Which Black Eyed Pea can’t see?

This week’s People magazine had an interesting article about Apl.de.ap, one of the singers in the hit-making, Grammy-winning group the Black Eyed Peas. He’s the “Pea” with the mohawk hairdo and sunglasses. Apl.de.ap is legally blind due to a lifelong eye condition called nystagmus, which causes involuntary movements of his eyes. This doesn’t seem to have slowed the 36 year old Filipino (born Allan Pineda Lindo). He is still able to deejay, break-dance, and do back-flips on stage. Once he makes himself familiar with a new stage, Apl.de.ap told People that ” I pictures myself and the floor in my head.” About his vision: “I’m good at shapes… If I’m not close, even if it’s big, I can’t read it… I doubted myself for a long time. .. I’m comfortable not using my vision. I weave around my problems.” He went on to say in the same article that “Until I discovered hip-hop, I felt I wasn’t going to accomplish anything.”

What is nystagmus? (Source: Medline Plus)

Nystagmus refers to rapid involuntary movements of the eyes that may be:

  • Side to side (horizontal nystagmus)
  • Up and down (vertical nystagmus)
  • Rotary

Depending on the cause, these movements may be in both eyes or in just one eye. The term “dancing eyes” has been used in regional dialect to describe nystagmus.

Uncontrollable eye movements are involuntary, rapid, and repetitive movement of the eyes. The involuntary eye movements of nystagmus are caused by abnormal function in the areas of the brain that control eye movements. The part of the inner ear that senses movement and position (the labyrinth) helps control eye movements.

The exact nature of these disorders is poorly understood.

There are two forms of nystagmus:

  • Congenital nystagmus is present at birth. This is the most common type.
  • Acquired nystagmus develops later in life because of a disease or injury.

What causes nystagmus?

Congenital nystagmus is usually mild, does not change in severity, and is not associated with any other disorder.

Affected people are not aware of the eye movements, although they may be noticed by a careful observer. If the movements are of large magnitude, visual acuity (sharpness of vision) may be less than 20/20. Surgery may improve visual acuity.

Rarely, nystagmus occurs as a result of congenital diseases of the eye that cause poor vision. Although this is rare, an ophthalmologist should evaluate any child with nystagmus to check for eye disease.

Inner ear disorders such as labyrinthitis or Meniere’s disease can lead to acquired nystagmus. However, the most common cause is probably toxic — certain drugs or medication, including Dilantin (an antiseizure medication), alcohol intoxication, or any sedating medicines can harm the labyrinth.

In young people, a common, serious cause of acquired nystagmus is head injury from motor vehicle accidents.

In older people, a common, serious cause is stroke (blood vessel blockage in the brain).

Any disease of the brain (such as multiple sclerosis or brain tumors) can cause nystagmus if the areas controlling eye movements are damaged.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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