 Binocular pendular nystagmus can be seen as part of congenital nystagmus or can be an acquired disorder seen usually in patients who have both disorders of the visual sensory pathway and structural problems in the brainstem. Again, multiple sclerosis is a common etiology for this. This patient's nystagmus are somewhat dissociated in that they are seen more prominently in the left eye than the right eye. One can see an occasional jerk nystagmus to the right, most evident in the right eye. Focusing your attention on the left eye, note that the oscillations are mainly pendular in waveform.