Ocular Motility Disturbances

The term ocular motility disturbance refers to any abnormal eye alignment or difficulty in controlling eye movements. We most often consider only the eye itself as the cause of low vision, and certainly factors such as near-sightedness, far-sightedness and cataracts take their toll. However, other important diseases of vision involve the brain and the muscles that control eye movement. Central to some of the manifestations is the fact that you need relatively good vision in both eyes for the brain to be able to interpret the information and create a 3D picture.  If this does not occur, you may have double vision. Having good information from both eyes is also necessary for good depth perception.

Strabismus is a condition where the two eyes are not facing in the same direction.  It is a relatively common condition in children and may be present at birth. However, strabismus in adults may occur as the result of brain injury (including stroke and traumatic brain injury) or injury to the eye itself, as well as other diseases or conditions such as diabetes, Graves’ disease, or Guillain-Barré syndrome. Symptoms may include: eyes that do not point in the same direction (including crossed eyes) double vision, and poor depth perception.  

Amblyopia is a condition in which your brain fails to process the information from one of your eyes. This may occur because one of your eyes is misaligned (strabismus) and incorporating that information would cause double vision. It may also occur if one of your eyes has much better vision than the other, and the brain selects the clearer image.

Nystagmus, sometimes called dancing eyes, is characterized by fast, uncontrollable eye movements. This may be present at birth. In adults, it may be caused by any of the following:

• Damage to brain tissue from stroke, trauma or infection
• Certain drugs, such as the drug used to control seizures, phentoin
• Excess alcohol intake
• Vitamin deficiency
• Diseases and conditions that affect the brain, such as brain tumors or multiple sclerosis (MS)

Treating Ocular Motility Disturbances
Treatment of ocular motility disorders vary based on the type of disorder and on the individual. It is extremely beneficial to catch these problems as early as possible, especially in children, so they have the best chance of regaining unimpaired vision. Our doctors at Houston Methodist Hospital provide a comprehensive eye exam to pinpoint the precise nature of the problem and to determine the best course of action.
For adults with strabismus, your doctor may suggest a series of steps to improve your vision:

• Glasses to correct vision
• Eye muscle exercises
• Surgery on eye muscles to correct the direction the eye points

For adults with amblyopia, treatment would involve correcting any underlying vision problems that caused the brain to edit out the information from that eye, such as strabismus, near- or far-sightedness, and cataracts. To force the brain to recognize the information from the affected eye, eye patches and/or drops to blur the vision in the better eye help to achieve the shift to using both eyes. 

There are no specific treatments for nystasmus, although spontaneous recovery may occur if the underlying causes resolve.

Of course, for any of these alignment and motility disorders, when an underlying trauma or disorder is present, that will need to be treated as well.