Retinal or Train Nystagmus

Railway Nystagmus
Physiological type of nystagmus. The eyes slowly follow the object and then quickly jerk back to start over. Also called Train or Optokinetic nystagmus Can be used to check vision in infants.

Optokinetic drum

Drum rotated Slowly

Slow pursuit

Saccadic

Pursuit movement
Slow conjugate eye movement that track a moving object and keep it on the fovea

Pathway
Visual inputs to Temporo-occipital junction Initiates pursuit movement

middle temporal cortex Dorsolateral pontine nuclei

Cerebellar vermis & flocculus Vestibular nuclei; Medial vestibular nuclei and nucleus prepositus hypoglossi For horizontal pursuit movement MVN excites: Contralateral abducens CN VI (Lateral Rectus) Medial longitudinal fasciculusCN III (Medial rectus)

Saccadic
Fast conjugate eye movement that place an object on fovea.

Pathway
Frontal eye field Paramedian Pontine reticular formation Parietal eye field Superior Colliculus then PPRF For horizontal saccadic movement PRFF burst cell signals Abducens nucleus CN VI (Lateral Rectus) Abducens motor neuron & interneuron Abducens interneuron CN III (Medial rectus) Medial longitudinal fasciculus

Drum rotated Rapidly

Fixation
Involves moving the eyes to bring a discrete portion of the visual field into focus on fovea.

Cerebellar Nystagmus
Tremor of the eyeballs that occur usually when one attemps to fixate the eyes on a scene to one side of the head. This off-center type of fixation result in rapid, tremolous movement of the eye rather than a steady fixation, and it is another manifestation of the failure of damping by the cerebellum. It occurs especially when the floccuonodular lobes are damaged, in this instance it is associated with loss of equilibrium bec of dysfunction of the pathway through the flocculonodular cerebellum from the semicircular duct.

Congenital Acquired nystagmus, called spasmus nutans, includes a head tilt and head bobbing and generally occurs between four to 12 months of age. It may last a few months to a few years, but generally goes away by itself.

Rhythmic, oscillating motions of the eyes are called nystagmus. The toand-fro motion is generally involuntary. Vertical nystagmus occurs much less frequently than horizontal nystagmus and is often, but not necessarily, a sign of serious brain damage. Nystagmus can be a normal physiological response or a result of a pathologic problem.
1 in 10000 people

http://www.youtube.com/watch?v=wNrOwjNCpzk

Railway nystagmus is a physiological type of nystagmus. It happens when someone is on a moving train (thus the term railway) and is watching a stationary object which appears to be going by. The eyes slowly follow the object and then quickly jerk back to start over. Railway nystagmus (also called optokinetic nystagmus) is a type of jerk nystagmus. This phenomenon can be used to check vision in infants. Nystagmus can also be induced by fooling the semicircular canals. Caloric stimulation refers to a medical method of testing their connections to the brain, and therefore to the eyes. Cold or warm water flushed into the ear canal will generate motion signals from the inner ear. The eyes will respond to this signal with nystagmus if the pathways are intact.

Causes and symptoms There are many causes of nystagmus. Nystagmus may be present at birth. It may be a result of the lack of development of normal binocular fixation early on in life. This can occur if there is a cataract at birth or a problem is some other part of the visual system. Some other conditions that nystagmus may be associated with include: Albinism. This condition is caused by a decrease in pigmentation and may affect the eyes. Disorders of the eyes. This may include optic atrophy, color blindness, very high nearsightedness (myopia) or severe astigmatism, or opacities in the structures of the eyes. Acute labyrinthitis. This is an inflammation in the inner ear. The patient may havedizziness (vertigo), nausea and vomiting, and nystagmus. Brain lesions. Disease in many parts of the brain can result in nystagmus. Alcohol and drugs. Alcohol and some medications (e.g., anti-epilepsy medications) can induce or exaggerate nystagmus. Multiple sclerosis. A disease of the central nervous system.

Diagnosis Nystagmus is a sign, not a disease. If abnormal, it indicates a problem in one of the systems controlling it. An ophthalmologist and/or neuro-ophthalmologist should be consulted. Treatment There is one kind of nystagmus that seems to occur harmlessly by itself. The condition, benign positional vertigo, produces vertigo and nystagmus when the head is moved in certain directions. It can arise spontaneously or after a concussion. Motion sickness medicines sometimes help. But the reaction will dissipate if continuously evoked. Each morning a patient is asked to produce the symptom by moving his or her head around until it no longer happens. This prevents it from returning for several hours or the entire day. Prisms, contact lenses, eyeglasses, or eye muscle surgery are some possible treatments. These therapies may reduce the nystagmus but may not alleviate it. Again, because nystagmus may be a symptom, it is important to determine the cause.

http://www.scholarpedia.org/article/Human_saccadic_eye_movements

https://www.google.com.ph/search?hl=en&q=optokinetic%20reflex%20pathway&um=1&ie=UTF-8&tbm=isch&source=og&sa=N&tab=wi&ei=sYkCUZ3KLMWxlAXlmoCQAw&biw=1366&bih=597&sei=3o4CUcHuOomKkwW

http://www.google.com.ph/imgres?um=1&hl=en&sa=N&tbo=d&biw=1366&bih=597&tbm=isch&t

http://en.wikipedia.org/wiki/Optokinetic_reflex

http://en.wikipedia.org/wiki/Saccade

http://en.wikipedia.org/wiki/Smooth_pursuit