Saccadic Eye Movement | 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. Saccadic eye movement describes rapid eye movements to change a point of fixation.

To start the exam, the patient is sitting comfortably with his head in neutral position. Without moving his head, the patient is instructed to follow and fix his gaze on a target about 3 feet or a meter away that is quickly moved and then held still momentarily. The target is moved in several different directions. The patient’s ability to quickly move to the target and fixate on it is noted.

Another option is to hold two targets in front of the patient on eye level at a distance of about 3 feet or 1 meter and about 12 inches or 30 centimeters apart. The patient is then instructed to look quickly from one target to the next as quickly as possible.

Inability to maintain focus on the target, over- or undershooting, and 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 and to have the patient perform several repetitions.

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Next to saccadic eye movement, your dizziness exam should include the following assessments:

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

References

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