5 ways to personalize VisualEyes™ to your needs

09 August 2023

As a clinician who sees patients day in and day out, you want personalized software that’s tailored to your preferences. Luckily, VisualEyes™ has an incredible amount of options for you to adjust your test protocol and software setup to work for your needs and wants! Below are 5 ways to personalize your VisualEyes™ software.

1. Turn on or silence audio indicators by test

Some clinicians love audio cues during testing and others do not. Regardless of your preference as a clinician, you have options in VisualEyes™! Under ‘System Default Settings’ and ‘Test Type Settings’, you can choose a test and define what audio cues (if any) you want during testing (Figures 1 and 2).

You can turn on a voice that speaks upon each interval or you can turn on a beep for each interval. You can even determine what you want the interval to be (from 5 to 30 seconds). These auditory cues can be especially beneficial for you (and the patient) to know how much longer is remaining in the test if you are not currently looking at the test screen. This flexible feature allows you to get exactly the auditory feedback you want for each test without having to completely mute your computer.

The following options are available. First, test type. This is set to smooth pursuit. Second, show numeric values on graphs. This can be either ON or OFF. Third, beep interval. This is set to 10 seconds. Fourth, speak on interval. This can be either ON or OFF. Fifth, beep on interval. This can be either ON or OFF. Sixth, count style. This can be either Down or Up. — **Figure 1:** Test type settings for smooth pursuit.

The following options are available. First, test type. This is set to caloric. Second, beep interval. This can be set to 5, 10, 20, or 30 seconds. Third, speak on interval. This can be either ON or OFF. Fourth, beep on interval. This can be either ON or OFF. Fifth, count style. This can be either Down or Up. Sixth, enable timer. This can be either ON or OFF. Seventh, irrigation interval. This is a slider that is set to seven minutes in the example. — **Figure 2:** Test type settings for the caloric test.

2. Add in your own clinical norms

Many clinics realize the importance of collecting site-specific normative values, especially for new tests that may not have published normative data. Under ‘System Default Settings’, there is a feature called ‘Threshold Levels’ where you can input your own normative data by age (Figure 3).

For the four velocities of 75, 100, 140, and 200 degrees per second, the user can input the relative threshold for the following age groups: 0 to 2, 3 to 4, 5 to 6, 7 to 8, 9 to 10, 11 to 20, 21 to 30, 31 to 40, 41 to 50, 51 to 60, 61 to 70, 71 to 80, 81 to 90, and 91 and above. The user can also import or export threshold levels or reset all thresholds to default. — **Figure 3:** Threshold levels for dynamic visual acuity (DVA) testing.

Adding in normative threshold data allows you to compare your patient’s data to this data set on not only the live graphs during testing, but also the summary graphs following testing. This allows you to truly call a patient’s results normal or abnormal. Plus, the green check mark or red diamond will then follow the inputted normative data.

3. Personalize order and timing of positions in tests

There are several tests that use multiple positions during testing, such as the Ocular Counter Roll (OCR) and Advanced Dix-Hallpike tests. Depending on your preferences and clinical flow, you may want to change the order or length of certain positions. To do this, go to ‘Protocol Management’ and select the test in the protocol you want to edit (Figure 4).

The user has accessed a protocol called VisualEyes 525. Three other protocols are also listed: VORTEQ Assessments, EyeSeeCam vHIT, and VORTEQ Diagnostics. On the left-hand side, there are the following options: New protocol, remove protocol, export protocol, import protocol, and restore factory template. The user has the following tests in their VisualEyes 525 protocol: Spontaneous nystagmus, gaze, smooth pursuit, random saccade, optokinetic, Dix Hallpike, positional, caloric, saccadometry, and ocular counter roll. Ocular counter roll is highlighted in yellow to indicate its selection. Inside the protocol, the user has the following options: Add test, edit test, remove test, and copy test. — **Figure 4:** Protocol management.

Select ‘Edit Test’. Here, you can change the name of the test and change target type or color. Click on the gear icon next to the test name to access more adjustments (Figure 5).

The user can make adjustments in two main pages labeled summary parameters and computer screen, with summary parameters shown. The following options are available. First, test name, which is set to Ocular Counter Roll. Second, Ocular Counter Roll is labeled as active with a checkmark. There’s a gear icon to the right of the test name. Third, use 3D guidance, which can be either ON or OFF. Fourth, target type, which is set to color. Fifth, target color, which is set to a bright green color. Sixth, background color, which is set to a dark-blue color. Finally, the user can reset to default or set as default. — **Figure 5:** Summary parameters for the Ocular Counter Roll test.

Change the order, length, or name of test sections to appeal to your specific clinical needs (Figure 6).

The user can make adjustments in three main pages labeled test parameters, computer screen, and secondary screen, with test parameters shown. The following options are available. First, test name, which is set to Ocular Counter Roll. Second, duration, which is set to 180 seconds. Third, skip calibration, which can be either ON or OFF. Fourth, save eye recording, which can be either ON or OFF. Below are test sections, two of which we can see all the details for. For the first test section, type is set to center, name is set to center, and duration is set to 30 seconds. For the second test section, type is set to head left, name is set to head left, angle is set to 30 degrees, and duration is set to 60 seconds. — **Figure 6:** Test parameters for the Ocular Counter Roll test.

4. Input report templates into VisualEyes™ for easy report writing

After you have finished testing your patient and are reviewing results on the ‘Session Review’ page, you may have noticed that there is a ‘Write Report’ option at the top of the page (Figure 7).

The following options are available. First, print filter, which is set to all completed tests. Second, write report. Third, test report summary. — **Figure 7:** ‘Write Report’ option.

When you click on ‘Write Report’, it brings you to a blank word processor where you can type and format your summary to be included with the test results (Figure 8).

The user can also format the text in the following ways: font type, font size, text alignment, bold, italics, and underline. There are also two drop-down menus labeled templates and findings. Finally, there’s an option to close the editor. — **Figure 8:** Report editor.

If you need help with getting your report started, there are pre-existing report templates included or you can create/import your own templates (Figure 9).

Upon clicking on the templates drop-down menu, this example shows the following available templates: normal VNG, normal VNG detailed, normal vHIT and VNG, normal vHIT detailed, and normal rotary chair. The normal VNG template is also shown, including the following details: referring physician, referral reason, case history, procedure, test results, impressions, and recommendations. Test results are listed for otoscopy and all the VNG sub-tests, including: spontaneous nystagmus, gaze tests, smooth pursuit, saccades, optokinetics, positional tests, Dix-Hallpike procedure, and caloric tests. — **Figure 9:** Report templates.

There are even templates for abnormal test findings that you can use or edit. The ‘Manage Findings’ or ‘Manage Templates’ options allow you to edit a pre-existing template or create your own (Figure 10).

Upon clicking on the findings drop-down menu, this example shows the following available templates: abnormal Dix-Hallpike, abnormal nystagmus, abnormal OPK, abnormal saccades, abnormal SHA gain, abnormal SHA phase and symmetry, abnormal smooth pursuit, and abnormal step test gain. In the findings editor, the user can format the text in the following ways: font type, font size, text alignment, bold, italics, and underline. There is also a new finding 1 drop-down menu with the following options: new finding, save finding, delete finding, and import/export. Finally, there’s an option to close the editor. — **Figure 10:** Findings editor.

After inputting and editing your written template, you can add this to your results printout, and the first page of your report will look as follows in Figure 11.

The VNG report includes the following details: patient ID, test time, referring physician, referral reason, case history, procedure, test results, impressions, and recommendations. Test results are listed for otoscopy and all the VNG sub-tests, including: spontaneous nystagmus, gaze tests, smooth pursuit, saccades, optokinetics, positional tests, Dix-Hallpike procedure, and caloric tests. — **Figure 11:** First page of a videonystagmography (VNG) report using a pre-existing template.

5. Switch the fixation light position

Using a fixation light during testing has many uses from both a diagnostic and logistic value.

Most importantly, a fixation light can help you determine if your patient can centrally suppress present nystagmus. This information can be critical in determining whether your patient’s nystagmus is of central or peripheral origin.

A fixation light can also help bring a patient’s eyes back into primary gaze (looking forward), as we know the direction of gaze can impact nystagmus strength.

The fixation light defaults to the left side. But this is something you can change! Under ‘System Default Settings’, go to ‘Input’ and ‘Fixation Light Position’ to toggle between the left and right sides (Figure 12). While you may not need to change this often, there are times that certain patient populations may have difficulty seeing the fixation light on one side.

Beyond the option to toggle the fixation light position between left and right, the following options are available. First, select source, which can be simulation mode, top mount camera, side mount binocular, or EyeSeeCam. Second, room camera, which can be none or integrated camera. Third, microphone, which can be none or microphone array. Fourth, show frame rate, which can be either ON or OFF. Finally, the user can browse and select video storage locations. — **Figure 12:** Toggling the fixation light position.

Improve your clinical flows

These options for personalizing your clinical flow exist to make your appointment with your patient smoother and more comfortable for you as the clinician. These are just a few examples of the many options available to you in Protocol Management and System Default Settings!

Explore and make the VisualEyes™ software personalized for your needs.

About the author

Dr. Liz Fuemmeler, Au.D., is a Clinical Product Manager with Interacoustics and Vestibular Program Director at Professional Hearing Center in Kansas City, MO.

Dr Liz Fuemmeler

Dr. Liz Fuemmeler is a Clinical Product Manager with Interacoustics and Vestibular Program Director at Professional Hearing Center in Kansas City, MO. She graduated with her doctorate in 2019 from Purdue University and received specialty training in vestibular and balance disorders at Boys Town National Research Hospital and the Mayo Clinic. While at Mayo Clinic, she trained in a concussion evaluation and rehabilitation program, which focused on utilizing vestibular testing to identify the presence and extent of issues following a concussion. Utilizing this training, she established a concussion program at a private practice in Kansas City, MO and participated in interdisciplinary evaluations for the Concussion Management Center at the University of Kansas Medical Center. She is actively involved in vestibular and concussion research and regularly lectures for local, national, and international conferences. Outside of her role with Interacoustics, she co-hosts a monthly podcast called "A Dose of Dizzy'' that reviews current vestibular protocols and research. She also is the past-president of the Missouri Academy of Audiology and volunteers with the American Academy of Audiology.

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Published: 09 August 2023

Modified: 04 June 2024