Nystagmus is an eye condition that causes your eyes to wobble. This can be congenital or acquired. Congenital means that this condition was present when you were born. Acquired means that this condition occurred after your birth and could also be associated with other causes of visual loss, for example a trauma or a condition such as oculocutaneous albinism.
This eye wobble can be horizontal (side to side), vertical (up and down) or pendular (rotational).
When your eye wobbles, you will notice that your vision decreases. You can also experience eye fatigue and aching. We advise to manage this with frequent breaks and managing your workload. This means to take into account visual stress and your general stress levels throughout the day.
You may also notice that your vision is worse when you are ill or fatigued. During these periods, it may be easier to use further magnification or text-to-speech devices.
The period approaching examinations can be particularly stressful. For this reason, we would advise you to reduce any potential stressors that could induce your Nystagmus.
We also look at techniques that can increase your efficiency or speed This also helps with overall social confidence and reduces eye fatigue.
This includes:
The first thing to take into account is that this is very normal for Nystagmus. Reassurance in these instances will reduce anxiety and help your child to self-regulate. Children are told to take breaks, but it is important to take into account what they do during these breaks.
Some children prefer a darkened room. Some prefer simple sensory toys. Others, taking into account light sensitivity, prefer some sort of activity. For example, a simple walk outdoors.
Some children may benefit from utilising their “null point”. A null point is a position of gaze where the Nystagmus dampens down. In this position, it is slower and therefore makes the vision more comfortable. It is important to relay this to teachers and to reduce visual stress so there is less need to rely on their null point.
Many children struggle to verbalise when their vision starts to blur or fatigue as a result of their nystagmus. In clinic, this will often happen when one eye is occluded for a period of time, at the end of a clinic or when feeling stressed or overwhelmed with information.
I once tested a child who saw me during the morning for a low vision
assessment and later was tested in the afternoon during their clinic appointment. Their acuity had dropped by 2 lines in each eye with no other abnormalities detected. I have found it very helpful to verbalise this
for the child, giving them a prompt or codeword to use in the moment, i.e. “is it a tired eyes day?”. This has helped dramatically with encouraging the child to verbalise this for themselves. I have also found asking “do the eyes need a break?” rather than “do you need a break?” offers some separation from the child’s attachment to their progress in a task and they are more likely to say “yes” when needed.
There are many organisations and charities with advice and social events for children with nystagmus: