Eye-Head Coordination | Dizziness Assessment

Deficits in cervical joint position sense, eye movement control and postural stability are often noted in patients with traumatic neck pain and cervicogenic dizziness due to abnormal cervical afferent input.Eye/head coordination describes the ability to maintaining a gaze when both the eyes and head are moving.

To perform the test have the patient seated with his head in neutral position.
Hold two targets in front of the patient at eye level about 3 feet or 1 meter away with a distance between the targets of about 12 inches or 30 centimeters.
The patient is then instructed to move the eyes and head in the same direction to focus on one target, leading with the eyes first and then the head ensuring the eyes keep focused on the target.
This can be performed with two targets held horizontally and vertically.

Inability to maintain focus on the target, over- or undershooting, reduced or awkward cervical motion, or reproduction of symptoms such as dizziness, blurring of vision, or nausea are signs of an abnormal response. It can be helpful to look at one eye at a time to be able to spot deviations from the norm.

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Next to eye-head coordination assessment, your dizziness exam should include the following assessments:

• Gaze stability
• Saccadic Eye Movement
• Postural Stability Assessment
• Joint Position Sense Error 
• Smooth Pursuit Neck Torsion Test
• Cervical Torsion Test
• Head-Neck Differentiation Test

Treleaven, J. (2008). Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control. Manual therapy, 13(1), 2-11.