A patient undergoes dynamic visual acuity (DVA) testing. There is a deterioration of 4 or more lines on the Snellen chart during active head shaking compared to static visual acuity. This finding is most characteristic of:
- A Bilateral peripheral vestibular loss ✓
- B Unilateral peripheral vestibular loss
- C Central vestibular lesion
- D Superior canal dehiscence
Correct answer: A. Bilateral peripheral vestibular loss
Explanation
Dynamic visual acuity tests the vestibulo-ocular reflex (VOR). B loss of 4 or more lines during head movement indicates bilateral vestibular loss, as the VOR cannot stabilize images on the retina during head motion. Unilateral loss typically causes minimal DVA change because the intact side compensates. Central lesions may affect DVA but bilateral peripheral loss produces the most marked deterioration.
Reference: Cummings Otolaryngology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.