Patients with congenital nystagmus (CN) often have associated conditions (e.g., strabismus, high astigmatism, and binocular inefficiency) that also impair visual acuity. Unfortunately, individually used techniques directed at reducing nystagmus have generally produced only slight increases in Snellen acuity. We present case reports of six patients with nystagmus seen in our clinic (University of Houston, College of Optometry) to illustrate the use of problem-specific management to improve visual acuity and/or binocular function. The results suggest that a comprehensive management strategy should include treatment of all associated conditions as well as therapy to improve the characteristics of the nystagmus wave form.