Details of Nystagmus Working Group Meeting 4 (2026-04-14)

Date/time

Tuesday 14th April 2026. Chaired by Helena Lee (University of Southampton). Vice-chair: Rebecca McLean (University of Leicester).

Agenda

  • Welcome and Apologies
  • Review and Approval of Previous Minutes
  • Review of Literature to Inform Technology Requirements
  • Review of Protocol Components
  • Key Issues and Required Actions
  • Next Steps and Timeline
  • Any Other Business

Meeting recording

Attendees

  • Onyeka Amiebenomo
  • Larry Abel
  • Audrey Bonnan
  • Artur Cideciyan
  • Amanda Douglass
  • Matt J Dunn
  • Ruth Hamilton
  • Sian Handley
  • Rasha S. Moustafa
  • Frank Proudlock
  • Andreas Sprenger
  • Herman Talsma
  • Thom Wilcockson

Apologies

  • Gemma Arblaster
  • Fatima Shawkat
  • Fiona Mulvey
  • Omar Mahroo
  • Mervyn Thomas
  • Jay Self

Notes

1. Welcome and Apologies

The Chair welcomed attendees to the meeting. Apologies noted fromGemma Arblaster;Fatima Shawkat; Fiona Mulvey; Omar Mahroo; Mervyn Thomas;Jay Self

2. Review and Approval of Previous Minutes

The minutes of the previous meeting were approved as an accurate record. Membership composition was reviewed, noting the formal addition of Optometry to subgroup representation and the withdrawal of one member due to capacity constraints.

Matters Arising and Review of Previous Action Points
  • Optometry added to subgroup membership categories – completed.
  • Standing agenda item on membership composition – implemented.
  • One member (Diederik de Hoerster) had withdrawn due to lack of capacity; this was noted.
  • The draft combined definition and purpose statement and fixation protocol/ guidance had been circulated using a shared OneDrive document; access issues for some members were acknowledged.
  •  
Terms of Reference and ISCET Governance Alignment
  • Subcommittee Terms of Reference have been adopted by other ISCET Subcommittees and will feed into wider ISCET governance discussions.
  • Members were informed of a draft ISCET general membership and ethics framework now available on the forum; feedback from subcommittees will be important to inform a more formalised ISCET structure.

3. Review of Literature to Inform Technology Requirements

LA and FM have begun collating evidence on sampling rate, spatial precision, and bandwidth.

Discussion highlighted the importance of:

  • Distinguishing between minimum clinical standards and ideal/aspirational standards
  • Avoiding division into separate “clinical” and “research” standards; a single minimum standard with flexibility was favoured.
  • Explicitly acknowledging limitations of current eye‑tracking systems (e.g. difficulties with large gaze angles, abnormal head posture, paediatric testing).

It was agreed that the guideline should:

  • Specify minimum acceptable standards
  • State where current technology does not yet meet clinical needs
  • Avoid naming specific manufacturers

4. Review of Protocol Components

The draft protocol was reviewed in detail.

Revisions to the definition and purpose section were agreed to improve clarity and clinical usability.

  • Key agreements:
    • Use of “eye position and/or movement” for clarity.
    • Replace “focus” with “fixate” to avoid ambiguity.
    • Simplify wording to improve readability.
    • Avoid over‑technical language in the main text; detailed definitions may be placed in footnotes.
Physiology Section
  • Members agreed that a brief overview of fixation physiology would be useful, without attempting a comprehensive review.
  • Possibility of inviting an external expert or adapting existing teaching material was discussed.
Clinical Applications Section
  • Extensive discussion took place on whether to list specific populations.
  • Concerns were raised that lists risk exclusion and reduce clarity for users.
  • Consensus:
    • The population list should be removed or heavily simplified.
    • Clinical relevance can instead be conveyed through:
      • General statements
      • Supporting editorials
      • Webinars and educational activities accompanying publication.
Normative / Reference Data
  • Drawing on ISCEV practice, members agreed that:
    • Centres may use published or shared reference data where local data collection is not feasible.
    • Any use of non‑local reference data must acknowledge limitations.
  • It was agreed that a separate ISCET policy on reference data would be preferable, with fixation guidelines cross‑referencing this document rather than duplicating content.
Fixation Protocol Parameters
  • Default recording duration of 30 seconds was provisionally agreed, with flexibility acknowledged for paediatric and special populations.
  • Members noted that many numerical thresholds lack a strong evidence base.
  • Agreed approach:
    • Identify parameters requiring evidence.
    • Where evidence is absent, use consensus and/or structured surveys as an interim solution.
Paediatric Recording
  • A general statement will be included recognising:
    • Reduced compliance and feasibility in infants and young children
    • The need for pragmatic adaptations rather than strict protocol adherence.
Artefact Handling and Analysis
  • Artefact handling and data analysis were agreed to be out of scope for this guideline and deferred to a future document.

5. Key Issues and Required Actions

A number of protocol parameters requiring evidence review or consensus agreement were identified. It was agreed that parameters would be listed in a table and assigned to subcommittee members for follow‑up, using a random allocation approach with paired reviewers.

Larry Abel and Fiona Mulvey were excluded from additional tasks due to their substantial workload on technology requirements. Ruth Hamilton to be excluded from task allocation due to role boundary.

6. Next Steps and Timeline

A consolidated technology requirements document will be prepared. Evidence‑gathering tasks will be completed and circulated in advance of the next meeting. The next meeting is provisionally planned for approximately two months’ time.

7. Any Other Business

No additional items were raised.


Actions

No.ActionOwnerTimeline
1Incorporate agreed revisions to definition and purpose sectionHelena LeePost-meeting
2Consolidate literature into a single technology requirements documentLarry Abel & Fiona Mulvey~2 months
3Draft brief overview of fixation physiology or identify suitable source materialHelena Lee / Larry AbelBefore next meeting
4Remove or simplify population list in clinical applications sectionHelena LeePost-meeting
5Define approach for referencing separate ISCET guidance on normative dataMatt J DunnBefore next meeting
6Create table of protocol parameters requiring evidence or consensusHelena Lee & Rebecca McLeanPost-meeting
7Allocate evidence-gathering tasks using random assignment with buddy systemHelena Lee & Rebecca McLeanPost-meeting
8Draft paediatric compliance acknowledgement statementHelena LeePost-meeting
9Confirm date and circulate agenda for next meetingChairWithin 2 weeks

Next meeting

  • Poll to be sent; meeting in approximately two months’ time.