Patient presents with involuntary eye movements, clinically identified as nystagmus.  Onset, frequency, and triggers of the nystagmus were assessed.  Characteristics of the nystagmus, including pendular nystagmus, jerk nystagmus, amplitude, frequency, and direction (horizontal nystagmus, vertical nystagmus, torsional nystagmus) were documented.  The patient's visual acuity, visual field defects, and any associated symptoms such as oscillopsia, vertigo, dizziness, or balance problems were evaluated.  Differential diagnosis considerations included congenital nystagmus, acquired nystagmus, central nervous system disorders, inner ear disorders, medications, and toxins.  Neurological examination, including cranial nerve assessment, was performed.  Further investigations may include electronystagmography (ENG), vestibular testing, MRI brain with and without contrast, or CT scan of the head depending on suspected etiology.  The patient's medical history, family history of nystagmus, and current medications were reviewed.  Treatment plan will be determined based on the underlying cause and may include observation, medication management for underlying conditions, vision therapy, or referral to a specialist such as a neuro-ophthalmologist or otolaryngologist.  Patient education on nystagmus management and prognosis was provided.  Follow-up appointments were scheduled for ongoing monitoring and assessment of treatment efficacy.  ICD-10 code for nystagmus (H55) and relevant modifiers will be applied for medical billing and coding purposes.