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Oculomotor Dysfunction

This can be divided into two main categories: smooth pursuit eye movements and saccadic eye movements. Smooth pursuit eye movements are those movements that allow for tracking of a moving object in space.  There are many tests available to determine if these movements are adequate.  Poor smooth pursuit eye movements are characterized by jerky, quick re-fixations to “catch up” to the moving object, a back and forth “flicking” motion when tracking at the midline, moving the head to keep the eyes on the object, and frequent loss of the target with re-fixations. Saccadic eye movements are quick purposeful and accurate movements used to track from one fixed point to another. There are several standardized tests available to determine if these eye movements are adequate. Poor saccadic eye movements are characterized by “undershooting” or “overshooting” the viewed object, skipping lines when reading, skipping words when reading, loss of place when reading, and difficulty copying from a book or the board at school. Subjects with poor ocular motor skills find reading difficult because of skipping words or lines.  The subject may also add words that are not there, and/or add or omit prefixes and suffixes.  Tracking a ball in ball sports is difficult and can result in the ball passing the subject before they react.  Sometimes, they have a diminished ability to point where an object is located. These eye movements are positively affected by vision therapy to become easier, more efficient, and automatic.  Once automatic, concentration to perform these movements is eliminated, and the subject is free to use their brain for higher order functioning.