| Vestibular/ocular motor test | Not
tested | Headache
(0 to 10) | Dizziness
(0 to 10) | Nausea
(0 to 10) | Fogginess
(0 to 10) | Comments |
| Baseline symptoms | | | | | | |
| Smooth pursuits | | | | | | |
Clinical assessment: - Was horizontal smooth pursuit completed without saccadic eye movement and as normally expected? Yes/No
- Number of intruding saccades: Direction: Right/left/bilateral
- Head movement associated with test? None/some head movement/large head movement
- Was vertical smooth pursuit completed without saccadic eye movement and as normally expected? Yes/No
- Number of intruding saccades: Direction: Up/down/both up and down
- Head movement associated with test? None/some head movement/large head movement
|
| * Saccades: horizontal (×10) | | | | | | |
Clinical assessment: - Were hypometric eye movements observed? Yes/No – If yes, which direction? Right/left/bilateral
- Were hypermetric eye movements observed? Yes/No – If yes, in which direction? Right/left/bilateral
- Was a long latency observed? Yes/No – If yes, in which direction? Right/left/bilateral
- Was poor conjugacy observed? Yes/No – If yes, in which direction? Right/left/bilateral
|
| * Saccades: vertical (×10) | | | | | | |
Clinical assessment: - Were hypometric eye movements observed? Yes/No – If yes, which direction? Up/down/both
- Were hypermetric eye movements observed? Yes/No – If yes, in which direction? Up/down/both
- Was a long latency observed? Yes/No – If yes, in which direction? Up/down/both
- Was poor conjugacy observed? Yes/No – If yes, in which direction? Up/down/both
|
Convergence
Near point (cm) | | | | | | 1: __________ |
| 2: __________ |
| 3: __________ |
Clinical assessment: - Did both eyes converge as expected? Yes/No – If no, record nature of abnormality:
- Record distance achieved on all 3 repetitions (cm):
- Was either eye observed to fail to converge? Yes/No – If yes, which eye? Right/left/both
- Distance of observed failure to converge (cm):
|
Vestibular-ocular reflex:
horizontal (20 seconds)
(metronome at 180) | | | | | | |
Clinical assessment: - Describe symptoms (headache, fogginess, nausea, and dizziness):
- Were corrective saccades observed at slower head movements? Yes/No
- Was horizontal head thrust test positive? Yes/No – If yes, what direction?
|
Vestibular-ocular reflex:
vertical (20 seconds) | | | | | | |
Clinical assessment: - Describe symptoms (headache, fogginess, nausea, and dizziness):
- Were corrective saccades observed at slower head movements? Yes/No
- Was RALP positive? Yes/No – If yes, what direction?
- Was LARP positive? Yes/No – If yes, what direction?
|
Visual motion sensitivity (×10)
(metronome at 50) | | | | | | |
Clinical assessment: - Describe symptoms (headache, fogginess, nausea, and dizziness):
- Was the participant able to maintain stable gaze on the target while moving? Yes/No – If no, in which direction were corrective saccades observed? Right/left/both
- Additional details:
|
| Optokinetic nystagmus | | | | | | |
| Hold lined paper about 15 to 30 cm in front of subject. Ask subject to fixate on its black and white stripes. Move the paper slowly in horizontal (left and right) and vertical (upward and downward) directions while observing eye movements. Slow eye movement in the direction of the moving paper, followed by a quick return movement, is considered normal. With normal function, there are no asymmetries in eye movements while moving the paper in different orientations. Clinical assessment: - Normal: Adequate OKN response in all directions, no asymmetry
- Mild problem: Poor OKN response, horizontal/vertical asymmetry
- Severe problem: No OKN response observed, large asymmetry
|
| Stereo visual acuity | Normal | Abnormal |
Clinical assessment: - Normal: 3 or 4 confident, speedy, and correct responses are made. Make several attempts if in doubt because patient is slow or hesitant. Some subjects can perform stereo tests monocularly. Thus, slow but correct responses are suspect. Only record stereopsis present if reliable discrimination is established.
- Abnormal: Stereopsis not demonstrated if patient fails to pick out the square with the target reliably and confidently over repeated presentations and/or patient reports being unable to see the target in depth, even when it is pointed out. Try the plate in both positions before recording this result. Consider checking the patient's understanding using twisting presentations and other techniques described in text.
|
