Figure 6 Another consequence of otolithic imbalance that accompanies skew deviation is the phenomenon of ocular counterroll

These fundus photographs show the extorsion (upper pole of the eye rotated away from the nose or toward the left shoulder) of the left eye (OS), with the disc-macular line rotated clockwise (according to the examiner), and the right eye (OD) intorted (upper pole of the eye toward the nose or toward the left shoulder) with the macular-disc line rotated clockwise (again, according to the examiner). A lesion within the otolith projections in the medial longitudinal fasciculus at the level of the left medulla (the side of the lower eye) or right pons or midbrain (side of the higher eye) would result in this appearance.