Oscillopsia can result from dysfunction involving the vestibuloocular reflex (VOR). Few studies have detailed the full spectrum of clinical characteristics and laboratory findings of this disabling condition.
To review causes and clinical characteristics of oscillopsia.
Retrospective review of clinical records of a series of patients with oscillopsia from the University Health Network Multidisciplinary Neurotology Clinic.
Review of 109 patients with oscillopsia showed near equal sex distribution and a mean age of 54.9 years (standard deviation 15.7). The most common peripheral vestibular causes were ototoxicity (19.3%) and Meniere’s disease (10.1%). The most common central cause involved cerebellar degeneration (7.3%). Only 43.1% complained of vertigo at any time. Head impulse testing demonstrated bilateral refixation saccades in 70% of patients, while over 95% had a loss of dynamic visual acuity ≥5 lines on LogMAR chart testing. Some 38.8% of patients demonstrated normal caloric responses, whereas only 26.5% exhibited evidence of a bilateral caloric loss. Over 50% of patients maintained otolithic function as demonstrated by cervical vestibular evoked myogenic potential testing. Most patients demonstrated low VOR gains bilaterally on magnetic scleral search coil testing.
A wide spectrum of clinical characteristics was identified in patients with oscillopsia. It is important for the physician to perform a thorough history, physical examination (including head impulse and dynamic visual acuity), and laboratory investigations.