Many clients call to discuss “Frenzel tests” in Kelowna if they’ve been experiencing vestibular issues such as dizziness or imbalance. Frenzel Goggles have been around since the 1950s and Infrared Video Goggles, sometimes referred to as “Video Frenzel Goggles”, have been used in research and clinical practices since the 1970s. Whether using Frenzel Google or Video Frenzel Googles, the healthcare professional examines a dizzy vestibular patient by observing their eye movements.

Obviously, the Video Frenzel Goggles are a step up in technology from the basic Frenzels. When using the video version, a clinician can see eye movements often suppressed in room light. The patient wearing the goggles only sees darkness, 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.

But what if we could take this type of testing even further? At Lakeside Hearing, we can. Our clients are often astounded by how much. We take vestibular health seriously. Since 1999, we have continued to build our services and programs in Tinnitus, Balance, and Hearing utilizing the knowledge of our staff which includes certified audiologists, counsellors, and physiotherapists. By combining these health professionals and the latest in vestibular technology, we can deliver a unique testing experience and more precise diagnosis.

Our vestibular health professionals explain the differences in testing options to ensure you have the best information to make a good healthcare decision and, more importantly, receive the diagnosis you need.

BASIC FRENZEL GOGGLES VS INFRARED VIDEO FRENZEL GOGGLES

Frenzel goggles range in capabilities and price. Basic Frenzel goggles light and magnify the eyes for observation and are typically used for evaluating patients with vestibular disorders and are not used as a diagnostic tool.

Basic Frenzel goggles do not track the eyes, produce tracings of the eye movements, or generate a report of any kind. However, the clinician can observe nystagmus as the patient undergoes various tests. Nystagmus is an involuntary rhythmic side-to-side, up and down or circular motion of the eyes that occurs in various conditions.

Infrared Video Frenzels have one or two cameras to help observe and record eye movements and are used as a balance assessment and vestibular rehabilitation tool, especially in administering various repositioning procedures to treat certain types of vertigo.

Video Frenzels allow the technician to record a video file of eye movements for a reference point during and post-therapy, including specific repositioning procedures. Video Frenzels provide far better capabilities than Basic Frenzels for more positive vestibular rehab outcomes.

With some Video Frenzels, you can record and project the image of the patient’s movements onto a wall-mounted monitor or on the laptop in real-time for improved patient treatment. They may also include audio recording features so the technician can see and hear the commands to review the session at a later time. As with basic Frenzel goggles, Video Frenzels do not produce any report, only video (and sometimes audio) files of the patient encounter.

Videonystagmography (VNG) technology is the gold standard for vestibular diagnostics. 

A VNG test uses upgraded goggles and infrared cameras and is by far the most expensive option, and for good reason. The eye-tracking software is highly complex, and the hardware costs are much higher than the technology used for Video Frenzels.

VNG tracks and records eye movements and nystagmus as a diagnostic tool, significantly reducing time-consuming manual reports, which can also be subject to human error. Using a complex algorithm, the device plots the results in reports where our qualified healthcare professionals can then interpret the information to reliably diagnose vestibular or central nervous system CNS issues.

What Does a VNG Test?

Videonystagmography (VNG) is a test that measures a type of involuntary eye movement called nystagmus. These movements can be slow or fast, steady, or jerky. Nystagmus causes your eyes to move from side to side, up and down, or both. It happens when the brain gets conflicting messages from your eyes and the balance system in the inner ear. These contradictory messages can cause dizziness.

A VNG evaluation does three things:

• Tests the visual pathways to the brain
• Evaluates the function of the equilibrium system in each inner ear,
• Provides information on how these systems work together for the body to be “in balance.”

You can briefly get nystagmus when you move your head a certain way or look at some types of patterns. But if you get it when you don’t move your head or if it lasts a long time, it may mean you have a disorder of the vestibular system.

Your vestibular system includes organs, nerves, and structures in your inner ear. It is your body’s main center of balance. The vestibular system works with your eyes, sense of touch, and brain.

Do I need a VNG?

You may need a VNG test if you have symptoms that could point to an inner ear disorder, such as:

• Balance problems
• Dizziness
• Feelings of pressure or fullness in your ears
• Light-headedness
• Tinnitus (ringing or buzzing in your ears)
• Vertigo

What happens during a VNG?

A VNG at Lakeside Hearing is performed by our audiologists, health care providers specialising in diagnosing, treating, and managing hearing loss.

During a VNG test, you sit in a dark exam room wearing a special set of goggles. The goggles house a camera that records your eye movements. Your audiologist asks you to watch lights moving on a TV screen or move your head and body in certain positions. The audiologist may also send small bursts of warm or cold water or air into your ears. The goggles record how your eyes move in response to these different actions.

There are three main parts to a VNG:

• Ocular testing. You will watch and follow moving and non-moving dots on a light bar.
• Positional testing. Your audiologist will move your head and body in different positions and check if this movement causes nystagmus.
• Caloric testing. Warm and cool water/air is placed in each ear. Cold water or air entering the inner ear should cause nystagmus. The eyes should then move away from the cold water in that ear and slowly back. When warm water or air enters the ear, the eyes should move slowly toward that ear and back. If the eyes don’t respond in these ways, it may mean damage to the inner ear’s nerves. Your audiologist will also check to see if one ear reacts differently from the other. If one ear is damaged, the response will be weaker than the other, or there may be no response.

A VNG test usually lasts around 60 minutes.

Will I need to do anything to prepare for a VNG?

Your audiologist will give you specific instructions to prepare for a VNG test. Most people don’t need to do anything special. Please tell us about all medications and supplements you take. You may have to stop taking certain medicines briefly before the test.

Are there any risks to a VNG?

The test may make you feel dizzy for a few minutes. Consider making arrangements for someone to drive you home in case the dizziness lasts for a more extended period.

What do the results mean?

If the results are not normal, it may mean you have a disorder of the inner ear such as:

• Meniere’s Disease; a disorder that causes dizziness, bouts of hearing loss, and tinnitus (ringing in the ears). It usually affects only one ear. Although there is no cure for Meniere’s Disease, it can be managed with medicine and/or changes in your diet.
• Labyrinthitis; a disorder that causes vertigo and imbalance caused when a part of the inner ear becomes infected or swollen. The condition sometimes goes away, but you may be prescribed antibiotics if diagnosed with an infection.
• Acoustic neuroma; a benign tumour that develops on the balance (vestibular) and hearing or auditory (cochlear) nerves leading from your inner ear to the brain,
• Benign paroxysmal positional vertigo (BPPV); one of the most common causes of vertigo — the sudden sensation that you’re spinning or that the inside of your head is spinning.
• Vestibular neuritis; a condition that affects the vestibular nerve, which connects the inner ear to the brain, causing prolonged vertigo, usually in the absence of significant hearing loss.

An abnormal result may also mean you have a condition that affects the parts of the brain that helps control your balance.

Lakeside Hearing audiologists and other team members are always here to answer your questions before, during or after a

. Whether you suffer from dizziness, vertigo, poor balance, brain fog, unsteadiness or motion sensitivity, our experienced vestibular audiologists at Lakeside Hearing, Balance, and Tinnitus can help.

We’re here to help you throughout your hearing health journey, from hearing assessments, hearing protection, hearing aids and hearing accessories, plus so much more!