WHAT ARE INFRARED VIDEO GOGGLES?
Infrared video goggles, sometimes referred to as “video frenzel goggles”, have been used in research and clinical practices since the 1970’s to make examination of a dizzy vestibular patient more effective by allowing a clinician to see eye movements that are often suppressed in room light. The patient wearing the goggles only sees darkness. This is also clinically known as visual fixation removed since the patient cannot see any object upon which they could fix their gaze. At the same time, the infrared cameras inside the goggles (one in front of each eye) allow the clinician to view the patient’s eyes via a computer or laptop screen.
How infrared light works: An infrared camera (also known as night vision) is a device that forms an image using infrared radiation, just as a traditional camera forms an image using visible light. Instead of the normal range of the visible light camera, infrared cameras utilize wavelengths at 940 nanometers in length. This invisible-to-the-eye light is what allows the infrared camera to sense and then have the connected screen display the patient’s eyes while they are in the dark inside the goggles.
How goggles improve diagnosis and treatment: When visualized via an infrared camera with visual fixation removed, specific eye movements can allow for a more efficient and accurate diagnosis and so lead to the best treatment for vestibular treatments, rather than a “best guess.” Effective treatments can get your patients better faster, and happy patients lead to repeat clientele and excellent word of mouth reports. You, your patients, and your company – everyone benefits!
Vestibular Technologies Comparison
|Insight Infrared Video Goggles||Other Infrared Goggles||Frenzel Goggles|
|Equipment and Training Requirements||
|Portability||Small, light, and portable - can move between treatment rooms, hospital rooms or ER, doctor’s office exam rooms, or in and out of patients’ homes as needed||Most not easily portable - stationary single room setup for an outpatient clinic; not designed for use in hospital rooms, ER, or patient’s homes||Small and portable with battery use; room must be dark for use, limiting utility in certain settings e.g. ER unless in private room|
|Camera Features||Dual cameras come standard and allows for viewing of one or both eyes per viewer preference||Single and dual camera systems are available; dual cameras are newer and more expensive||Thickened lenses utilized instead of camera for viewing, so visual fixation not fully removed|
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Visualizing Eye Movements
The primary use of infrared video goggles is to see a close-up image of the patient’s eye. While using infrared video goggles, you may see brisker and/or a greater variety in types of eye movements than you are used to seeing if your prior vestibular exams have been done in room light.
Refer to your vestibular education resources from prior education/courses and use mentorship, including online resources such as social media groups of experienced vestibular therapists if in-person mentorship is less available to you, to continually get feedback and refine your skill at interpreting various eye movements.
The articles listed below demonstrate how infrared video goggles and related technologies have been used in the diagnosis and treatment of vestibular disorders.
- Baba S, Fukumoto A, Aoyagi M, Koizumi Y, Ikezono T, Yagi T. (2004). A Comparative Study on the Observation of Spontaneous Nystagmus with Frenzel Glasses and an Infrared CCD Camera. Journal of Nippon Medical School. 71 (1): 25-29. Full text: https://www.jstage.jst.go.jp/article/jnms/71/1/71_1_25/_pdf/-char/en
- Gananca M, Caovilla H, Gananca F. (2010). Electronystagmography versus videonystagmography. Brazilian Journal of Otorhinolaryngology (Impr.). 76 (3): 399-403. Full text: http://www.scielo.br/pdf/bjorl/v76n3/en_v76n3a21.pdf or http://www.scielo.br/scielo.php?pid=s1808-86942010000300021&script=sci_arttext&tlng=en
- Hain T. “Frenzel goggles.” Dizziness and Balance. Chicago Hearing and Balance, 3 August 2016. Web. Accessed 12 April 2018.
- Huh YE, Kim JS. (2013). Bedside evaluation of dizzy patients. Journal of Clinical Neurology. 9 (4): 203-213. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840130/
- Kattah JC, Talkad AV, Wang DZ, Hsieh YH, Newman-Toker DE. (2009). HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging. Stroke. 40(11): 3504-3510.
- Klaus J, Strupp M, Siegbert K, Schuler O, Glasauer S, Brandt T. (2002). Suppression of eye movements improves balance. Brain. 125 (9): 2005-2011.
- Newman-Toker DE, Curthoys IS, Halmagyi GM. Diagnosing stroke in acute vertigo: the HINTS family of eye movement tests and the future of the “Eye ECG.” Seminars in Neurology. 35 (5): 506-521.
- “Nystagmus.” American Optometric Association. American Optometric Association, 2018. Web. Accessed 12 April 2018.
- Ruckenstein MJ, Shepard N. (2000). Balance function testing: a rational approach. Practical Issues in the Management of the Dizzy and Balance Disorder Patient. 33 (3): 507-517.
- Shepherd N. (2009). Signs and symptoms of central vestibular disorders. American Speech-Language-Hearing Association. https://www.asha.org/Articles/Signs-and-Symptoms-of-Central-Vestibular-Disorders/ Accessed 12 April 2018.
- Stern RM, Hu S, Anderson RB, Leibowitz HW, Koch KL. (1990). The effects of fixation and restricted visual field on vection-induced motion sickness. Aviation Space and Environmental Medicine. 61 (8): 712-715.
- Webb NA, Griffin MJ. (2002). Optokinetic stimuli: motion sickness, visual acuity, and eye movements. Aviation Space and Environmental Medicine. 73 (4): 351-358.
Vestibular Course Providers
|Organization||Course Topics||Format||Level||Credentials||Organization Name|
|360 Neuro Health||Rehabilitation; Concussion||In-Person Courses||Basic; Intermediate; Advanced||PT; OT; Aud||360 Neuro Health|
|American Academy of Audiology||Healthcare||Conference||Basic; Intermediate||Aud||American Academy of Audiology|
|American Academy of Otolaryngology||Healthcare||Conference||Intermediate; Advanced||MD; DO||American Academy of Otolaryngology|
|American Institute of Balance||Rehabilitation; Concussion; Cervicogenic||Online Courses; In-Person Courses||Basic; Intermediate||PT; Aud; MD; DO; PA; NP; OT||American Institute of Balance|
|APTA - Academy of Neurologic Physical Therapy||Rehabilitation; Concussion||In-Person Courses||Basic; Intermediate; Advanced||PT; OT||APTA - Academy of Neurologic Physical Therapy|
|APTA - Academy of Neurologic Physical Therapy Conference||Rehabilitation; Concussion; Pediatric||Online Courses||Basic; Intermediate; Advanced||PT; PTA||APTA - Academy of Neurologic Physical Therapy Conference|
|APTA - Combined Sections Meeting||Rehabilitation; Concussion; Pediatric||In-Person Courses||Intermediate; Advanced||PT||APTA - Combined Sections Meeting|
|APTA - University of Pittsburgh||Rehabilitation||In-Person Courses||Intermediate; Advanced||PT; OT; MD; DO; Aud; PA; NP||APTA - University of Pittsburgh|
|Association of Migraine Disorders||Healthcare||Conference||Intermediate; Advanced||MD; DO; PA; NP||Association of Migraine Disorders|
|Audiology Online||Healthcare||Online Courses||Basic; Intermediate; Advanced||Aud||Audiology Online|
|Carrick Institute||Chiropractic Care||In-Person Courses||Basic; Intermediate; Advanced||DC||Carrick Institute|
|Combined Otolaryngolgy Spring Meetings||Healthcare||In-Person Courses||Intermediate||MD; DO||Combined Otolaryngolgy Spring Meetings|
|Dizziness and Balance Rehabilitation Clinic in Canada||Rehabilitation; Concussion||In-Person Courses||Basic; Intermediate; Advanced||PT; OT; MD; DO; DC||Dizziness and Balance Rehabilitation Clinic in Canada|
|Education Resources, Inc.||Rehabilitation; Concussion; Cervicogenic; Pediatric||In-Person Courses; Online Courses||Basic; Intermediate; Advanced||PT; PTA; OT; OTA; Aud||Education Resources, Inc.|
|Elite Rehabilitation Solutions||Rehabilitation; Concussion||In-Person Courses; Online Courses||Basic; Intermediate||PT||Elite Rehabilitation Solutions|
|Emory University Competency Based Course||Rehabilitation||In-Person Courses||Intermediate; Advanced||PT; OT; MD; DO||Emory University Competency Based Course|
|EvidenceCEU||Rehabilitation; Concussion; Cervicogenic||In-Person Courses; Online Courses||Basic; Intermediate; Advanced||PT; PTA||EvidenceCEU|
|Functional Neurology Seminars||Chiropractic Care||Online Courses||Intermediate; Advanced||DC||Functional Neurology Seminars|
|Great Lakes Seminars||Rehabilitation||In-Person Courses||Basic||PT||Great Lakes Seminars|
|Healing Vertigo||Rehabilitation; Concussion||Online Courses||Basic; Intermediate||PT; OT; Aud||Healing Vertigo|
|Healthclick||Rehabilitation; Concussion||In-Person Courses; Online Courses||Basic; Intermediate; Advanced||PT; PTA; OT; OTA||Healthclick|
|International Association of Functional Neurology and Rehabilitation||Chiropractic Care||Conference||Basic; Intermediate; Advanced||DC||International Association of Functional Neurology and Rehabilitation|
|International Symposium on Clinical Neuroscience||Chiropractic Care||Conference||Intermediate; Advanced||DC||International Symposium on Clinical Neuroscience|
|International Vestibular Conference||Healthcare; Rehabilitation||Conference||Intermediate; Advanced||PT||International Vestibular Conference|
|Johns Hopkins Medicine||Healthcare||In-Person Courses||Advanced||MD; DO||Johns Hopkins Medicine|
|Mayo School of Continuous Professional Development||Healthcare||Conference||Intermediate; Advanced||MD; DO||Mayo School of Continuous Professional Development|
|Medbridge||Rehabilitation||Online Courses||Basic; Intermediate||PT; PTA; OT; OTA||Medbridge|
|Motivations, Inc.||Rehabilitation; Pediatric||In-Person Courses||Basic; Intermediate||PT; PTA; OT||Motivations, Inc.|
|Noesis Therapy Seminars||Concussion; Rehabilitation||In-Person Courses; Online Courses||Basic; Intermediate; Advanced||PT; OT; DC; Aud; PA; PTA; OTA||Noesis Therapy Seminars|
|North 49 Therapy||Rehabilitation||Online Courses; In-Person Courses||Basic; Intermediate||PT||North 49 Therapy|
|OTcourses.com||Rehabilitation||Online Courses||Basic; Intermediate; Advanced||OT; OTA||OTcourses.com|
|PESI Rehab||Rehabilitation||In-Person Courses||Basic; Intermediate||PT; PTA; OT; OTA; MD; DO; Aud||PESI Rehab|
|Posture and Balance Concepts||Rehabilitation||In-Person Courses||Basic; Intermediate||PT; PTA; OT; OTA||Posture and Balance Concepts|
|Shirley Ryan Ability Lab Academy||Rehabilitation||In-Person Courses||Basic; Intermediate||PT; PTA; OT; OTA||Shirley Ryan Ability Lab Academy|
|Skill Works||Rehabilitation; Cervicogenic||In-Person Courses||Basic; Intermediate||PT||Skill Works|
|Specialty Therapy||Rehabilitation; Pediatric||In-Person Courses||Basic; Intermediate; Advanced||PT; PTA; OT; OTA||Specialty Therapy|
|St. Joseph's/Candlar Center for Oto-Neurology||Healthcare||In-Person Courses; Online Courses||Intermediate||MD; DO; Aud||St. Joseph's/Candlar Center for Oto-Neurology|
|Summit Professional Education||Rehabilitation||Online Courses||Basic||PT; PTA; OT; OTA||Summit Professional Education|
|Therapy Insights||Rehabilitation||Online Courses||Basic; Intermediate||PT; OT; OTA; PTA||Therapy Insights|
|Therapy Network Seminars||Rehabilitation||In-Person Courses||Basic; Intermediate||PT; PTA; OT; OTA||Therapy Network Seminars|
|Topple Diagnostics||Rehabilitation||Online Courses; In-Person Courses||Basic||PT; OT; Aud; NP; PA||Topple Diagnostics|
|University of Manchester||Healthcare||Online Courses||Intermediate; Advanced||Aud||University of Manchester|
|University of Pittsburgh||Rehabilitation; Concussion; Cervicogenic||Online Courses; In-Person Courses||Advanced||PT||University of Pittsburgh|
|Vestibular Today||Rehabilitation||In-Person Courses; Online Courses||Basic; Intermediate||PT; PTA; OT; OTA; Aud||Vestibular Today|