The high-frequency oscillopsia test

There is a need to develop bedside tests of the vestibulo-ocular reflex (VOR) that could be used in the clinical situation to screen patients who may be candidates for further evaluation. In 1984 Barber described the oscillopsia test, which compared visual acuity with and without head movement. Barber indicated that head movement should occur at greater than 1 Hz. This study was performed to evaluate the oscillopsia test at higher frequencies (2 to 7 Hertz) in the hope of improving its performance. The sensitivity and specificity of this test were evaluated using three examiners (the authors) and were referenced to clinical electronystagmographic results in 115 patients and 17 control subjects. The oscillopsia test evaluated in this study was highly specific, but not highly sensitive. It did not detect vestibular loss or subjective dizziness in more than 50% of cases. The high frequency oscillopsia test does not appear to be an effective screening test for VOR abnormalities or vestibular loss.