• Illustration by Christine Gralapp.
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    Neuro-Ophthalmology/Orbit

    Clinical assessment of vestibular ocular reflex suppression. A, The patient is seated in a swivel chair, fixating on the letters of a near card held at arm’s length. B, If VOR suppression is normal (intact), the eyes maintain fixation on the target as the chair, the patient’s head and arms, and the card rotate together as a unit. C, Conversely, if VOR suppression is impaired, the eyes are dragged off the target during rotation owing to an inability to cancel the VOR. In this example, the chair is rotated to the patient’s right, and the VOR moves the eyes to the patient’s left, prompting a rightward saccade to regain the target; this result likely indicates right cerebellar system pathology.