Congenital nystagmus is an involuntary, rhythmic oscillation or shaking of the eyeballs. It is not uncommon to see congenital nystagmus in clinical practice. Here is an answer to some of the concerns of parents of children with congenital nystagmus in clinical practice. 1. A routine eye examination is done to see if there is an organic lesion. 2. Each patient needs an optometry to see if there is myopia, hyperopia, or astigmatism. If the child has myopia, hyperopia or astigmatism, he/she should wear glasses in time. Can children with nystagmus who are found to have poor vision during the vision test go to school normally? Nystagmus patients have much poorer vision in one eye than in both eyes, and vision tests are usually done to cover one eye to check the vision of one eye. People use binocular vision in daily life, so when parents see that their children with nystagmus have poor vision in one eye, there is no need to worry too much, as in the cases we have seen in clinical work, children with nystagmus can basically go to school as normal children. Can amblyopia in children with nystagmus be cured? The amblyopia of children with nystagmus is different from other causes of amblyopia (other causes of amblyopia are easily cured), while the vision of children with nystagmus is difficult to improve. 4. Can nystagmus be treated? There is no cure for nystagmus, but there are treatments to improve clinical symptoms. Surgery and trigeminal lenses are commonly used. Nystagmus is divided into dominant nystagmus and recessive nystagmus. The dominant nystagmus is divided into motor nystagmus and perceptual nystagmus. The treatments for motor nystagmus and perceptual nystagmus are different. Motor nystagmus is the most common form of nystagmus in clinical practice. Motor nystagmus is caused by abnormalities in the nerve center or motor control pathways. The treatments for motor nystagmus are surgery and trigeminal lenses, with surgery being the primary treatment. These treatments are used to reduce nystagmus, eliminate compensatory head position, and improve visual acuity. (1) Most patients with motor nystagmus will have a tilted or slanted head or eyes looking up or down, because the nystagmus is lightest and the vision is clearest when the head is tilted or slanted, which is called the “middle band” or “resting eye position”, also called This position is also called the “compensatory head position”. The patient is most likely to show a tilted or slanted head when watching TV or focusing on objects. Therefore, it is recommended that parents provide a picture of the patient with a tilted or slanted head at the time of the visit to facilitate the doctor’s judgment. If a patient with nystagmus has a tilted or slanted head, the tilted head can be surgically corrected so that the position with the clearest vision is shifted to the front, so that the patient no longer has a tilted or slanted head. Since this position is the lightest position for nystagmus, the nystagmus will be the lightest and the vision will be the best after the surgery, and the surgery is generally more effective. (2) A small number of patients with motor nystagmus who do not have a “compensated head position” can also undergo surgery or wear a trigeminal lens, but the effect of surgery is not as obvious as that of patients with a “compensated head position”. 2. Perceptual nystagmus is caused by low vision due to various pathologies at birth, which results in visual afferent defects. Treatment of perceptual nystagmus focuses on removing the cause and restoring visual acuity. Nystagmus will improve or even disappear as visual acuity improves. For example, if a congenital cataract causes perceptual nystagmus, it will improve with improved visual acuity through surgical removal of the cataract and postoperative amblyopia training. V. Is surgery for nystagmus safe? Will surgery for nystagmus cause vision loss? Nystagmus surgery is similar to strabismus surgery. Strabismus surgery has a history of 150 years and is one of the safest surgeries. The procedure does not open the eye, so it usually does not affect vision, and you can see normally when you open the gauze the day after surgery, which basically does not affect your normal life and is less risky. VI. When should I have nystagmus surgery? It is generally recommended that nystagmus surgery be performed before starting elementary school. At the age of 3 or 4, there is no urgency to operate first, because it has been observed clinically that some children with nystagmus will improve their compensatory head position as they get older. If the child has refractive error and the compensatory head position is obvious, it is recommended to perform nystagmus surgery before going to elementary school. On the one hand, when the child sees through the glasses, the external objects cannot be seen through the glasses, which is not conducive to the improvement of visual acuity; on the other hand, the crooked head will lead to ridicule by the classmates, which will lead to trauma in the child’s mind.