Vestibulo - ocular Dysfunction in Vertigo: Diagnostic Role of Dynamic Visual Acuity and Outcomes of Rehabilitation

Vestibulo-ocular reflex (VOR) dysfunction contributes to impaired gaze stabilization and postural control in vertigo patients. Dynamic Visual Acuity (DVA) testing serves as a sensitive indicator of VOR integrity. To analyze vestibulo-ocular dysfunction through DVA and correlate its abnormalities with neuro-otological findings and rehabilitation outcomes. This prospective observational study included 27 patients diagnosed with vestibulo-ocular dysfunction between April 2019 and August 2024. All underwent neuro-otological assessment including DVA, Subjective Visual Vertical (SVV), Craniocorpography (CCG), and Video Nystagmography (VNG). Patients with abnormal DVA were enrolled for vestibular rehabilitation therapy (VRT) for 6 months, and improvement was assessed using Dizziness Handicap Inventory (DHI). Out of 27 patients (15 males, 12 females), reduced DVA was observed in 23 (85.2%), static SVV abnormality in 10 (37%), dynamic SVV deviation in 16 (59.3%), and abnormal CCG in 15 (55.6%). Reduced VOR gain correlated significantly with abnormal DVA (p < 0.05). Following 6 months of VRT, mean DHI improved from 42.1 ± 8.2 to 11.3 ± 4.5 (p < 0.01), with 89% reporting symptom resolution. Dynamic Visual Acuity is a sensitive, non-invasive marker for vestibulo-ocular dysfunction. Early identification and structured vestibular rehabilitation significantly improve functional recovery and quality of life.