What are DOLL EYES?

nurseunderwater · Apr 17, 2004

http://www.mcqs.com/mrcp1/modules.php?name=News&file=article&sid=8

found this....it is a gaze d/o.....eyes move like that of a doll when you move the head...conjugated, fixed.

BRANDY LPN · Apr 17, 2004

Saw this in nursing school and it is freaky, the eyes stay put no matter how you move the head. The pt I saw it in had a head injury....had been a pedestrian in a hit and run. Thats all I remember though, I think that it is a very very bad sign, one that means the head injury can not be treated but am really not sure. The only reason I remember it at all is because it is so weird looking, definately something you will recognize again after you see it once.

redwinggirlie · Apr 17, 2004

These are reflexive movements of the eyes in the opposite direction the head is being moved. Deals with problems with brain stem function. When you see Doll's eye negative, the eyes are fixed.That's the brain stem problem.... Doll's eye present is a normal response and that's when the eyes move in the opposite direction.

TweetiePieRN · Apr 17, 2004

redwinggirlie said:
These are reflexive movements of the eyes in the opposite direction the head is being moved. Deals with problems with brain stem function. When you see Doll's eye negative, the eyes are fixed.That's the brain stem problem.... Doll's eye present is a normal response and that's when the eyes move in the opposite direction.

So basically when dolls eye is present this is a good thing. No doll's eye...it's bad!! Is that correct?

deab · Apr 17, 2004

TweetiePieRN said:
My nursing student friend mentioned to me something called "Doll's Eye syndrome". Can someone explain what this is??

Doll's eyes - a maneuver designed to determine if the eye movement control centers in the brainstem are working. If you take a comatose patient and gently roll the head side to side, it is a good sign if the eyes move opposite to the head (like a baby doll). That means the vestibular system is working and a reflex eye movement is working. However, if the eyes just stay fixed with respect to the head, that isn't such a good sign. Again, that is a test to assess the function of brainstem.

Hope this helps!!

TweetiePieRN · Apr 17, 2004

A Big thank you goes out to all of you who have replied!! :)

gwenith, BSN, RN · Apr 17, 2004

Doll's eye reflex is more correctly called the oculocephalic reflex. It is where rotation/flexion of the of the head cause transient eye movement in the opposite direction (Lindsay, Bone and Callander 1997 Neurology and Neurosurgery Illustratedp 30)

Doll's eye reflex is only seen on unconscious patients and it only shows brain stem functioning so depending on the patient it can be a good sign - not good when it is the only sign still intact.

sharann, BSN, RN · Apr 17, 2004

Just make sure they've been cleared for C-spine injuries before testing for Doll's Eyes!

gwenith, BSN, RN · Apr 17, 2004

Good point Sharann - suspicion of c-spine injury always goes hand in hand with head injury. Even Hickey (the long time bible of neuro nursing) states that doll's eye reflex should be performed by a medical practitioner.

TinyNurse, RN · May 20, 2004

wow as a new grad i had my first dolls eyes last week......

turn the pateints head and the eyes don't move opposite.

The doc was with me the entire time and said it........ finally as a new grad i saw it.........

UK2USA · May 21, 2004

In the UK the Doll's Eye test is one of the tests that we make to ascertain brain stem death.