Nystagmus
Disclaimer
These guidelines have been produced to guide clinical decision making for general practitioners (GPs). They are not strict protocols. Clinical common-sense should be applied at all times. These clinical guidelines should never be relied on as a substitute for proper assessment with respect to the particular circumstances of each case and the needs of each patient. Clinicians should also consider the local skill level available and their local area policies before following any guideline.
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Referral to Emergency Department:
If any of the following are present or suspected, please refer the patient to the Emergency Department (via ambulance if necessary) or seek emergency medical advice if in a remote region.
- Sudden onset nystagmus
- Nystagmus with any new neurological symptoms
Immediately contact on-call registrar or service to arrange an immediate Ophthalmology assessment (seen within 7 days):
- Standalone vertical nystagmus
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Introduction
A condition where the eye/s make rapid, repetitive, uncontrolled movements. They may move in different directions, classified as; horizontal, vertical or rotary. There are two types of Nystagmus; congenital or acquired.
Pre-referral investigations
- Examination
- For children aged ≥ 5 years: best corrected visual acuity
Pre-referral management
When to refer
Refer to the Ophthalmology Department
Suspected or present nystagmus.
How to refer
- Routine non-urgent referrals from a GP or a Consultant are made via the Central Referral Service
- Routine non-urgent referrals from a nurse practitioner, non-medical referrers or private hospitals are made via the PCH Referral Office (Fax: 6456 0097 or email PCH.Referrals@health.wa.gov.au)
- Urgent referrals (less than seven days) are made via the PCH Referral Office. Please call Perth Children’s Hospital Switch on 6456 2222 to discuss referral with the relevant speciality registrar.
Essential information to include in your referral
History
- Relevant history, onset, duration, and severity of symptoms
- Include age that nystagmus originally noted
- Relevant past medical history (e.g. history of head or eye injury, neurological conditions, albinism)
- Relevant family history
- Details of previous treatment and outcome
- Current medication list
- Any known allergies
Useful resources
| Reviewer/Team: |
Ophthalmology Department, PCH |
Last reviewed: |
May 2026 |
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