Congenital Nystagmus (CN) is a pathological involuntary oscillation of the eyes with an onset within the first few months of life, with an incidence of about 1:3000. It is a life-long oculomotor disorder that cannot be explained by any underlying neurological abnormality which might compromise adaptive mechanisms. There is no cure, and CN has so far defied explanation in spite of numerous attempts to model the disorder. In this theoretical study we show that these eye oscillations could develop as an adaptive response to maximise visual contrast with poor foveal function in the infant visuomotor system, at a time of peak neural plasticity. We propose that CN is a normal developmental adaptive response to an abnormal congenital sensory input. This can explain why CN does not emerge later in life and why CN is so refractory to treatment. It also implies that any therapeutic intervention would need to be very early in life
