Miner's Nystagmus

By Stuart M. Smith, MD and B. James McCallum, MD

Nystagmus is a fancy word for the freakish back and forth eye movements you see after someone has spun around too many times. In that situation, it is the eyes trying to account for the still sloshing fluid of the middle ear. For miners, it is an occupational disease affecting the nerves of the eyes, causing a spasmodic movement of the eyeball, either rotary or from side to side.

Eighty percent of cases occur in coal miners and is presumed to be caused by deficient lighting, although exposure to noxious gases and neurosis has been postulated as well. Those stricken first notice decreased visual acuity, then flashing lights and headaches, finally comes pain with light exposure and night blindness.

Police test for horizontal gaze nystagmus as part of a field sobriety test. The test involves observation of a suspect's pupil as they follow a moving object, noting (1) lack of smooth pursuit, (2) distinct and sustained nystagmus at maximum deviation, and (3) the onset of nystagmus prior to 45 degrees. Which basically means that too much eye-wonk could land you in the cells for the night.

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