Eye Movement Recording as a Clinical Tool

Quantitative recording and analysis of eye movements are valuable tools in the diagnosis and management of eye movement abnormalities. There have been improvements in techniques of stimulating, recording, and measuring eye movements, and the value of systematically testing the several, different types of movements (ocular motor subsystems) has been recognized. The advantages and disadvantages of commonly used eye movement recording techniques are reviewed. The examination of saccades, pursuit, optokinetic nystagmus, vestibulo-ocular response, and interactions between ocular motor subsystems is described. Disorders that commonly impair each type of eye movement are discussed. Many disorders produce characteristic patterns of eye movement abnormalities, that can be demonstrated by recordings. Several of these disorders are reviewed. Quantitative studies are helpful in detecting mild, subclinical impairment of eye movements and in following the clinical course of disorders, such as cranial nerve palsies. Perhaps, the most significant clinical contribution of quantitative studies has been to improve the sensitivity and accuracy of the clinician's examination without the techniques of the eye movement laboratory. By comparing his observations with those from recordings, he can learn to recognize mild impairment of eye movement subsystems and characteristic patterns of abnormalities.