• The visually controlled eye tracking systems (saccadic, smooth pursuit, and optokinetic) were compared in 25 young and middle-aged normal subjects (mean age, 42 years), 14 elderly patients with vertebrobasilar insufficiency (VBI) (mean age, 67 years) and 14 elderly normal subjects (mean age, 65 years). The young normal subjects were consistently superior to both elderly groups on all measurements, but there was no significant difference between the performance of patients with VBI and the elderly normal subjects. This study emphasizes the critical importance of taking age into consideration when evaluating saccades, smooth pursuit and optokinetic nystagmus.