What is Pendular Nystagmus?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 02 October 2019
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Pendular nystagmus is an eye disorder where one or both eyes move involuntarily in a rhythmic up and down or back and forth motion. It can be paired with other forms of nystagmus like jerk nystagmus, where the eyes twitch at variable speeds. There are a number of causes for this condition and treatment options vary, depending on why it is happening. An ophthalmologist is typically involved in evaluation of the patient and development of a treatment plan to address the disorder.

This condition can be congenital or acquired, and is most commonly acquired. Vision loss early in life can cause pendular nystagmus and is a frequent cause of this condition. Another cause is multiple sclerosis, a disease involving progressive damage to the nerves. As the nerves are damaged, the patient can lose nerve and muscle control and this may manifest in the form of involuntary movements like nystagmus.

Movement of the eyes is controlled by a complex set of muscles working cooperatively. Problems with a patient's sense of balance can cause nystagmus, as can nerve and muscle disorders. In the case of pendular nystagmus, the eyes may mirror each other or track differently, depending on the nature of the condition. Most commonly, they move in concert and at a steady rate. This causes visual disturbances for the patient and can also attract unwanted attention.


In a patient with involuntary eye movement, an evaluation will be performed to learn more about what is happening. This can include an eye exam, medical imaging studies to check for lesions on the brain, and an interview to check for any obvious risk factors, such as a history of neurological impairment. This information is used in the development of a treatment plan for the pendular nystagmus, which can include medications and surgery, as well as treatment of the underlying cause of the problem.

Strange eye movements in someone without a history of vision problems can be a sign of early vision loss or damage to the brain. Especially in young children, they are a cause for concern and it is advisable to contact a doctor to discuss a medical examination. Providing information about when the pendular nystagmus or other abnormal eye movements were first observed is helpful, as is taking notes on any other changes in a patient's behavior or health. A child who has trouble completing assignments in school, for example, might be struggling with vision loss rather than simply being unmotivated, or may have a neurological problem making it difficult to do schoolwork.


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