What Is Oscillopsia?

Oscillopsia is a disturbance in vision that makes it seem like things you’re looking at are moving when they’re not. It is associated with poor visual acuity and is a disabling and distressing condition reported by numerous patients with neurological disorders. Oscillopsia is often not an underlying condition in and of itself but a symptom. People with this visual problem often have a problem in the ocular motor system, which is a complex structure with multiple subsystems. These subsystems help stabilize images on the retina when the eyes and head move, and any disturbance in one of the systems can cause issues with vision.

 Oscillopsia Symptoms

The most common symptom of oscillopsia is feeling that objects and surroundings are moving even though they are stationary. People with oscillopsia will often report that they see things jumping, vibrating, shaking, or jiggling. It usually happens when people are moving, and it can trigger other symptoms:

• Blurry vision
• Vertigo
• Nausea
• Dizziness
• Lack of coordination
• Difficulty maintaining balance

Causes

Oscillopsia is often a symptom of conditions that affect eye movement. One of the causes is an impaired vestibulo-ocular reflex (VOR), which is responsible for helping us maintain balance when we are moving. It also helps your eyes move in coordination with your head. When your eyes and head are not in sync, objects you see will appear to be moving even if they are still. A number of diseases and severe head injuries can affect the vestibulo-ocular reflex, including:

• Neurological conditions: They damage the central nervous system, and, among other problems, they can affect the ocular motor system, causing oscillopsia. For example, people who have seizures, multiple sclerosis, and superior oblique myokymia (rhythmic involuntary contractions of the superior oblique muscle, which helps with eye movement) have higher chances of developing it. 
•  Conditions that affect the inner ear: Inner ear disorders often appear when there is a problem in the vestibulo-ocular reflex, which is responsible for keeping the balance when we are doing activities such as walking. Meniere's disease is one of these conditions that can cause oscillopsia. 
• Conditions that cause brain inflammation: Conditions such as meningitis and tumors can cause oscillopsia.
• Brain or head injuries: They can affect the normal function of the vestibulo-ocular reflex.
• Conditions that affect eye muscles: For example, people with nystagmus, an involuntary eye movement, often have oscillopsia.

Diagnosis

Your healthcare provider will review your medical history and ask questions about your symptoms, including how long you have had them. They will also conduct an eye exam to check for any problems with eye alignment.

They will also perform oculomotor and coordination tests during the appointment. However, to uncover what underlying condition is causing oscillopsia, your healthcare provider will probably request additional imaging and tests, which may include:

• CT scan
• MRI
• Ear exam
• Neurological exam
• Blood and urine tests
• Electrocardiogram and echocardiogram

Treatment

After getting a diagnosis, you can discuss with your healthcare provider the best way to treat the condition. When the oscillopsia is related to an impaired vestibulo-ocular reflex, there are high chances of recovery. VOR function frequently recovers spontaneously over time, which has been attributed to neuroplasticity and does not require any intervention.

People who are born with nystagmus, for example, can manage their condition with glasses, contact lenses, or medication. Patients with multiple sclerosis who experience vision problems, including oscillopsia, will have to discuss with the healthcare provider the best way to manage it.

Vision therapy

An optometrist can help with exercises that strengthen the eye and improve eye control. A range of exercises can help improve the symptoms, including reading some lines using different filters and lenses. 

Vision therapy also helps with eye movements, and people with oscillopsia who participate in this form of treatment can potentially regain control over eye movement, especially when the condition is in an early stage.

Medication

Most drug treatments are based on case reports and will depend on the underlying condition. There isn't a specific drug to treat oscillopsia, but healthcare providers will prescribe medications to treat the underlying condition that is causing it.

Your healthcare provider may prescribe a muscle relaxant (e.g., baclofen) or anti-anxiety medication. The treatment can also include anticonvulsants.

Adaptation

When people are born with a condition that causes oscillopsia, the brain can often adapt and fix it. However, in some cases, treatment is not efficient and the patient will have to learn to live with the symptom. In this case, the best option is to discuss with the healthcare provider the best way to mitigate oscillopsia's impact on daily life and improve life quality.

Prognosis

Many people can cope with oscillopsia for a long period before discovering what is causing the problem. The prognosis will depend on the diagnosis and stage of the condition. Some problems, such as VOR dysfunctions, can be treated and monitored. In other cases, patients will have to learn to live with oscillopsia.

A Word From Verywell

Oscillopsia has a considerable impact on a person's daily life. Therefore, it is essential to schedule an appointment with a healthcare provider as soon as they notice the symptoms. An early diagnosis can be crucial to successful treatment. People with oscillopsia often can't live alone, and they will need help with daily activities. Those changes often have a significant impact on the emotional side, and it is vital to have a support system that will help someone cope with it.