sclerosis or closed head trauma

present without occlusion

slow constant velocity drift takes the eyes off target, followed by a quick corrective saccade

caused by brain stem or cerebellar or demyelinating disease, occurs in the first few months of life


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