Research

Nystagmus is a neurological condition that causes an involuntary control of the movement of the eyes. This can move the eyes horizontally, vertically, or in some rare cases, a “circle”. Some people call it “Dancing Eyes”. It can reduce visual acuity, dizziness, sensitivity to light, etc. Unlike most eye conditions, it isn’t an issue with the eyes themselves, rather it comes from an abnormal function in the parts of the brain that controls eye movement.

Nystagmus can either be genetically passed down or acquired later in life. It is more common for Nystagmus to be genetic rather than acquired. Nystagmus that is genetically passed down is called Congenital Nystagmus. Most conditions of Nystagmus are X-linked nystagmus which is commonly known as a mutation of gene FRMD7. Any mutations to this gene will lead to the creation of a protein that will cause an abnormal production in the nerve cells in the areas of the brain that controls eye movement (Cerebellum). There are also other mutations that can cause Nystagmus, but these are all mutations on the X-chromosome which can include an incomplete CSNB or CSNB2.

Nystagmus can also be acquired later due to many variations of issues. For example, head trauma, alcohol intoxication, and many different types of diseases can cause Nystagmus and do not have to be genetic in these cases. When someone goes to the hospital with head trauma, they are most likely checked to see if they have Nystagmus, which can be a sign of a serious injury. Individuals with Congenital Nystagmus would usually inform beforehand that their nystagmus is not correlated with their injury.

Scientists believe that cases of Nystagmus occur in the Cerebellum part of the brain, which has a core function of controlling eye movement and “adapting” to its environmental conditions. The Cerebellum is in the back of the head and connects the brain to the spinal cord. The Cerebellum has two hemispheres. The outer portion of it contains neurons while the inner portion communicates with the cerebral cortex.

There are also ongoing studies that are studying how the cerebellum affects emotions, and other similar factors. It is also a part of the vestibular-ocular reflex (VOR) which stabilizes the eyes during movements. It is a crucial part of stabilizing vision and any damage to this can cause Nystagmus. Nystagmus can also be commonly acquired with a Chiari Malformation, which is a structural defect in one or both cerebellar tonsils 

Nystagmus can be diagnosed in many ways. It can be most diagnosed easily since it is a “visual” condition. It can also be recorded by a device called Electronystagmography which measures eye movement using external electrodes. For acquired Nystagmus, there are some other symptoms other than involuntary eye movement, which includes headaches.

People live with Nystagmus in many ways that a visually impaired individual would. They would read books in large print, change magnification, use a larger screen, etc. to help them see things more clearly. When it comes to the treatment of Nystagmus, there are many different conflicting ideas on what the “cure” is. As of now, there is no official cure but there are some proposed methods to help treat it. For example, there are drugs like Gabapentin, Baclofen, memantine, etc. but it also depends on the type of Nystagmus it is. There were also some clinical trials of a surgical treatment known as Tenotomy which divides a tendon to repair the damage but ended in 2001. Congenital Nystagmus is the hardest to “improve” since it is a genetic condition.

According to a trial conducted in 2001 internationally, there were 10 participants, all above 18 but under 65 that were given two drugs, Gabapentin, and Memantine. After two weeks, they then had their visual acuity reassessed to see if there were any differences. In the documentation for the trial, it stated that there were no adverse effects on taking either drug, but the data proved that Gabapentin was a more effective drug to treat Nystagmus than Memantine.

The data was measured in logMAR, commonly known as visual acuity. It determines just how far you can see by using a normal eye test, with the larger text having a higher logMAR number and the smaller text having a smaller logMAR number. In the data, any negative numbers showed improvement in eyesight, since that meant that they could see smaller text.

This study was only conducted on acquired Nystagmus since that is a lot easier to treat than Congenital Nystagmus since it is a genetic condition. If there were any new trials conducted, I would suggest also including individuals who have Nystagmus as a genetic condition rather than acquired Nystagmus.

In my proposed solution, I hypothesized that if an image/video were to move at the same rate of the involuntary eye movement, whether that is vertical or horizontal, in theory, it would be “stabilized’ in the eyes of the individual seeing the media. If there was a program made to essentially “tune” the amount of movement on a specific image/video, in theory, it could be used to help anyone with Nystagmus see clearer and farther compared to individuals with higher visual acuity. Some of the biggest issues with this solution would not be the creation of the program, but rather how the distance of an individual's eyes compares to the relative “movement” that will be needed. For example, if there is a set amount of movement on an image/video and the person were to move farther, would it affect how clear it is?

A year after my initial research, devices that use eye tracking and AR and VR are beginning to become more popular recently. For example, Apple released their new device called the Apple Vision Pro on February 2, 2024. Since then, the way we view our entire world can essentially be changed. Aside from its features and “spatial computing”, it brings about many new accessibility features that we simply could not have achieved before with just glasses. According to its specifications, when an individual wears the headset, through dual cameras, each 6.5MP, an extremely powerful chip, and a 3660x3200 per-eye resolution at 100 Hz, their entire world is seen through a display. If a cheaper option is created for users with Nystagmus in which their entire world can be seen through similar technology but allows for oscillation to treat or even eliminate the effects of their Nystagmus, what is now considered by many as a “gimmick” as it has just released can be used to change the lives of many and inevitably revolutionize medicinal technology.