Recovery of dynamic visual acuity in unilateral vestibular hypofunction

Arch Otolaryngol Head Neck Surg. 2003 Aug;129(8):819-24. doi: 10.1001/archotol.129.8.819.


Objective: To determine the effect of vestibular exercises on the recovery of visual acuity during head movement in patients with unilateral vestibular hypofunction.

Study design: Prospective, randomized, double-blind study.

Setting: Ambulatory referral center.

Patients: Twenty-one patients with unilateral vestibular hypofunction, aged 20 to 86 years.

Intervention: One group (13 patients) performed vestibular exercises designed to enhance the vestibulo-ocular reflex, and the other group (8 patients) performed placebo exercises. The placebo group was switched to vestibular exercises after 4 weeks.

Outcome measures: Measurements of dynamic visual acuity (DVA) during predictable (DVA-predictable) and unpredictable (DVA-unpredictable) head movements by means of a computerized test and measurement of intensity of oscillopsia by means of a visual analog scale.

Results: As a group, patients who performed vestibular exercises showed a significant improvement in DVA-predictable (P<.001) and DVA-unpredictable (P<.001), while those performing placebo exercises did not (P =.07). On the basis of stepwise regression analysis, the leading factor contributing to improvement was vestibular exercises. This reached significance for DVA-predictable (P =.009) but not DVA-unpredictable (P =.11). Other factors examined included age, time from onset, initial DVA, oscillopsia, and duration of treatment. Changes in oscillopsia did not correlate with DVA-predictable or DVA-unpredictable.

Conclusions: Use of vestibular exercises is the main factor involved in recovery of DVA-predictable and DVA-unpredictable in patients with unilateral vestibular hypofunction. Exercises may foster the use of centrally programmed eye movements that could substitute for the vestibulo-ocular reflex. The DVA-predictable would benefit more from this than would DVA-unpredictable.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Double-Blind Method
  • Exercise Therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Regression Analysis
  • Vestibular Diseases / physiopathology*
  • Vestibular Diseases / therapy*
  • Visual Acuity / physiology*