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Comprehensive Informal Tests of Ocular Control & Balance Systems

Assess multiple systems involved in balance and ocular range of motion. Conduct various tests including volitional saccades, head thrust, nystagmus examination, and postural control evaluations for a comprehensive assessment. Helpful for identifying issues related to VOR gain, bilateral weakness, Hennebert’s sign, and post-rotary nystagmus.

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Comprehensive Informal Tests of Ocular Control & Balance Systems

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  1. Informal Tests of the Systems Involved in Balance

  2. Ocular Range of Motion/Gaze Stability • Move a target (18” from nose)35-40 degrees Left and Right.30-35 degrees Up and Down.25-30 degrees DiagonallyPausing 15-20 second • Volitional Saccades

  3. Frenzel lens exam: (no target)

  4. Monocular Eye Cover • looking for vertical adjustment

  5. Passive Head Rotation • screening for bilateral weakness.

  6. Halmagyi Head Thrust • rapid isolated unidirectional screening for low VOR gain on side turning towards.

  7. Head Shake • “No” movement vigorously for 15-20 secs then examine with Frenzel lenses. Nyst usually away from lesion side.

  8. Pneumatic Otoscopy • Looking for Hennebert’s sign.

  9. Post-Rotary Nyst • in swivel chair

  10. Hallpike maneuver

  11. VSR/Postural Control • Past-Pointing – arms out pointing with index fingers to examiners hands, then up and back to examiner’s hands 2 to 3 times w/ eyes open and several times with eyes closed. Both arms move toward weaker ear.

  12. Romberg • -- eyes closed, feet together. • Tandem (Sharpened) Romberg – eyes closed heel to toe.

  13. Modified CTSIB • eyes open firm surface • eyes closed firm surface • eyes open compressible surface • eyes closed compressible surface

  14. Fukuda • 50 steps in place with eyes closed. Rotate toward weaker labyrinth.

  15. Casual Gait • walking 15 feet, with eyes open. • With and without head turns.

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