Doll's eyes test

Timothy C. Hain, MDJanuary 10, 2022

The VOR (vestibulo-ocular reflex) gain is most helpful for diagnosing ototoxicity and other bilateral vestibulopathies. There are several methods of quantifying it at the bedside. Dynamic visual (DIE test), ophthalmoscope test, and variants of the "Dolls eyes". A rapid "Dolls Eyes", is called the HIT (head impulse test). When the word "Dolls Eyes" is used, it usually refers to the slower variant.

The "Dolls Eyes" test involves turning the the head while watching the eyes. So the inputs are vestibular, proprioceptive, and possibly visual (if the eyes are open). Posner (Diagnosis of Stupor and Coma), calls this test the "oculocephalic test", which is very reasonable -- combines head and eyes.

So what is abnormal in the "Dolls Eyes test" ? Some toy dolls have eyes that are painted on, and some have some inertia and move opposite to the head.

Most of the time, it is considered normal to have a Dolls eye response - -i.e a functioning oculocephalic reflex, so I guess we are assuming that the Doll is one of the newer ones.

 


References

  1. Posner, J. Diagnosis of Stupor and Coma, 3rd edition, page 54-55.