Introduction:
Oscillopsia is a sensation or a visual disturbance in which the patient feels that the surrounding objects are constantly oscillating, moving, or vibrating even though they are stationary. Oscillopsia is commonly encountered in patients with neurological disorders. It is mainly a consequence of the instability of the ocular system. Sometimes, the ocular system gets damaged to the extent that it no longer holds the images steady on the retina. Oscillopsia can also be associated with problems in the alignment of the eyes, specific systems in the brain, along with certain components of the inner ear that regulate the balance and control of the body.
What Is the Ocular System?
The ocular system comprises the eyes and the central visual system that help in vision. The images pass through the components of the central visual system, including the lens, cornea, and fluids, to reach the retina. The signals from the retina reach the brain through the optic nerve, and the person can see the images. The ocular system not only helps in vision but also plays an important role in the balance and stability of the body. The retina is the eyes' principal organ that contains receptors known as the rods and cones. When light strikes these receptors, the signals reach the brain and help the person identify the objects around him. For example, if a person walks straight on the street, the objects become vertically aligned and move in and out of the peripheral vision.
Why Does Oscillopsia Occur?
Oscillopsia usually occurs due to nervous system disorders that affect eye movements or damage the parts of the eyes, brain, and inner ear that control the body's balance, stability, and movements. It is often associated with a condition known as nystagmus, wherein the patient has abnormal or rapid eye movements. The conditions that affect the parts of the brain, including the cerebellum, are some of the most common causes of oscillopsia. One of the possible causes of oscillopsia is the loss of vestibulo-ocular reflex. Normally, this reflex coordinates the head and the eye movements. However, if this reflex fails to work, the eyes do not move in line with the head. As a result, the patient feels that the objects in front of him are jumping or vibrating. Some of the other conditions associated with oscillopsia are listed below:
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Seizures.
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Multiple sclerosis (an autoimmune disorder that affects the central nervous system, including the brain and spinal cord).
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Superior oblique myokymia (it is a rare condition characterized by the rhythmic contractions of the superior oblique muscles).
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Brain or head injuries, especially cerebral injuries.
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Stroke.
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Diseases that damage the middle ear, including Meniere's disease.
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Meningitis and other disorders of the brain and the surrounding structures.
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Constant use of lithium and other anti-seizure medications.
What Happens in Oscillopsia?
Oscillopsis is a disorder wherein the patient has a sensation that his surrounding objects are moving or vibrating. Sometimes, patients experience vision problems, including distorted vision, and feel that the entire world is moving. As a result, the images blur, jump, jiggle, or shake. The signs and symptoms of oscillopsia are listed below:
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Nausea.
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Dizziness.
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Vertigo.
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Problems (related to balance or coordination).
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Difficulty in walking or moving around.
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Problems in concentrating or focusing on a particular object.
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Stress
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Frustration.
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Head injuries.
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Disability due to injury.
Some patients report that they only experience vision problems or shaking vision when moving. The problems resolve once they are stable or stop moving. However, this is unnecessary as the symptoms might persist even if the person is lying down or standing still. Some people might have it when they change their body posture. The major problem associated with oscillopsia is that the patients suffering from it find it difficult to survive alone. They get anxious, feel frustrated, and need constant support from their near ones.
What Are Some of the Risk Factors for Oscillopsia?
Some of the factors or conditions that increase the risk of oscillopsia are listed below:
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Brain tumor or injuries.
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Extrinsic eye muscle injuries.
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Taking anti-seizure drugs or Aminoglycosides.
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Alcohol abuse.
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Drug abuse.
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Patients who have a family history of nystagmus.
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Eye disorders, including cataracts or strabismus.
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Albinism or hypopigmentation.
How Is Oscillopsia Diagnosed?
The most significant point to be noted here is that oscillopsia is not a medical condition. Instead, it is a symptom of numerous conditions that affect the eyes. So, an ophthalmologist needs to diagnose the exact cause of oscillopsia. As a result, the doctor obtains a thorough medical history of the patient and asks him the following questions:
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When do the symptoms occur?
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What does it feel like?
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Do the symptoms get better or worsen with a change of position?
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How often do the symptoms occur?
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When did they initiate?
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Do central nervous or visual symptoms accompany the oscillopsia symptoms?
After obtaining the medical history, the doctor conducts other diagnostic tests to confirm whether the patient has oscillopsia. This is because the symptoms of oscillopsia resemble many other eye conditions. The diagnostic tests are listed below:
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Neurological examinations.
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CT (computed tomography) scan.
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Ophthalmoscopy (examination of the retina, fundus, and other parts at the back of the eyes).
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Electrocardiogram (ECG or EKG).
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Lumbar puncture test (it is performed in the lower back region to diagnose cardiac conditions).
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Audiogram (a hearing test that shows the degree and types of hearing loss).
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Blood and urine tests.
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Psychological tests.
How Is Oscillopsia Treated?
Oscillopsia is typically a symptom of an underlying eye condition. However, nothing has been known about the direct treatment approaches for oscillopsia. The doctor treats the condition depending on the underlying causes. If oscillopsia occurs due to nystagmus, the treatment methods are listed below:
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Special contact lenses or glasses can provide clear vision and slow eye movements.
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Surgical intervention can be done to treat nystagmus.
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Reducing the consumption of alcohol.
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Surgeries can be done to correct the position of the eye muscles to have coordination between the head and eye movements.
The other treatment options are described below:
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Vision Therapy - Vision therapy is especially helpful for conditions like nystagmus as it causes rapid eye movements. The patient can consult an optometrist for optometric vision therapy. Vision therapy includes progressive exercises that improve a person's visual skills. The doctor might ask the patient to read some paragraphs from a textbook using therapeutic lenses. The patient can also be asked to read a book by standing on a balance board. Oscillopsia can also be treated with oculomotor-based auditory feedback techniques so that the patient has better control over his eye movements.
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Medications - Medicines are rarely recommended for oscillopsia. However, studies report that the conditions responsible for oscillopsia might respond well to medicines that block gamma amino butyric acid (GABA), which is an amino acid mainly found in the brain. Clonazepam and Gabapentin are examples of such drugs.
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Getting Adapted - Some patients might not require treatment as their brains adapt to oscillopsia. This is especially true for infants with congenital oscillopsia because they get used to the condition during neural development. However, they continue to face vision problems. Oscillopsia becomes unmanageable if it occurs due to damage to the brain or vestibulo-ocular system.
Conclusion:
Oscillopsia is a visual disorder that makes a person feel that the objects around them are vibrating. It is a common disorder that might make a person depressed. However, the patient must not get worried as several treatment options are available to address this problem. Hence, the patient must consult the doctor at the earliest to learn more about the condition.
