Become a Resus Member for FREE! Get access to Resus learning resources and learn about upcoming events SUBSCRIBE [email protected]

The Oculocephalic Reflex

Advertise Your Event

Do you have an upcoming event that your would like to share with colleagues? We would love to hear from you!

Click on the “contact” button below, fill out the details in the pop-up and hit “submit”.

Subscribe to Resus

Get the latest updates on our Conferences PLUS our Webcasts and Education Newsletters. And it's FREE!

  • We respect your privacy
  • This field is for validation purposes and should be left unchanged.

Register Now:

The Primary Exam
Learn More
Emcore
Learn More

What is the Oculocephalic Reflex and how do you use it?

This reflex is brainstem mediated and keeps the eyes looking straight ahead when the head is turned, in an unconscious patient. It’s a test to use on the unconscious patient to see if the brainstem is intact.

The best way to remember this is by thinking of doll’s eyes. It is in fact called the doll’s eye reflex. The old dolls used to have the eyes painted on, so that when you turned the head, the eyes moved with the head. This would indicate that the brainstem was not intact. The more modern dolls have eyes that move back towards the centre, when the head is turned.

The reflex is mediated by three cranial nerves VIII, III and VI.

When the head is turned to one side, the semicircular canals pick up this movement and send a signal via CN VIII to the medial vestibular nucleus, which then sends a signal via the ipsilateral CNIII to the medial rectus muscle and via the contralateral CNVI to the lateral rectus muscle. So when the head is turned to one side, the eyes move in the opposite direction to face the centre.

The way to perform this test in the unconscious patient, is to hold the head(assuming no cervical injury), with eyes held open. The head is turned rapidly to one side. The eyes will move in a smooth motion to the centre, i.e.., looking forward. If they do not and continue to look sideways; it indicates that the brainstem is not intact ie., a possible poor outcome.

admin

Leave a Comment