Eye Movement Disorders: An Overview

Generally, our eye movements while we are awake are voluntary, meaning that my eyes move towards whatever I want to look at. While we’re sleeping or when we sense a threat to our eyes, our eye movements are involuntary, meaning they are reflexive and I don’t have to consciously think about what my eyes should do during my dream or when a ball is flying towards my face.

However, the eyes can have conditions that affect their movement. These conditions have an immediate and often serious affect on those afflicted, since these conditions tend to affect vision.

One of the most common eye movement disorders is called nystagmus. Nystagmus is an involuntary movement of the eyeballs (usually in both). When the movement is only vertical, it is referred to as vertical nystagmus, and horizontal movement is called horizontal nystagmus. A rarer version of nystagmus moves the eyeballs in a circular pattern.

Some cases of nystagmus are congenital, meaning that the patient was born with the condition. This is often the case for those that also have albinism. Most cases of nystagmus are acquired, however, and there are many causes of acquired nystagmus, including stroke, substance abuse, serious head injury, and multiple sclerosis.

The treatment options for nystagmus vary widely. In the case of substance abuse, halting the use of drugs and alcohol can resolve the issue. Many patients find that nystagmus minimizes when they are fitted for eyeglasses or contact lenses.

Another common eye movement disorder called strabismus is present when the eyeballs do not move together, but in different directions (known as being ‘cross-eyed’).

Strabismus is a common issue among children: 4 percent of American children will experience strabismus, whether it is inborn or occurs after birth. The vast majority of these children do not present any brain abnormality, leading doctors to believe that most cases of strabismus are issues of the eye muscles. In most cases of childhood strabismus, the stronger eye will be patched during the day, forcing the eye with weaker muscle control to strengthen as the brain relies on it solely for vision. If this treatment is consistently used at the first sign of strabismus, the issue can and often does completely resolve itself. If treatment is delayed, however, the condition can become permanent.

In serious, resistant cases of childhood strabismus, surgery can be considered for very young children. The surgery is performed on the eye muscle, rather than the eyeball, and is typically successful with a recovery time of only a few days.

In families where there is a history of vision and/or eye issues, children should see an eye doctor at least by the age of three, unless their pediatrician recommends a vision examination sooner. Having vision exams for children twice per year will help diagnose any condition as early as possible, making treatment easier and more effective. Make sure your doctors know about family history of vision difficulty and eye issues, so they can be especially vigilant.