How Infrared Video-Nystagmography Drives Accurate Diagnosis
Many vestibular conditions are paroxysmal: dizziness attacks occur intermittently at home, at work, or during specific head positions. Traditional clinic exams without eye recording often miss the brief burst of nystagmus that reveals exactly which semicircular canal or neural pathway is responsible.
Why Visual Fixation Must Be Removed
The human brain naturally uses visual landmarks (such as room walls or a doctor’s finger) to suppress vestibular nystagmus through cortical fixation pathways. The DizzyDoctor Goggles place the patient in total darkness while illuminated by infrared light invisible to the human eye, unmasking the purest vestibular response.
Key Conditions Evaluated with the Goggles
- Benign Paroxysmal Positional Vertigo (BPPV): Identifies torsional, upbeating, or horizontal nystagmus to pinpoint the posterior, horizontal, or anterior canal, and distinguishes canalithiasis (free-floating otoconia) from cupulolithiasis (adherent otoconia).
- Menière’s Disease: Captures the fluctuating paralytic vs. recovery nystagmus characteristic of endolymphatic hydrops flares.
- Vestibular Migraine: Evaluates central ocular patterns, pursuit abnormalities, and non-fatiguing positional nystagmus.
- Aviation Spatial Disorientation: Used by Dr. Purcell in-flight to record aviator eye movements under multi-axis gravitational transitions and cockpit turbulence.
What to Expect During Your Evaluation
The goggles are placed comfortably over your eyes and secured with an adjustable headstrap. Dr. Purcell or your clinician will guide you through diagnostic positioning maneuvers (such as the Dix-Hallpike and Supine Roll tests). The high-definition infrared eye feed is displayed in real-time, recorded, and reviewed with you during your visit so you can see your own eye movements and understand your diagnosis.
At a glance
- What it records
- Eye movements (nystagmus) during dizziness or positional testing
- How long
- A few minutes per recording, during a visit or an episode
- Preparation
- None beyond skipping eye makeup
- How it feels
- Painless; the goggles block out light so the eyes can be filmed
What to expect
- The goggles fit over your eyes like a lightweight mask and block out room light, so your eyes can't fix on anything.
- Infrared video records your eyes while you sit, lie down, or turn your head into set positions.
- If you have spells at home, the recording can capture what your eyes do during a real episode, which is often the most useful information of all.
- The recording is reviewed with your history and examination rather than on its own.
How to prepare
- Don't wear eye makeup on the day of your visit.
- Bring your glasses if you wear them.
- If you're recording an episode at home, sit or lie somewhere safe before you start, and follow the instructions you were given for sending the video.
These are general guidelines. When your test is scheduled, our office will confirm the instructions for your visit. Never stop a prescribed medication without first asking the clinician who prescribed it.
After the test
There's no recovery time. Your clinician uses the eye-movement pattern to decide on treatment, such as a repositioning maneuver, vestibular rehabilitation, or further testing.
Related conditions
Further reading
- NystagmusMedlinePlus
- Balance disordersNIDCD (NIH)