Which test primarily assesses the vestibulo-ocular reflex?

• A. Rotational testing
• B. Caloric testing
• C. OKN testing
• D. Doll's head maneuver

Answer: (D)

The vestibulo-ocular reflex stabilizes your gaze when the head moves by generating eye movements opposite to the head’s motion. In the Doll's head maneuver, the examiner passively turns the patient’s head while they fixate on a stationary target; if the VOR is intact, the eyes drift in the opposite direction to the head turn to keep the target steady. This isolates the VOR because the movement is purely vestibular-driven, not dependent on visual motion cues. Rotational testing also assesses VOR but involves active head movement and broader vestibular responses; caloric testing stimulates the vestibular system with temperature changes and mainly evaluates canal function at low frequencies; OKN testing measures the optokinetic reflex driven by moving visual stimuli. Therefore, the Doll's head maneuver best targets the vestibulo-ocular reflex.