Nystagmus (eye tremor) – causes, treatment

Nystagmus (eye trembling)

Nystagmus , i.e. trembling of the eyes , represents a limitation of vision . It even occurs in healthy people and is therefore not always pathological. Nystagmus is to be distinguished from eye twitching  and eye flickering .

What is nystagmus?

Eye tremor (nystagmus) is generally understood to mean involuntary eye movement in a horizontal direction. It is not always a disease, because the trembling of the eyes also occurs in everyday life.

If a point in the distance is aimed at during a train journey, the eye swings to the maximum position and then moves back with a jerk. A gaze-holding weakness is assumed in so-called latent nystagmus (final position nystagmus). Here, a moving object cannot be fixed long enough without the eye moving back to its original position.

This form of eye tremor often occurs in patients who suffer from strabismus in the first two years of life . Another manifestation of eye tremor is primary congenital nystagmus. It is congenital but weakens during childhood. It is more pronounced when the patient is staring at an object.

Ocular nystagmus, on the other hand, is an acquired form of eye tremor that occurs as a result of another eye disease. Here the eye swings in the first months of life. These movements are gradually weakening. If this form occurs after the sixth month of life, a jerky eye trembling can be seen more often.


The causes of primary congenital and latent eye tremors are largely unknown. Both forms are congenital or acquired in early childhood. Recessive inheritance can occur in congenital nystagmus. However, this rarely occurs.

Ocular nystagmus is caused by a previous disease of the eye. This includes the cataract or gray star , which means a clouding of the lens of the eye. Added to this is optic atrophy. Here, a decline in tissue occurs on the optic nerve.

Aniridia is a congenital eye disease. The patients lack the iris. In albinism , a genetically determined lack of pigment leads to limitations in visual acuity.

A scar on the retina also leads to visual disturbances and reduced visual acuity, which is accompanied by eye tremors.

diseases with this symptom

Diagnosis & History

The ophthalmologist uses Frenzel glasses to diagnose eye tremors . With it, he can see the eye in a significantly enlarged view and thus assess the horizontal deflections. The frequency of the tremor as well as the amplitude and direction of the eye are decisive.

The doctor can provoke the nystagmus with a thermal test. To do this, the ear is rinsed with cold and warm water. Another method of provocation is the swivel chair test. For this purpose, the patient is set in motion on a swivel chair. The eye tremor is triggered by his attempts to fixate on a point and occurs in the opposite direction after stopping the chair.

The abnormal activity of the eye muscles must also be assessed. Electrooculography (EOG) is used for this purpose . Eye trembling can cause the patient to hold his head in a forced position. In addition, untreated nystagmus leads to a reduction in visual acuity in both eyes.


A nystagmus, i.e. a stiffening, a tremor or a miscoordination of the eyes, is not only considered to be a visual impairment. If nystagmus is not counteracted, complications can occur that can affect the entire ophthalmological apparatus. Normally, nystagmus is only temporary and subsides when the source of stress ceases to exist, for example when leaving the computer workstation, with sufficient vacation time or regular eye exercises.

However, this overload syndrome can lead to a permanent reduction in vision. Therefore, eye tests and examinations should be carried out in good time and regularly, which ideally are even financed by the employer or the necessary visual aids. However, nystagmus can be triggered not only by strenuous work in front of a screen or, for example, strenuous night driving in the car, but also by drug abuse.

As far as the eyes are concerned, the long-term complications of drug abuse include not only nystagmus but also visual hallucinations , which must be considered together as they progress. From a purely cognitive point of view, nystagmus manifests itself in the fact that focusing with the eyes is difficult or, in extreme cases, it hurts or is no longer possible with precision. This is why headaches or migraines are often associated with the symptoms, which can become chronic over time. Complications are also amplified when various sources of stress add up, such as strenuous night work under poor lighting conditions.

When should you go to the doctor?

If the nystagmus is only temporary, a doctor’s visit is not necessary. In the case of non-disease-related nystagmus (physiological nystagmus), the eye function returns to normal after a short time. However, the pathological form of this eye disease (pathological nystagmus) should not remain untreated, as otherwise the visual acuity is permanently reduced. The first person to contact here is an ophthalmologist . Depending on the cause of the disease, a neurologist or ENT doctor can also be consulted.

If the eye tremors often occur both at rest and when moving, it is advisable to see a doctor as soon as possible. Dizziness and a trembling perception of the environment are signs of pathological nystagmus. The cause can lie in the brain and should therefore be clarified.

Eye injuries can also be the reason for eye tremors. If the symptoms occur in connection with an injury, a doctor should be consulted. This can prevent any further complications.

Drug use, such as ecstasy, can also trigger nystagmus. Since both the sense of balance and vision can be disturbed here, the ophthalmologist together with other specialists will make a comprehensive diagnosis and work out possible therapy.

Treatment & Therapy

The treatment of the eye tremors is intended to bring about a significant improvement in the patient’s visual acuity. This can be achieved by integrating prism lenses into normal glasses.

In the case of congenital forms of eye tremors, it is sometimes more advantageous to carry out an additional operation. A compulsive head position can also be corrected here. To calm eye trembling when looking sideways, the eye muscles are shifted so that patients can look straight ahead in the future.

If the patient’s eye trembling calms down when looking up close, there are also surgical procedures for correcting the eye muscles. The combined treatment with prism glasses can then provide the necessary relief.

Outlook & Forecast

If the nystagmus is weak, using the healthy eye can have a compensatory effect in some people. In this case, the existing visual acuity is completely sufficient, so that no further measures need to be taken.

Without medical help, people suffering from a congenital or acquired disorder will not improve their state of health. The use of visual aids often alleviates the symptoms. However , the use of glasses or contact lenses does not lead to a permanent reduction in symptoms, since the visual aid only supports the eyes.

A long-lasting improvement in the nystagmus can be achieved through surgery. The prospects for this are classified as quite good. An eye muscle operation helps many affected people to a good prognosis and a permanent increase in visual acuity. Good results are also achieved with drug treatment. However, as soon as the drug is discontinued, there is a relapse and the recurrence of the eye tremors.

For people who do not have permanent eye tremors, it is often sufficient if they take it easy. Sufficient sleep and the avoidance of certain stimuli sometimes cause spontaneous healing. Situations where an object cannot be fixed long enough due to movement taking place should be avoided entirely.


There are no preventive measures for eye tremors, which are usually congenital or acquired in infancy. In view of the declining visual acuity, it is important to consult the ophthalmologist immediately in the event of any abnormalities in order to have the cause of the eye tremors clarified.

You can do that yourself

If the nystagmus is not severe, it can easily be counteracted with conscious behavior. Caution: The following tips will not help with pathological nystagmus. In this case, medical treatment is necessary. The self-help tips are only intended for spontaneously occurring eye tremors.

If the cause is not getting enough sleep in the days before the eye tremors appear, a longer night’s sleep will provide rapid relief. A stress-free environment can also help the symptom resolve sooner. Stress that occurs can best be reduced with relaxation techniques such as yoga or autogenic training , which in turn help to reduce nystagmus.

Certain stimuli can also trigger nystagmus. With sufficient rest and rest, an improvement will soon set in. It is often enough for patients to reduce screen work and rest instead. Certain eye gymnastics exercises can also help against the tremors.

You should also avoid concentrating on a distant point – for example when viewing the landscape while driving a car. This can aggravate or re-trigger the nystagmus because the eye cannot fixate on a specific object in this situation. The patient should therefore not look out of the window while driving so that the eye can recover.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.