This concise practice points document provides a structured approach to the investigation and management of nystagmus in children. It supports clinicians in navigating complex differential diagnoses, identifying urgent red flag features, and applying appropriate investigation pathways including clinical assessment, imaging and genetic testing. The guidance also outlines practical management options across optical, medical and surgical interventions, alongside referral pathways and long-term support for patients and families. It emphasises the importance of holistic care, including visual optimisation and access to education and support services.