Eye movement dysfunctions in psychiatric patients: a review

Impairments of smooth pursuit eye movements occur in a high proportion of schizophrenic patients and in a lower but significant percentage of patients with affective psychoses, as well as patients with structural and metabolic disorders of the central nervous system. These findings have been confirmed using a wide range of tracking tasks, recording techniques, and scoring procedures, and therefore cannot be attributed to measurement artifact. The eye movement disruption in schizophrenics does not seem to result from drug treatment or simple inattention. Eye tracking pattern appears to be under genetic control and some impairments may reflect a predisposition to functional psychosis. The smooth pursuit eye movement impairment has been attributed to a central nervous system dysfunction that manifests itself in a disorder of nonvoluntary attention. The study of other oculomotor functions, such as the oculocephalic reflex, optokinetic and vestibular nystagmus, and saccadic eye movements, suggests that the locus of the central nervous system disruption is above the brainstem.