Eye Movements

Vertigo is a form of dizziness which can result in a loss of balance, a feeling of falling, trouble walking or standing, or nausea. There is more than one type of vertigo, each with a different cause, and sometimes requiring different treatment. Now a proof of concept study has found that special goggles that measure eye movements during an episode of vertigo may help more accurately diagnose which type of vertigo a person has.

Accurate diagnosis is important

The study is publish in the May 15, 2019, online issue of Neurology, the medical journal of the American Academy of Neurology. Vertigo can be a disabling condition, so an accurate diagnosis is important to effectively treat and stop the vertigo as soon as possible,” said study author Miriam S. Welgampola, MD, Ph.D., of the University of Sydney in Australia and a member of the American Academy of Neurology.

Observing a person’s eye movements during an episode can help make the diagnosis, but people don’t always have an episode when they are at the doctor’s office. For the study, researchers gave participants a pair of video-oculography goggles that record the uncontroll eye movements that accompany vertigo.

The study involve 117 people who had previously diagnose; so with one of three conditions that cause vertigo. Of the group, 43 people had Meniere’s disease; so an inner ear disorder that can affect hearing and balance; so 67 had vestibular migraine that can cause vertigo but may not cause a headache, and seven had benign paroxysmal positional vertigo, one of the most common causes of vertigo, where a person’s head movements trigger the episodes.

Goggles to record video

Researchers taught each participant how to use the goggles; so to record video of their eye movements at home whenever they had a vertigo episode. Eye movements that accompany vertigo are repetitive and uncontrolled; also the eyes can move side to side, up and down or around in circles.

For the majority of people with Meniere’s disease who had fast horizontal eye movements; so the goggles were able to diagnose the type of vertigo accurately with a sensitivity of 95% and a specificity of 82%. Sensitivity is the percentage of actual positives that are correctly identify as positive. Specificity is the percentage of negatives that are correctly identified. By comparison, audio tests for Meniere’s disease have both a sensitivity and specificity of 91%.

While further studies are need in larger groups; so providing people with a pair of goggles that they can easily use at home; so to record eye movement has the potential to help with vertigo diagnosis not only by a neurologist in a clinic; but also by physicians in an emergency room and physicians diagnosing patients remotely as well, said Welgampola.

Limitations of the study include that some participants did not feel well enough to wear the goggles; sowhen experiencing vertigo. Additionally, others did not wear them when they thought their vertigo was too mild. Also, some medications taken for vertigo may have influence eye movement.