I recently made a bold claim: You cannot holistically assess vestibular dysfunction without understanding ocular motility. Today, we start building that foundation. Part 1 of our 5-part series begins where all eye movement understanding must begin: How do the eyes actually move together? We’re building toward understanding why posterior canal BPPV creates “upward” nystagmus when […]

Click here to get the ‘Part 5: BPPV Nomenclature is Canal-Based — NOT Muscle Based’ handout The posterior canal connects to the ipsilateral Superior Oblique (SO) and contralateral Inferior Rectus (IR) — muscles that pull the eye DOWN. So why does posterior canal BPPV produce UPbeating nystagmus? If you’ve ever paused mid-explanation, trying to reconcile muscle […]

Click here to get the ‘PIVC Activation Paradox’ handout A colleague called a couple of nights ago to discuss an article she was reading and brainstorm about activities that activate versus suppress the peri-insular vestibular cortex (PIVC). Her curiosity derailed my plan to post “Part 5” of my EOM educational series —because the conversation focused on […]

Click here to get the ‘Neural Asymmetry & The Recovery Paradox’ handout We’ve explored the VOR—how semicircular canals drive compensatory eye movements through elegant push-pull dynamics. But here’s what the anatomy lesson doesn’t tell you: When peripheral vestibular function is lost, how much of VOR recovery actually comes from the periphery healing? In patients with […]

Click here to get the ‘Semicircular Canal Influence – The VOR Connection’ handout In Parts 1 and 2, we built the foundation: conjugate gaze and how individual muscle actions combine into synergistic patterns. Now the payoff: why the vestibular system cares about all of this. The VOR isn’t random. It exploits the exact same muscle […]

Click here to get the ‘From Primary Cranial Nerve Actions to Functional Synergistic Patterns’ handout We learn the extraocular muscles one at a time. Clean. Organized. Easy to memorize. But here’s the reality: our patients don’t functionally move one muscle at a time. When your patient looks up, each eye fires both its Superior Rectus […]

Click here to access the handout for full educational breakdown in the attached Ever notice how your patients with autonomic dysfunction seem to have “tunnel vision” — not ophthalmologically, but functionally? There’s a reason. I’m in the middle of a series on extraocular muscles, cranial nerves, and VOR connections. But I wanted to pause and share […]

Click here to access the handout – a deeper dive into the primary extraocular muscle actions and how conjugate gaze creates the compass foundation for clinical assessment I recently made a bold claim: You cannot holistically assess vestibular dysfunction without understanding ocular motility. Today, we start building that foundation. Part 1 of our 5-part series […]

The APTA’s recent Vestibular Rehabilitation Practice Guideline states clearly: “Vision training is not VRT.” And I completely agree. But here’s the challenge: that statement has led some clinicians to question why our education—including Certificate of Competency in Vestibular Rehabilitation (CCVR) 3.0 Course—embraces such an in-depth understanding of ocular motility beyond nystagmus assessment. Here’s my answer: […]