The advantage of VOG skew testing
Thanks to their ease of use and reproducibility, automated systems do
not rely on expert knowledge and can thus be used by non-specialists
reliably. Although the APCT is a fast and effective clinical exam for
the semi-quantitative detection of eye misalignment, it has the
disadvantage of being highly dependent on the examiner’s
experience,5 thus leading to high interrater
variability.5
Such clinical tests are also time consuming and the patients’
cooperation might be limited because of dizziness and nausea. Experts,
familiar with eye movement examinations, however, might not benefit as
much as non-experts from an automated system, unless the automated skew
test is part of a comprehensive battery of other vestibular tests
integrated into one and the same device like the one we evaluated here.
There are other clinical signs associated with skew deviation in dizzy
patients such as ocular counterroll detected by
fundoscopy,19 subjective visual
vertical,17 the maddox rods,18,19 or
by the Hess-Lancaster test and Parks-Bielschowsky
test.19 Such additional tests performed by experts
could add more diagnostic certainty in patients with suspected skew
deviation.