What is Nystagmus and What Does it Look Like?

By Cheryl Wylie, MSc (PT)

Has someone ever told you your eyes are moving when you are feeling vertigo? That eye movement is called nystagmus, and is a common sign of many vestibular disorders, including benign paroxysmal positional vertigo (BPPV).

Nystagmus is a rhythmic, uncontrollable eye movement that is being driven by our vestibular system. When we have BPPV, the presence of the crystals in our inner ear canals creates an incorrect signal, making our vestibular system think we are turning our head.

Because of reflexes that exists between our ear and our eyes; reflexes that help us maintain stable vision while we are moving; this incorrect signal triggers the reflex and this is what creates the nystagmus. 

We will also see nystagmus in other disorders including acute vestibular neuritis, Meniere's disease and vestibular migraine disorder. Nystagmus in these conditions will look different from that seen in BPPV. Vestibular physiotherapist will use the appearance of nystagmus, as well as what provokes it, to help determine your diagnosis. 

Below is an example of upbeating torsional nystagmus, which is a common type of nystagmus seen in posterior BPPV.