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  • Updated 06.14.2023
  • Released 02.21.2000
  • Expires For CME 06.14.2026




Nystagmus is the term used to describe involuntary rhythmic oscillations initiated by a slow drift of the eyes. Such oscillations can be physiologic; they can usually be differentiated from pathologic nystagmus by the oscillatory features alone. Pathologic nystagmus is usually a manifestation of brainstem or cerebellar dysfunction, although impaired vision may be a contributing factor, especially with onset early in life. Impairments in neuromuscular transmission and ocular motor palsies may also rarely produce pathologic nystagmus. Localization of the underlying disorder depends on identifying the pattern of the oscillations in conjunction with the setting and accompanying neurologic manifestations. This article reviews the common forms of nystagmus, including their clinical features, mechanisms, mimickers, evaluation, and treatment.

Key points

• Nystagmus refers to rhythmic involuntary oscillations of the eyes.

• Nystagmus may be physiologic or pathologic, congenital or acquired, pendular or jerk.

• It should be differentiated from other types of ocular oscillations, including saccadic intrusions and other “nystagmoid” movements.

• Identifying the pattern of the oscillations is critical to diagnosis.

• Pharmacologic agents and other interventions are sometimes effective in dampening the nystagmus and lessening associated visual symptoms.

Historical note and terminology

The word “nystagmus” originates from the Greek word nustagmos, meaning “drowsiness” or “nodding.” The oscillations of the eyes in nystagmus were likened to the nodding head movements of sleepiness (31).

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