Eyes rolling back involves the upward and sometimes inward movement of the eyeballs, often appearing as if only the whites of the eyes are visible. This phenomenon can be a conscious, expressive gesture or an involuntary movement. Understanding its forms and potential reasons helps clarify when it is a normal occurrence and when it might signal an underlying health consideration.
Understanding Eye Rolling
Eyes rolling back describes a movement where the eyeballs turn upwards, often disappearing partially or fully under the upper eyelids. This action can be voluntary, a deliberate gesture used to express emotions like annoyance, or involuntary, involving uncontrolled movements without conscious effort. Eye movement is managed by a complex system of six extraocular muscles surrounding each eyeball, coordinated by brain signals. These muscles allow for precise and coordinated eye movements, but when their control is disrupted, involuntary actions can occur.
Common Reasons for Involuntary Eye Rolling
Involuntary eye rolling can stem from various causes, from typical bodily functions to medical conditions. During sleep, particularly as an individual drifts off, eyes may slowly roll back. This also occurs during rapid eye movement (REM) sleep, a phase associated with dreaming. In moments of deep concentration or intense emotion, some individuals might exhibit transient, involuntary eye movements.
Fatigue and insufficient sleep can affect eye control. Extreme tiredness or sleep deprivation can lead to involuntary eye movements, including darting or twitching. Stress and anxiety also contribute to such movements. High levels of stress can trigger hormone release, impacting muscle control and potentially causing eyes to dart erratically or twitch.
Medications
Medications can induce involuntary eye movements as a side effect. Oculogyric crisis (OGC) is a rare but distinct reaction characterized by sustained, involuntary upward eye deviation, lasting minutes to hours. This condition is most frequently associated with antipsychotic drugs, but antiemetics, antidepressants, and anticonvulsants can also be triggers. Tardive dyskinesia, another medication-induced movement disorder, can cause rapid eye blinking and, in some instances, eyes sticking in an upward position, often from long-term antipsychotic use. Sedatives and central nervous system depressants may also cause uncontrolled eye movements.
Neurological Conditions
Neurological conditions often manifest with involuntary eye movements. Seizure disorders are a notable cause; during absence seizures, a person may stare blankly, and their eyes might turn upwards or eyelids flutter. Tonic seizures, which involve muscle stiffening, can also cause the eyes to roll back. Epilepsy with eyelid myoclonia, also known as Jeavons syndrome, involves sudden eyelid closures, eye flickering, and eyes rolling upwards. Eyes rolling back can also occur during a fainting spell, medically termed syncope, particularly vasovagal syncope, where blood flow to the brain temporarily decreases.
When to Seek Medical Advice
While eyes rolling back can be harmless, certain circumstances warrant medical evaluation. Seek professional medical advice if involuntary eye rolling is accompanied by other symptoms. These include loss of consciousness, confusion, unresponsiveness, jerky body movements, changes in breathing patterns, difficulty with speech, or persistent dizziness.
Medical attention is recommended if the eye rolling becomes frequent, prolonged, or occurs without any apparent benign cause, such as during sleep or strong emotion. If movements begin suddenly and are a new symptom, particularly after a head injury, consult a healthcare provider. If these episodes interfere with daily activities or cause distress, a medical assessment can help determine the underlying cause and appropriate course of action.
Medical Evaluation and Treatment Approaches
When involuntary eye rolling prompts a visit to a healthcare professional, the diagnostic process begins with a detailed medical history. The doctor will ask about the eye movements’ nature, frequency, duration, and any accompanying symptoms. This is followed by a thorough neurological examination to assess overall neurological function. If a neurological cause is suspected, further tests might be ordered.
These tests could include an electroencephalogram (EEG) to detect seizure activity, or a magnetic resonance imaging (MRI) scan of the brain to identify structural abnormalities. However, these diagnostic tests are usually reserved for cases where other symptoms suggest a neurological condition.
Treatment focuses on addressing the identified underlying cause. This might involve adjusting or discontinuing medications if a drug reaction is the culprit, or prescribing specific treatments for seizure disorders or other neurological conditions. Lifestyle modifications, such as improving sleep hygiene or stress management, may be suggested if fatigue or anxiety are contributing factors. While some causes require medical intervention, many instances of eye rolling are benign, and a medical evaluation can provide clarity and reassurance.