Insight
September 2015

Studies show that $1 billion is wasted each year on unnecessary tests and hospital admissions for people with dizziness who are suspected of having a stroke but who actually have benign inner ear problems. On the other hand, about 40,000 to 70,000 patients have strokes each year that are initially missed when they come to the emergency room presenting dizziness.

To differentiate stroke from other conditions that cause dizziness, neurologist David Newman-Toker devised a technique that looks for minute differences in eye movements.

A 2009 study showed that the test can outperform more standard clinical tests for stroke, including an MRI or CT scan, but they come with a drawback. “Learning to administer these tests correctly requires months to years of mentorship and can be extremely difficult, even for specialists,” he says.

To automate the process, Newman-Toker turned to video-oculography. While researchers and physicians have been using the approach for years to diagnose balance issues, it has never been used for stroke. 

He is now testing the capability of a pair of computerized eye goggles to administer this exam.The technology resembles a pair of swim goggles and uses a video camera connected to a computer to examine eye movements. In patients with severe dizziness, if the goggles find the eyes stay stable when the head is rotated, eye jerking changes direction or either eye is higher, the patient has a stroke; otherwise, it is a benign postviral ear condition known as vestibular neuritis. 

Newman-Toker is working to demonstrate the device’s accuracy and utility in emergency room clinical practice and says the technology could be in use in about five years.