Last edited 11/2019 and last reviewed 06/2022

  • oscillopsia is a symptom of jumbling eye movements, manifested as blurred vision when walking or running, and is caused by poor stabilization of the retinal image during head movement
    • occurs primarily from loss of the vestibular ocular reflex (VOR) or ocular oscillations (1,2,3)
      • the former is a conjugate eye movement that stabilizes the vision in the opposite direction of head motion
    • in contrast, ocular oscillation or nystagmus caused by certain brain abnormalities (e.g., cancer metastasis or radiation necrosis), may also provoke oscillopsia (4)
      • radiation-induced oscillopsia in nasopharyngeal carcinoma patients is attributed to bilateral VOR loss, possibly as a result of higher radiation doses (5)

With respect to oscillopsia in multiple sclerosis (6):

  • consider gabapentin as a first-line drug to treat oscillopsia
  • consider memantine as the second-line treatment for oscillopsia in people with MS
  • refer the person with MS for specialist advice if there is no improvement of oscillopsia after treatment with gabapentin and memantine or side effects prevent continued use