In my fairly short tenure as a physical therapist, the majority of the continuing education I’ve attended has been on vestibular rehabilitation (close to 50 hours worth). I choose to do this because, in my formal education, we had maybe 6 hours total time in the classroom on this topic. My neuro prof wasn’t strong in this area, and so had to bring in a clinician from the community to teach it who had minimal time available. So, I’ve undertaken the task of educating myself on this topic. I supposed I’d call myself an expert on the experts– meaning I feel I can tell who’s good at vestibular rehab, who’s not, and therefore who to address questions to.
I’ve recently asked a couple of those experts what they think about the necessity of using Frenzel lenses in diagnosing vestibular deficits. The first few classes I took, the instructors said it didn’t matter. They’re nice, but expensive, so just get experience watching lots of eyeballs both in the clinic and on YouTube. But when I went to apply what I learned and looked at lots of eyeballs, I felt like I couldn’t see as well and when I did see something, I wasn’t sure what I was seeing, because these nystamuses (sp?) are so small. But why would a facility pay for the goggles and then the environmental set-up necessary to use them– a dark room with space to do the testing in at least, maybe a tv monitor– if they aren’t 100% necessary? Answer: they don’t. I’ve asked my facility and I got a “no.” So I set out to find someone who would co-oberate my un-expert hunch.
I finally found 2 this past weekend. Both of the instructors at my class this past weekend said that you can’t really do vestibular rehab appropriately unless you have Frenzel lenses. The reason: you can suppress nystagmus with visual fixation via the smooth pursuit system when your eyes are allowed to focus during the exam, so you will miss mild-moderate cases and may not accurately diagnosis what you do see. Bingo!
Now if I can get my facility on board, how do I, the un-expert, know what to recommend to purchase? I want to make an informed decision, for the sake of my company, obviously and being knowledgeable in the subject will back up my claim to know how to utilize this costly equipment with current patients. The experts mentioned above sent me here: Frenzel goggles. The page is from a Chicago based, MD led dizziness clinic and discusses different models and features available. The pages looks like its almost 10 years old, but the basics still apply, or so it appears to me.
Thought I’d share what I learned: I (and you!) need some Frenzels and that resource on how to go about choosing some.