| Smooth pursuit |
Description: observe the eyes as they track a moving object at 20°/s with the head stationary |
| Result: corrective saccades observed with pursuit to the left suggesting potential CNS dysfunction (*Red Flag) |
| Saccades |
Description: observe the eyes as they quickly look back and forth between two horizontally or vertically placed objects |
| Result: target reached with one corrective saccade and was normal |
| VOR cancellation |
Description: observe the eyes as they fixate on the clinician’s nose while the clinician moves the patient’s head horizontally at a speed of 1 Hz |
| Result: corrective saccades observed with head rotations to left suggesting potential CNS dysfunction (*Red Flag) |
| Head thrust test |
Description: an unpredictable, small amplitude head thrust to each side is applied with high acceleration. The patient’s head is flexed 30° and they are instructed to fixate on the examiner’s nose |
| Result: corrective saccade observed with head thrusts to the left suggesting VOR dysfunction due to central or peripheral dysfunction |
| Dynamic visual acuity test |
Description: the patient reads eye chart with head stationary then again while the head is oscillated in the horizontal plane at a speed of 2 Hz |
| Result: visual acuity decreased by eight lines suggesting VOR deficit due to CNS or peripheral dysfunction |
| Spontaneous nystagmus test |
Description: observe the eyes for nystagmus while patient is sitting stationary |
| Result: spontaneous left beating nystagmus observed suggesting imbalance of the resting firing rate of vestibular neurons due to peripheral or central dysfunction |
| Gaze holding nystagmus |
Description: observe the eyes while the patient holds their gaze about 30° to the right, left, up, and down |
| Result: left beating nystagmus observed with left gaze, right beating nystagmus observed with right gaze (direction changing) suggesting potential CNS dysfunction (*Red Flag) |
| Head-shake test |
Description: the patient’s head is flexed 30° and oscillated horizontally 20 times at 2 Hz, the eyes are observed upon cessation of head movement |
| Result: nystagmus not observed and was normal |
| Hallpike–Dix test |
Description: the patient’s head is rotated 45° to the right/left while in sitting, the patient is then assisted into supine with the head extended about 30° |
| Result: purely torsional nystagmus (the absence of vertical component) towards the left was elicited suggesting potential CNS dysfunction (*Red Flag) |
