The Vertigo Recording Goggles (VRG) are a unique system designed to allow a patient the opportunity to use their smart phone in a setting remote from a clinical environment to record their eye movements in “real time” during an attack of disequilibrium or vertigo by accurately performing what is called the Dix-Hallpike Test and the Supine Positional Test. This important data, if collected properly, may allow a physician to better identify why the patient has these episodes of “dizziness”. Video recordings from the goggles may be uploaded to the DizzyDoctor website where additional data regarding eye tracking and head position stability can be presented along with the sequence of video records to the physician at a later time.
The goggles were designed by Dr. Ian Purcell after decades of working with vertigo patients. The most difficult component to managing a “dizzy” patient was seeing the patient during a vertiginous event. As Dr. Purcell was only located in San Diego, California, he had limited access to patients outside of the area. Most of his patients continually had brief or prolonged episodes of vertigo away from the clinic and were often symptom free or normal at the time they presented for evaluation in the clinic. This is a prolonged and confusing diagnostic process. For years, Dr. Purcell and his Otolaryngology (ENT) colleagues discussed the need for remote access diagnosis for their patients. After eight years of research and design, the VRG unit was created.
“This is very exciting for the world of ENT and Neurology because now we can actually collect important video oculography data on patients when they are briefly symptomatic and inaccessible to the clinic. Now we can accurately and systematically look at some of their data and better decide whether their attacks of ‘dizziness’ were from BPPV, Meniere’s disease, migraine, or some cardiogenic/cardiovascular cause. The best part is the patient can utilize their smart phone, which is something everyone has access to”.
The goggles are designed to be an inexpensive, high-tech way to utilize a readily available smart phone to obtain accurate eye movement recordings at the time a patient is dizzy. The goggle unit has a LED illumination system as well as special focusing lenses to obtain a high resolution video recording of the patient’s eye. The DizzyDoctor App uses the iPhones internal gyroscope and verbal commands to accurately direct the patient to the proper head positions in three-dimensional space before they are allowed to record their eye movements. The DizzyDoctor App also uses the iPhone’s 6 axis gyroscope to collect head movement data during the recording session to verify the patient’s head was held relatively still while saving eye movement data. This is very important because normal rhythmic eye movements and vestibular ocular reflexes that are generated when the patient moves their head in space may accidently be interpreted as abnormal if this data set was not also presented to the interpreting physician.
The patient is often given the VRG unit by their physician and told to download the DizzyDoctor application onto their iPhone. At the time they are experiencing a “dizzy” attack, they may clip their iPhone into the goggle unit and begin recording their data. “The nice thing is the patient can be traveling in Paris, France and obtain a video recording data set below the Eiffel tower on a park bench if needed” says Dr. Purcell.
The DizzyDoctor® System 1.0.0 Eye Movement Monitor is indicated for use in the medical office, and in the home setting for monitoring patients with a diagnosis of dizziness caused by peripheral vestibular disorders who are under the supervision of a physician. The device detects abnormal eye movements in response to standard positional maneuvers by recording, tracking, storing and displaying vertical, horizontal and torsional eye movements. This device provides no diagnosis and does not provide diagnostic recommendations.
Dizziness and postural instability are common in patients in Otolaryngology practice. Accurate diagnosis and choice of treatment is hampered by difficulties in obtaining thorough histories and perceptions that physical examination is complex. The DizzyDoctor® System 1.0.0 broadens physician access to video recordings of abnormal eye movement disorders with an easily operated device for in-office use by health professionals and for in-home use by patients experiencing exacerbating episodes of dizziness outside the office setting.
Using mobile and web-based technology, The DizzyDoctor® System 1.0.0 allows recording of patient of abnormal eye movements in response to standard head positions used for monitoring peripheral vestibular disorders such as Benign Paroxysmal Positional Vertigo. It consists of Vertigo Recording Googles (VRG) with a secure holder for the patient’s iPhone, an iPhone Application for step-by-step audio instructions for medically-recognized Dix-Hallpike maneuvers, gyroscopic feedback for enabling correct head positioning, and accurate video-recording of eye movements in response to standard head positions used for assessing balance disorders. The VRG secure docking station for the iPhone which aligns with the patient’s pupil. The VRG has no direct electrical connection with external devices or equipment, and uses light from two LEDs during recording sessions. The VRG uses a standard iPhone compatible macro lens to adjust the focal length of the iPhone camera lens, and secures with a flexible headband. Key components of the patient’s iPhone support the DizzyDoctor® System 1.0.0 including: an accelerometer and gyroscope, a video camera, storage of video recordings, audio voice/speaker system for real-time interaction with the patient, standard software for downloading and playing mobile applications from external App vendors, software for web-based processes including uploading stored videos. The DizzyDoctor® Mobile App provides audio support for step-by-step procedures in recording eye movements in relation to positional changes during self-testing, The DizzyDoctor® System is supported by a comprehensive web-based platform for secure patient and physician registration, as well as uploading, processing and downloading videos from the professional- and self-testing for abnormal eye movements. Processed videos are accessed and viewed by physicians on their desk-top office computers.
This device does not provide a medical diagnosis. In conjunction with other tests, the DizzyDoctor System provides the user's doctor with important diagnostic information that may be helpful in understanding the cause of dizziness.