The VOR: Keeping Your Gaze Steady

  • The VOR is a reflex that stabilizes your gaze during head movements.
  • When you move your head, the VOR moves your eyes in the opposite direction to keep your eyes focused on a fixed point.
  • This is important because the vestibular system (responsible for balance) is much faster than the visual system.

Why is the VOR Important?

  • It allows you to see a clear image while your head is moving (e.g., reading on a train).
  • The visual system is too slow to compensate for head movements on its own.

Modulating the VOR Gain

  • The amount your eyes move with the VOR (gain) can be adjusted.
  • When focusing on a near object, your eyes need to move more to maintain fixation compared to focusing on a distant object.
  • The cerebellum (specifically the flocculus and nodulus) constantly adjusts the VOR gain to optimize gaze stability.

Turning Off the VOR

  • In some situations, you don’t want the VOR to oppose head movements.
  • For example, if you want to look far to the side, you need to move your head and keep your eyes focused within the head (not following the head movement).
  • The cerebellum can turn off the VOR or adjust the gain to zero.

Clinical Applications

  • Testing the VOR is a common way to assess brain function in unconscious patients.
    • Dolls’ eyes: If the VOR gain is fixed at 1 (eyes always move opposite to head movement), it suggests cerebellar damage.
    • No VOR: If the eyes move with the head, it suggests brain stem dysfunction.

Additional Points

  • The cerebellum constantly adapts the VOR throughout the day.
  • Changing glasses requires recalibrating the VOR, which is also controlled by the cerebellum.

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