Chapter 33 - The electrooculogram

Abstract

The electrooculogram (EOG) measures the cornea-positive standing potential relative to the back of the eye. By attaching skin electrodes outside the eye near the lateral and medial canthus, the potential can be measured by having the patient move the eyes horizontally a set distance. The voltage becomes smaller in the dark, reaching its lowest potential after 8-12min, the so-called dark trough. When the lights are turned on, the potential rises, reaching a peak by about 10min. When the size of the light peak is compared to the dark trough, the normal ratio should be near 2:1. A light peak:dark trough ratio of less than 1.7 is considered abnormal. The origin of electrooculographic potentials is the pigment epithelium of the retina interacting with the midretina. The light rise of the potential requires both a normal pigment epithelium and normal midretinal function. The most common use of the electrooculogram is to confirm Best disease. Best disease is identified by the appearance of an egg-yellow fundus and can be confirmed by recording both an electroretinogram (ERG) and electrooculogram (EOG). The ERG will be normal and the EOG will be abnormal. The EOG is also used for tracking eye movement.