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Patients with non-compensated vestibular dysfunction frequently complain of the ability to maintain dynamic visual acuity during activities which require the movement of the head. When this occurs the patient is experiencing oscillopsia, which is the symptom resulting from a non-functional vestibulo-ocular reflex (VOR). To measure the presence of oscillopsia, tests of dynamic visual acuity (DVA) may be used. A recent test of DVA has been reported which is administered while patients are walking on a treadmill. Although this test has been shown to be useful in evaluating DVA in patients, there are several disadvantages to treadmill use. These include physical space, cost and accessibility. Additionally, walking at the required treadmill speed to produce sufficient head movement may pose difficulties and be medically contraindicated for patients with certain health risks. The purpose of this study was to evaluate a different method to measure DVA in patients which would not require the use of the treadmill, but instead utilize a volitional head movement to reveal oscillopsia. In this study, patients performed the DVA test in two conditions: (1) walking on a treadmill, and (2) seated on a chair volitionally moving the head. In this study, DVA was tested in both conditions with 15 adults with normal vestibular function, and 16 adults with vestibular impairment. Results revealed that both methods, treadmill walking and volitional head movement, appeared equivalent for measuring DVA in normal subjects and vestibular impaired subjects. The lack of finding a significant main effect of method, and interactions that include method, supports the equivalence of volitional head movement to a treadmill approach for the measurement of DVA.

Professional research project (Au.D.)--University of South Florida, 2002. / Title from PDF of title page. / Document formatted into pages; contains 24 pages. / Includes bibliographical references. / Text (Electronic thesis) in PDF format. / ABSTRACT: Patients with non-compensated vestibular dysfunction frequently complain of the ability to maintain dynamic visual acuity during activities which require the movement of the head. When this occurs the patient is experiencing oscillopsia, which is the symptom resulting from a non-functional vestibulo-ocular reflex (VOR). To measure the presence of oscillopsia, tests of dynamic visual acuity (DVA) may be used.A recent test of DVA has been reported which is administered while patients are walking on a treadmill. Although this test has been shown to be useful in evaluating DVA in patients, there are several disadvantages to treadmill use. These include physical space, cost and accessibility. Additionally, walking at the required treadmill speed to produce sufficient head movement may pose difficulties and be medically contraindicated for patients with certain health risks. The purpose of this study was to evaluate a different method to measure DVA in patients which would not require the use of the treadmill, but instead utilize a volitional head movement to reveal oscillopsia. In this study, patients performed the DVA test in two conditions: (1) walking on a treadmill, and (2) seated on a chair volitionally moving the head.In this study, DVA was tested in both conditions with 15 adults with normal vestibular function, and 16 adults with vestibular impairment. Results revealed that both methods, treadmill walking and volitional head movement, appeared equivalent for measuring DVA in normal subjects and vestibular impaired subjects. The lack of finding a significant main effect of method, and interactions that include method, supports the equivalence of volitional head movement to a treadmill approach for the measurement of DVA. / System requirements: World Wide Web browser and PDF reader. / Mode of access: World Wide Web.

Les manifestations neuro-ophtalmologiques, observées dans la sclérose en plaques sont parfaitement déterminées à l’heure actuelle. Cependant, l’aspect chronique des troubles visuels résultants n’est pas toujours précisément évalué, or de telles lacunes sont un frein à leur prise en charge. Dans une première partie, les caractéristiques des troubles visuels chroniques ont été mesurées. Il s’agissait de quantifier le pourcentage de plaintes visuelles chroniques chez des patients atteints de sclérose en plaques puis de mesurer le degré d’intensité des troubles visuels chroniques, de déterminer leurs origines physiopathologiques et de rendre compte de leur retentissement sur la qualité de vie des patients se plaignant de troubles chroniques. Les voies visuelles afférentes étaient altérées dans 68% des cas. Des troubles oculomoteurs étaient fréquemment observés (89%) dont le nystagmus pendulaire (28%), source de gêne visuelle. Dans une seconde partie, nous nous sommes donc intéressés au nystagmus pendulaire et à sa conséquence fonctionnelle, l’oscillopsie, afin de proposer une prise en charge spécifique. Néanmoins, les mécanismes de ce nystagmus ne sont pas encore bien définis. Il était donc important de développer une hypothèse explicative à partir de l’observation de deux cas particuliers de nystagmus monoculaire et de démontrer que le nystagmus pendulaire de la sclérose en plaques est à distinguer du nystagmus pendulaire du tremblement oculopalatin, souvent confondus. Enfin, nous proposons une méthode évaluant la détection du mouvement (par stimuli de contraste asservis au regard) ainsi qu’un protocole de stimulation optocinétique tentant de réduire ce symptôme / Neuro-ophthalmic manifestations observed in multiple sclerosis are well-known. However, the chronic feature of visual dysfunctions is not always precisely determinated. These imprecision impede the development of specific therapeutic approach. In a first part, the chronic characteristics of visual dysfunctions were assessed. The percentage of chronic visual complaints in multiple sclerosis patients was quantified and then the intensity of chronic visual deficits was measured, their pathophysiologic origins determined and finally their impact on quality of life was taken into account. Visual pathways were impaired in 68% of patients. Ocular motor disorders were frequently observed (89%) including pendular nystagmus (28%), accounted for visual discomfort. In a second part, we focused on pendular nystagmus and its functional consequence, oscillopsia, to propose a specific treatment. First of all, the mechanisms of this nystagmus are not yet well defined. Therefore, we developed some hypothesis from the observation of two patients with monocular nystagmus and demonstrated in a second part that the pendular nystagmus in multiple sclerosis is distinct from the pendular nystagmus of oculopalatal tremor. Finally, we proposed a method evaluating oscillopsia (motion detection by contrast stimuli moving synchronically with gaze) that was tested before and after an optokinetic stimulation protocol aimed to reduce this symptom