Eye movement and electrophysiological findings in an infant with hemispheric pathology

A visually unresponsive infant had a normal ophthalmological examination. Eye-movement studies using electro-oculography revealed asymmetrical binocular smooth pursuit, binocular optokinetic nystagmus and vestibulo-ocular reflex. Electrophysiological testing showed markedly asymmetrical occipital flash and pattern visual evoked potentials. Both investigations suggested a posterior right-hemispheric problem, which was confirmed with cranial ultrasound. This case study illustrates the usefulness of non-invasive techniques in neuro-ophthalmological investigations of young children.