A study was undertaken to identify the etiologic factor of reduced visual acuity in congenital nystagmus. Fourteen children with congenital nystagmus and reduced visual acuity were examined, using a modified "E" game test. Their success rate in identifying vertical lines was compared with their success rate in identifying horizontal lines. The children identified both vertical and horizontal lines with a similar rate of success. These results may indicate that poor vision in congenital nystagmus patients is partly the result of amblyopia.