Patients with horizontal gaze dysfunction complain of horizontal diplopia. When asked to describe their double vision they respond that it is side by side. Volitional horizontal saccadic gaze is controlled in the frontal lobe. Horizontal pursuit gaze is controlled in the occipital lobe (Fig. 10.1). Saccadic gaze goes from fovea to fovea (20/20 to 20/20) with blur in between. Pursuit gaze maintains the fovea on the object of regard, following it with 20/20 acuity. An apt analogy would be a dove hunter walking through a field. He spots a dove and raises his shotgun and sights the dove-that’s the saccade. Following the dove (keeping it on his fovea) prior to shooting is the pursuit movement. Seeing the dove fall (or escape) requires another saccade.