Hello,
I don't know if you read my intro a few days back, but yes, I've had nystagmus. It developed along with BPPV which came on two weeks after I had a sceleral buckle (silicone band) surgically implanted around my left eye for a retinal detachment 3-1/2 years ago (also when the MS symptoms came on).
The BPPV was atypical & did not respond to treatment. They insisted that was what the nystagums was from, and it did get better over the course of a year, though some residual nystagmus remains that they told me I was probably born with.
It's not as much of a problem for me as it sounds for you - but in the course of me researching all these symptoms of mine, I did read about the muscle clips. One side-effect from that I read, is that the eyes might no longer track together but separately. This could create vision problems and/or dizziness/balance problems.
The Botox I've read about for other symptoms, and sounds like it would have much less potential for side-effects, and any that one did experience, would be temporary vs. the permanence of the muscle clips.
Just my 2cents - I've had six eye surgeries altogether, and sometimes that is the only option. Hope you have a really good eye doctor you trust, as that surely helps.
Take care & good luck!