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Difference Between Horizontal Nystagmus and Vertical Nystagmus

Nystagmus is a medical condition causing rapid, spontaneous, involuntary movement of the eyes. It usually affects both eyes, but can also affect only one of them.

Nystagmus can occur without any effect on the vision or can cause problems, including blurriness. Children do not see objects “flickering” but rather have blurred vision. “Flickering” of the visual field is reported in adults. It is classified according to different indicators. Depending on the type of movement, there are two main types of nystagmus:

  • Jerk nystagmus — combination of quick eye movement in one direction, and a slower movement in the opposite one;
  • Pendular nystagmus — the eyes move with equal speed in each direction.

Depending on the time of the appearance, it is divided into:

  • Congenital nystagmus – the exact cause of the congenital form is not known, it is believed that nystagmus is inherited from the parents.
  • Acquired nystagmus – may occur as a result of a variety of causes.

Depending on the conditions in which it appears, it is divided into:

  • Spontaneous nystagmus – begins at rest;
  • Provoked nystagmus – caused by body movement (e.g. shaking of the head).

Depending on the damaging effect on the body, it is divided into:

  • Physiological nystagmus – there is no damaging effect on the body;
  • Pathological nystagmus – most often present with underlying disease.

Depending on the direction of the eyes’ movement, it is divided into:

  • Vertical nystagmus;
  • Horizontal nystagmus;
  • Rotary nystagmus.

The diagnosis of nystagmus can be made by an ophthalmologist, otoneurologist, or neurologist. In order to be completely accurate and proven, a detailed examination of the eyes must be performed – visual acuity, eye bottoms, etc.

Nystagmus treatment is aimed at improving visual acuity. Glasses, contact lenses, surgical interventions, insertion of botox into muscles, etc. are used.

 

What is Horizontal Nystagmus?

Horizontal nystagmus is a medical term used to denote involuntary, rapid, and repetitive movements of the eyeball in a horizontal position. This is the most common form of nystagmus. It can be congenital or acquired.

Horizontal nystagmus may occur as a result of:

    • Nervous system disorders, e.g. multiple sclerosis;
    • Diseases of the circulatory system, e.g. stroke;
    • Injuries, poisonings, and some other consequences of the effects of external causes, e.g. trauma;
    • Diseases of the endocrine system, metabolism and eating disorders, e.g. albinism;
    • Diseases of the eye and its appendages, e.g. impaired refraction, myopia, astigmatism, congenital cataract;
    • Side effect after medication, e.g. for epilepsy;
    • Congenital anomalies, deformities, and chromosomal aberrations, e.g. Marinesco-Sjogren syndrome, Garland-Moorhause syndrome, cataract-dwarfism ataxia, spastic ataxia, syndrome of Gorlin-Chaudhry-Moss, spinocerebellar ataxia, etc.

Depending on the direction of the fast movement, the horizontal jerk nystagmus can be:

  • Left beating;
  • Right beating.

 

What is Vertical Nystagmus?

Vertical nystagmus is a medical term used to denote involuntary, rapid, and repetitive vertical movements of the eyeball. It can gradually lead to visual impairment. Vertical nystagmus occurs rarely than horizontal nystagmus and can be congenital or acquired.

Vertical nystagmus typically originates in the central nervous system. Other causes that may lead to the development of the condition include:

  • High phenytoin toxicity;
  • Large chiasmatic glioma;
  • Craniopharyngioma;
  • Suprasellar tumor;
  • Cerebellar ataxia;
  • Trauma;
  • Chiari Malformation;
  • Thalamic hemorrhage;
  • Multiple sclerosis.

The vertical jerk nystagmus is classified as:

  • Up beating;
  • Down beating.

 

Difference Between Horizontal Nystagmus and Vertical Nystagmus

Definition

Horizontal Nystagmus: Horizontal nystagmus is a medical term used to denote involuntary, rapid, and repetitive movements of the eyeball in a horizontal position.

Vertical Nystagmus: Vertical nystagmus is a medical term used to denote involuntary, rapid, and repetitive vertical movements of the eyeball.

Occurrences

Horizontal Nystagmus: Horizontal nystagmus is the most common form of nystagmus.

Vertical Nystagmus: Vertical nystagmus is less common than horizontal nystagmus.

Etiology

Horizontal Nystagmus: Horizontal nystagmus may occur as a result of nervous system disorders, diseases of the circulatory system, injuries, poisonings, and some other consequences of the effects of external causes, diseases of the endocrine system, metabolism and eating disorders, diseases of the eye and its appendages, side effect after medication, congenital anomalies, deformities, and chromosomal aberrations.

Vertical Nystagmus: Vertical nystagmus typically originates in the central nervous system. Other causes that may lead to the development of the condition include high phenytoin toxicity, large chiasmatic glioma, craniopharyngioma, suprasellar tumor, cerebellar ataxia, trauma, Chiari malformation, thalamic hemorrhage; multiple sclerosis.

Examples

Horizontal Nystagmus: Depending on the direction of the fast movement, the horizontal jerk nystagmus can be left beating or right beating.

Vertical Nystagmus: Depending on the direction of the fast movement, the vertical jerk nystagmus is classified as up beating or down beating.

Horizontal Nystagmus Vs  Vertical Nystagmus

 

Summary:

  • Nystagmus is a medical condition causing rapid, spontaneous, involuntary movement of the eyes. It usually affects both eyes, but can also affect only one of them.
  • Nystagmus can occur without any effect on the vision or can cause problems, including blurriness.
  • Nystagmus is classified according to different indicators. Depending on the direction of the eyes’ movement, it is divided into horizontal, vertical, and rotary nystagmus;
  • Horizontal nystagmus is a medical term used to denote involuntary, rapid, and repetitive movements of the eyeball in a horizontal position (lateral).
  • Vertical nystagmus is a medical term used to denote involuntary, rapid, and repetitive vertical movements of the eyeball.
  • Horizontal nystagmus is the most common form of nystagmus.
  • Depending on the direction of the fast movement, the horizontal jerk nystagmus is divided into left beating and right beating. Depending on the direction of the fast movement, the vertical jerk nystagmus is classified as up beating or down beating.
  • Horizontal nystagmus may occur as a result of nervous system disorders, diseases of the circulatory system, injuries, poisonings, diseases of the endocrine system, metabolism and eating disorders, diseases of the eye and its appendages, side effect after medication, congenital anomalies, etc. Vertical nystagmus may occur as a result of nervous system disorders, high phenytoin toxicity, large chiasmatic glioma, craniopharyngioma, suprasellar tumor, cerebellar ataxia, trauma, Chiari malformation, thalamic hemorrhage; multiple sclerosis, etc.

 

Dr. Mariam Bozhilova Forest Research Institute, BAS

Environmental Expert with PhD in Botany at Forest Research Institute, Bulgarian Academy of Sciences.
Mariam has a Master’s degree in Ecology and a PhD in Botany.
Currently, she works in the Forest Research Institute, Bulgarian Academy of Sciences.
Mariam has more than 10 years of professional experience in scientific research and environmental consultancy. She has worked within non-profit, profit, and academic environment, and consulted business clients and competent authorities.
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Dr. Mariam Bozhilova Forest Research Institute, BAS

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References :


[0]Drake, E. Sloane's Medical Word Book. 5th Edition. Philadelphia: Elsevier Sanders. 2012. Print.

[1]Hertle, R., L. Dell'Osso. Nystagmus in Infancy and Childhood: Current Concepts in Mechanisms, Diagnoses, and Management. 1st Edition. Oxford: Oxford University Press. 2013. Print.

[2]Warrell, D., T. Cox, J. Firth. Oxford Textbook of Medicine, Vol. 2. Oxford: Oxford University Press. 2010. Print.

[3]Image credit: https://icrcat.com/wp-content/uploads/2016/06/NISTAGMO-FINAL_EN.png

[4]Image credit: https://icrcat.com/wp-content/uploads/2016/06/NISTAGMO-FINAL_EN-1044x451.png

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