BEDSIDE PURSUITS VISION SKILL ASSESSMENT​

– Hello and welcome to this episode of CI TV. My name is Dr. Abbey Houde and I’m here with Dr Freddy Garcia. Today we’re going to be talking about eye movements, specifically pursuits. Pursuits are the ability for a patient to be able to track a moving target with their eyes. The reason this is important is because neuroscience has mapped out specific regions in the brain that correspond with specific eye movements. By observing this, you get a beautiful window into the function of the patient’s central nervous system.

– So let’s talk about how we do this. In the early part of our day, we’ll actually take a little dot and put it on our thumb, because we’re gonna ask our patient to hold on to that target, that dot in a moment. Now if we were to instruct them to just look at our thumb as we’ve moved it, some patients will look at the tip of the thumb, some will look at the base, some may look at the right side or the left side, and they’ll look like their eyes aren’t holding onto the target, which will invalidate this test. So we wanna be able to give them a very specific target. That dot, which Dr. Abbey has on her thumb right now.

– So I’m gonna stand in front of my patient at least 18 inches away, that way they’re out of convergence. I’m gonna have them stare at the target while it moves in a horizontal plane. Starting at one Hertz and then two Hertz.

– Now what you’re looking for is again, can they hold on to that dot or that target? It should match the speed of your thumb, it should look as smooth as your arm was moving. Now some patients, their eyes will actually be in front of the target, and their eyes will have to slow down as the thumb catches up. Another patient, their eyes may actually fall behind that target and you may see a refixation saccade or fast eye movement as they try to get back on to the target. Either one of those may be indicative of parietal lobe dysfunction as the parietal lobe is highly responsible for holding on to a target and following it visually.

– This test, along with your other neurological base testing, can really provide a specific treatment plan for your patients. We really hope this information serves you well, and we’ll see you next time at CI TV