Primer on Nystagmus

Nystagmus (pronounced “ni-stag-muss”) is a condition where the eyes of an individual will undergo uncontrollable rapid movement

The movement can be side to side, up and down, circular, or any combination of the three. It can also occur in both eyes independent of each and can vary in speed. Due to the complexity and recalcitrant behavior, the vision that the patient may experience can be affected. Most will find that they have a reduction in sight.

There are two main types of nystagmus: congenital (or infantile) and acquired. 

Congenital nystagmus occurs in infants within the first few months of their birth. Rather than seeing things as “shaky”, most children will have their vision blurred. Causes may be due to problems in the development of the eyes of regions of the brain that affect the visual system. Some will also find that the condition is inherited from their parents or the byproduct of a different medical condition. There are also those with “idiopathic infantile nystagmus”, which is when the cause is unidentifiable. 

Acquired, on the other hand, is found later in life and can be caused by anything that affects the function of the eye. This can range from eye diseases to seemingly unconnected illnesses to lifestyle choices. Adults with acquired nystagmus will often describe their vision as “shaky”.

The main symptom associated with nystagmus is uncontrollable eye movement. In addition, this can lead to various other problems:

  • Long or shortsightedness 
  • Light sensitivity
  • Dizziness 
  • Headaches
  • Poor depth perception
  • Poor balance

Unfortunately, there is currently no cure for nystagmus. 

However, it is possible to reduce the effects associated. Glasses can be worn to help with reduced vision and larger text sizes can greatly aid children who are learning to read. 

Some people may also find that they have a “null zone”. This is a point at which the involuntary eye movement is reduced and could involve maintaining the head at a tilted position. 

Operations can help reduce the necessity for these awkward positions and studies have been done to test the possibility and efficacy of altering or enlarging a patient’s “null zone” through surgical intervention. There has also been research into the use of non-surgical intervention methods such as contact lenses and prisms. 

Primer on Cataracts

The lens in an eye function similarly to those in cameras. They help to focus the visual surrounding onto the retina to provide an undistorted picture. 

What this means is that in order for the lens to function at its maximum capacity, one vital condition is that the lens remains transparent. 

Cataracts is a condition where the cells and water content in the lens undergo changes. The individual’s lens may then begin to develop cloudy patches. Over time, these patches can increase in size and lead to vision becoming hazy, blurry, and lacking in colour. While the condition usually develops in both eyes, when and how will not necessarily be the same. Some may find that their vision drastically changes in a few months, while others may not experience any changes for years. 

According to an assessment from the World Health Organization (WHO), cataracts are responsible for 51% of world blindness. Although most cases are related to the general side-effects of ageing, it can be caused by injuries, other eye conditions, or a variety of lifestyle choices. It is also possible for children to be born with cataracts (often referred to as “congenital”, “infantile”, or “developmental” depending on how early they manifest). 

Fortunately, once cataracts have been confirmed, they can be removed at any stage. The surgery involves replacing the affected lens with an artificial lens implant. This is normally done under local anaesthetic and can be performed as a day procedure. It is not uncommon for a patient’s ophthalmologist to delay surgery if the cataracts have not progressed very far. This is done due to the slight risk associated with the procedure as well as the personal situation of the patient.  Under the NHS, operations are normally only suggested if the patient’s vision is outside the legal limit to drive. 

For example, if the patient has another existing eye condition, it is possible that cataract surgery may not be able to improve the individual’s sight. 

Additionally, cataracts surgery can only be performed in one eye at a time. This means that there may be a period of months between operations if both eyes need treatment. 

Post-surgery recovery is normal fairly straightforward. The dressing can normally be removed after a day and antibiotic drops are given to help stave off infection. Other short-term precautions including not rubbing the eyes, staying away from heavy activities, and not swimming.