Using high level technology (infrared goggles- Vestitest) our Physiotherapist is trained to assess subtle movements of the eye in reaction to certain clinical tests. These movements (Nystagmus) arise when there is an imbalance in the Vestibular/Inner Ear System. Your Vestibular System is responsible for keeping your eyes and gaze steady, especially during head movements. So if your Vestibular System is imbalanced (one side damaged/affected) your eyes can slightly drift towards the 'affected' side. Your brain then 'centrally compensates' to correct this and in turn your eyes 'flick' back to the center. This 'flick' back is what is most obvious during the Nystagmus observation. There are many different patterns of Nystagmus E.G. horizontal, torsional, vertical, in all different directions, and these can be in numerous combinations. Nystagmus are the key to diagnosis as certain patterns represent specific Vestibular or Central Disorders. 

Many clinicians assess the 'Dizzy Patient' without use of such technology, or means of removing visual fixation. Your brain very quickly compensates to these eye movements and lessens their intensity. Meaning that without infrared goggles key spontaneous, position or gaze nystagmus can be missed. Potentially leading to misdiagnosis and treatment.