Visual acuity while walking and oscillopsia severity in healthy subjects and patients with unilateral and bilateral vestibular function loss

Arch Otolaryngol Head Neck Surg. 2012 Mar;138(3):301-6. doi: 10.1001/archoto.2012.4.


Objectives: To assess visual acuity (VA) while the patient is walking and to evaluate oscillopsia severity in patients with bilateral vestibulopathy (BV) and in patients with unilateral vestibular loss (UVL).

Design: Prospective study with a group of patients with BV, a group of patients with UVL, and a control group of healthy subjects.

Setting: Tertiary academic center.

Participants: Thirty seven patients with BV(age range, 29-80 years), 11 patients with UVL (age range, 48-75 years), and 57 healthy subjects (age range 20-77 years).

Intervention: Computation of the difference between the VA measured in static conditions and in dynamic conditions while walking on a treadmill at 2, 4, and 6 km/h. Oscillopsia severity was assessed with a questionnaire that we developed.

Main outcome measures: Differences in VA at 2, 4, and 6 km/h and oscillopsia severity score.

Results: As a group, patients with BV showed a significant increase of the VA differences compared with healthy subjects (P < .001) and patients with UVL (P < .001) for all 3 walking velocities. Normality thresholds were defined as healthy subjects' 95% CI. Sensitivity of the test was 97% for discriminating patients with BV. Moderate to extreme oscillopsia severity was found in 81% of patients with BV and in 9% of patients with UVL. Differences in VA did not correlate with oscillopsia severity scores in patients with BV (P > .05 for all comparisons).

Conclusions: We designed a highly sensitive, simple, cost-effective protocol to assess dynamic VA under physiologic conditions and a questionnaire to determine oscillopsia severity. Both tools could be used for the evaluation of new treatments for BV and patients with UVL.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Ocular Motility Disorders / physiopathology*
  • Prospective Studies
  • Regression Analysis
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Surveys and Questionnaires
  • Vestibular Diseases / physiopathology*
  • Vestibular Function Tests
  • Visual Acuity*
  • Walking / physiology*