The video ocular counter-roll (vOCR): a clinical test to detect loss of otolith-ocular function

Jorge Otero-Millan, Carolina Treviño, Ariel Winnick, David S. Zee, John P. Carey, Amir Kheradmand

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Conclusion: vOCR can detect loss of otolith-ocular function without specifying the side of vestibular loss. Since vOCR is measured with a simple head tilt maneuver, it can be potentially used as a bedside clinical test in combination with video head impulse test. Objective: Video-oculography (VOG) goggles are being integrated into the bedside assessment of patients with vestibular disorders. Lacking, however, is a method to evaluate otolith function. This study validated a VOG test for loss of otolith function. Methods: VOG was used to measure ocular counter-roll (vOCR) in 12 healthy controls, 14 patients with unilateral vestibular loss (UVL), and six patients with bilateral vestibular loss (BVL) with a static lateral head tilt of 30°. The results were compared with vestibular evoked myogenic potentials (VEMP), a widely-used laboratory test of otolith function. Results: The average vOCR for healthy controls (4.6°) was significantly different from UVL (2.7°) and BVL (1.6°) patients (p < 0.0001). The vOCR and VEMP measurements were correlated across subjects, especially the click and tap oVEMPs (click oVEMP R = 0.45, tap oVEMP R = 0.51; p < 0.0003). The receiver operator characteristic (ROC) analysis showed that vOCR and VEMPs detected loss of otolith function equally well. The best threshold for vOCR to detect vestibular loss was at 3°. The vOCR values from the side of vestibular loss and the healthy side were not different in UVL patients (2.53° vs 2.8°; p = 0.59).

Original languageEnglish (US)
Pages (from-to)593-597
Number of pages5
JournalActa Oto-Laryngologica
Issue number6
StatePublished - Jun 3 2017


  • OCR
  • VOG
  • clinical test
  • ocular counter-roll
  • otolith
  • vestibular
  • video-oculography

ASJC Scopus subject areas

  • Otorhinolaryngology


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