assessment of nystagmus

Last reviewed 03/2023

The eyes are assessed at rest:

  • jerk nystagmus may be seen at rest (2nd or 3rd degree)
  • nystagmus with equal velovity in both directions is termed pendular nystagmus and is associated with central scotomata

The eye movements in the horizontal and vertical plane are assessed by asking the patient to follow a finger which is moved smoothly at a distance of about 50 cm.

  • jerk nystagmus may be elicited in a particular direction of gaze
  • nystagmus in an abducting eye with failure of adduction of the other eye suggests an internuclear ophthalmoplegia

Saccadic eye movements to the left and right may reveal nystagmus-like movements including:

  • subtle internuclear ophthalmoplegias
  • opsoclonus
  • ocular dysmetria
  • ocular flutter

Nystagmus may be provoked by specific positions of the head - this is termed positional nystagmus.