What is Oscillopsia?
Oscillopsia is a sensation where a person feels that the surrounding environment is constantly moving when in reality everything is stationary. Oscillopsia is a symptom rather than a condition of certain medical conditions that affect the movement of the eyes or the ability of the eyes to stabilize images especially when in motion. Oscillopsia is often associated with poor visual acuity. It is seen more in people with underlying neurological disorders and severely affects their quality of life.[1,2]
Medically speaking, when we speak of visual stability the images that one sees are projected on to the retina. For these images to be stable there are two reflexes at play called the vestibulo-ocular and optokinetic reflex. These reflexes make sure that a stationary object is perceived as stationary by the eye even when the person may be moving. This is also called as space consistency. Most people with Oscillopsia have abnormal eye movements as a result of which there is excessive motion of images in the retina or there is an abnormality with the vestibulo-ocular reflex. This is what causes a perception that objects are moving even though they are stationary.[1,2]
Another reason suggested for Oscillopsia is an impairment of the spatial constancy which under normal circumstances compensate for gaze displacements but more data is needed in this regard.[1,2]
What Causes Oscillopsia?
As stated above, Oscillopsia occurs as a result of abnormalities in the eye which alter the way the eyes, inner ear, and the brain processes and stabilize images and maintains balance. Oscillopsia is often linked to nystagmus which is a condition that causes abnormal eye movements.
Another common cause of Oscillopsia is conditions that affect the cerebellum or the oculomotor system resulting in instability of images. It is the oculomotor system that helps in keeping the images in the eyes stable even when the head and the eyes are in motion
Any sort of damage to this system impairs vision and causes the person to feel as if everything around him is in motion even when everything is stationary. This is especially observed with any movement of the head. There are also certain medical conditions that may cause Oscillopsia. These include neurological disorders like seizures and multiple sclerosis.
A severe head or brain injury is also one of the causes of Oscillopsia. A person with stroke that affects the muscles of the eyes also at times can cause Oscillopsia. Medical conditions that damage the inner ear are also one of the causes of Oscillopsia.
Certain condition like tumors that can cause brain inflammation also can be one of the causes of Oscillopsia. There have been documented cases of some people born with Oscillopsia but this is very rare.
What are the Symptoms of Oscillopsia?
As the definition of Oscillopsia suggests the primary symptom of this condition is a perception that the environment is moving or oscillating especially with head movements. A person with Oscillopsia will see images as blurred, jiggling, jumping, or shaking. Additionally, the person will also complain of dizziness, nausea, difficulty ambulating or driving, problems with balance and coordination, risk of injury due to running on to objects, problems with focus, frustration and excessive stress due to all the problems with vision.
Majority of the symptoms of Oscillopsia occur during movement of the head and eyes. The vision stabilizes when the movement stops. However, on rare occasions symptoms can occur when lying or sitting. Oscillopsia is a disabling condition as the vision is severely impacted due to this condition which additionally puts the person at risk for further injuries. It is important to note that people with Oscillopsia should not be left alone. This adds to the frustration of being dependent on others for any type of movement.
How is Oscillopsia Treated?
Oscillopsia generally occurs as a result of an underlying medical condition. As of now, there is no specific treatment for this condition. Thus treatment is dependent on the underlying cause. If Oscillopsia is caused due to nystagmus then use of special glasses can be effective in stabilizing the images. Sometimes medication and even surgery may be required to treat nystagmus which inadvertently treats Oscillopsia.
Vision Therapy: There are numerous vision therapies that are quite effective in treating Oscillopsia. This therapy involves progressive exercises which need to be done diligently under the supervision of an optometrist. These exercises are aimed at improving visual acuity and skills and decrease Oscillopsia. Some experts have stated that relaxation techniques also help people with Oscillopsia to manage their symptoms effectively.
Medication: It is quite rare for physicians to prescribe medications to treat Oscillopsia, especially if nystagmus is believed to be the cause of it. However, it has been observed that Oscillopsia caused by certain medical conditions respond favorably to medications. These medications block gamma aminobutyric acid which is an amino acid produced naturally in the body that acts as a messenger to the brain. Some of the examples of these medications are Klonopin and Neurontin. There have also been cases of anticonvulsants and beta-blockers being used to treat Oscillopsia successfully.
Adaptation: This is not a treatment as such but over time the brain may adapt to the condition. This is seen especially in infants who are born with Oscillopsia. The brain in such children adapts to the condition with time as the child grows even though they may still have some visual impairments.
It should be mentioned here that if Oscillopsia is caused due to a significant brain or head injury then the damage caused to the vestibulo-ocular system is permanent. In such a scenario it is not possible to treat Oscillopsia. If a patient is not responsive to the treatments mentioned above, then unfortunately there is very little that is left to do for people with Oscillopsia.
In conclusion, people with Oscillopsia tend to have a sensation that the outside environment is moving even though everything is steady. This is observed with any movement of the head. Oscillopsia can be caused due to several medical conditions but is usually seen in people with underlying neurologic disorder like multiple sclerosis or seizures.[1,2]
The treatment for Oscillopsia depends on the underlying cause of it that has been mentioned above in detail. Thus, it is vital to speak to an eye specialist as soon as one observes any visual defect to prevent any complications or permanent damage due to Oscillopsia.[1,2]