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Vestibulo-ocular reflex

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Caloric testing involves the irrigation of the external auditory meatus with hot (44øC) or cold (30øC) water with the head raised 30ø from the supine position. It produces a temporary nystagmus secondary to convection currents set up in the lateral semicircular canal.

Each ear can be tested separately and is irrigated for 40 seconds with 5 minutes being allowed between irrigations. The time elapsed between the commencement of irrigation and the cessation of nystagmus is recorded.

Ice water ensures a maximal stimulus and is used for testing for brain stem death or head injury prognostication.


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