Oculocephalic Reflex (Doll’s Maneuver)
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Oculocephalic reflex
A. To perform the oculocephalic reflex, rotate the patient’s head horizontally (back and forth) and vertically (up and down) and observe the patient’s eye movements.
B. Interpretation.
a. In a normal patient, the patient’s eyes will appear as though they are fixated on a target in the distance; both eyes will rotate in conjugate in the opposite direction of the head movement.
b. Lack of eye movement indicates an abnormality in the vestibulo-ocular reflex pathway. More discrete pathologies may produce more select eye movement abnormalities.
Prior to performing the oculocephalic reflex, ensure that the patient’s neck is stable (ie, that the patient has not suffered from a cervical spine injury).