End-point nystagmus is considered physiological or pathological?

• A. Physiological
• B. Pathological
• C. Both
• D. Neither

Answer: (A)

End-point nystagmus is a normal, physiological phenomenon that appears when the eyes are held at the far limits of their range. As you reach extreme gaze, the neural control and the mechanical properties of the extraocular muscles can’t perfectly hold the eye still, so small, rapid corrective movements occur. This is a benign finding seen in healthy individuals and it usually disappears when you move the gaze back toward center. It helps separate a harmless end-point drift from a true pathological nystagmus, which would reflect underlying vestibular, cerebellar, or brainstem dysfunction and often persists or has other abnormal features. So, end-point nystagmus is best understood as a physiological occurrence at the edge of the eye’s range, not a sign of disease.