Surgery for nystagmus can be indicated in several clinical situations.  Before considering surgery, pathologic causes for nystagmus must be ruled out.   Red flags for pathologic nystagmus include:  vertical nystagmus, asymmetric nystagmus, new onset nystagmus (not present from birth), intermittent nystagmus, and nystagmus associated with other neurological signs.  Also, nonsurgical treatment for nystagmus is usually considered, in appropriate cases, before surgical intervention is entertained.

 Surgery for nystagmus causing a consistently present abnormal head posture is performed to relocate the position of decreased nystagmus (optimal vision) to the primary gaze position. 

This can be accomplished by various means with recession/resection procedures , (Kestenbaum/Anderson) procedure being the most common.  Surgery can be done for both vertical and horizontal types of nystagmus.