To evaluate the feasibility of spectral domain optical coherence tomography (SD-OCT) macular scanning as a means of studying the afferent visual system in nystagmus patients. Nystagmus patients who underwent SD-OCT, clinical evaluation, and eye movement recordings were recruited for this prospective, single-center, noncomparative study. Three SD-OCT macular three-dimensional cube scans per eye (200 x 200 x 1024 samplings in a 6 x 6 mm region) were obtained for qualitative retinal morphology analysis. Nineteen patients (6-68 years; average, 19 years) were analyzed. Of these, 17 patients had infantile nystagmus syndrome, and 2 had fusion maldevelopment nystagmus; 17 patients (89%) had associated sensory system abnormalities, including 9 (47%) with albinism. Macular images were successfully obtained in all but 1 patient (95%). Of the 8 successfully imaged oculocutaneous patients, 7 patients demonstrated "fovea plana," and all demonstrated abnormal morphology. SD-OCT reliably provides detailed structural imaging of the fovea in nystagmus patients.