Fleeting, uncontrolled eye movements, often described as “twitching,” are common in infants because their visual system is still in the early stages of development. The complex coordination between the eyes and the brain takes time to establish, leading to temporary periods where eye control is imperfect. Most of the time, these minor, transient movements are a completely normal feature of a maturing nervous system.
The Difference Between Benign and Concerning Movements
Benign movements are typically random, non-rhythmic, and very brief, often appearing as a quick flicker or a small, singular jump. It is also common for a newborn’s eyes to occasionally appear misaligned or crossed, particularly when the baby is tired or focusing on an object very close to their face. This lack of perfect coordination usually resolves naturally as the baby’s eye muscles strengthen over the first few months of life.
Movements that warrant closer attention are those that are sustained, repetitive, or rhythmic. These movements involve the eyes rapidly jumping or wiggling back and forth, up and down, or in a circle. If the movements are constant, last longer than a few seconds, or appear to be a patterned jerking motion, it signals a movement that is less likely due to simple developmental immaturity. Observing whether the movement occurs when the baby is alert or only during sleep provides important context.
Common and Benign Causes of Eye Movement
The primary reason for transient eye movements in infants is the immaturity of the central nervous system. A baby’s brain and the muscles that control eye movement are still learning how to work together in a coordinated fashion. This developmental phase means that the fine-tuned control required for steady gaze has not yet been fully wired.
Sleep is another frequent source of involuntary eye activity, specifically during the rapid eye movement (REM) stage. During REM sleep, the eyes move quickly beneath the eyelids, and the baby may also display twitches of the face and extremities. These movements are a standard part of the sleep cycle. Brief, non-sustained eye movements can sometimes be triggered by overstimulation or fatigue.
Understanding Nystagmus
When involuntary eye movements are sustained, rhythmic, and uncontrollable, the condition is referred to as nystagmus. Nystagmus is a symptom characterized by the eyes shaking or wiggling, usually in a side-to-side direction, but sometimes vertically or circularly.
Infantile nystagmus typically appears between six weeks and six months of age and requires medical evaluation. This type can be distinguished as either sensory or motor. Sensory nystagmus is associated with conditions that impair vision, such as cataracts or optic nerve disorders, where the brain cannot receive clear visual information. Motor nystagmus, conversely, means the eyes have poor motor control without an underlying vision problem.
In both forms, nystagmus is a sign that the brain’s control over eye position is compromised. While some forms have relatively good outcomes, others may be associated with reduced visual acuity, making a thorough eye examination necessary. Early detection is important because the underlying causes of sensory nystagmus can sometimes be treated to prevent long-term vision issues.
Warning Signs and When to Contact a Pediatrician
While many infant eye movements are benign, certain observable signs require a call to the pediatrician or a pediatric ophthalmologist. Any eye movements that are sustained, repetitive, or rhythmic for more than a few seconds should be brought to a doctor’s attention. This is especially true if the movements are consistently rapid and appear to be a continuous wiggling or jumping of the eyes.
You should seek medical advice if the twitching is accompanied by other atypical signs, or if the movements:
- Are accompanied by a consistent head tilt or frequent squinting when looking at objects.
- Involve an inability for the baby to track moving objects or make eye contact after the first few months.
- Appear to occur in only one eye.
- Begin after the baby is six months old.
- Worsen over time, as they may signal an acquired condition.