Patient Compliance

Patient Compliance VNG Testing

Help patients successfully prepare for VNG tests

Preparation and patient compliance are vital elements for completing a successful series of VNG tests. Many practices distribute pre-appointment paperwork with information such as timing for the following:

--Medications to temporarily discontinue

--Medications to continue

--What to wear: comfortable clothes, flat shoes

--Eye prep, such as not wearing eye makeup or contact lenses

--When to avoid eating food and drinking caffeine or alcohol prior to testing

--What to expect regarding induced dizziness, the possibility of not driving oneself home

The preparation sheets are a helpful reference for patients who have no experience with vestibular disorders or VNG testing. There is quite an extensive list of do's and don'ts, which can be quite overwhelming.

To further improve patient compliance, practices who distribute papers and/or web information with Q and A's of what is actually involved with the VNG testing can go that much further to assist their patients. Most people are already feeling nervous about a doctor visit, especially when they are undergoing tests that they have no idea of what is involved. I know I was completely caught off guard when I learned that a full battery of VNG tests involves a series of eighteen tests and that it would take up to 30 or 45 minutes.

The information doesn't have to be clinical or complex, just keep it simple such as:

What to Expect for Your VNG Testing

Overall Objective

The overall objective of your VNG testing is to stimulate and visually record your eye movements under various circumstances. This is very likely to make you feel dizzy. Be prepared for dizziness and even the possibility of feeling nauseous or even throwing up in some cases. Both are common reactions during VNG testing. Your technician will help you as much as possible.

First Phase of VNG Testing

--The first portion of the tests, you will be asked to wear head gear consisting of goggles that have built in camera/s

--One eye will be shielded with a cover and the other one will be video recorded

--Keep your eyes wide open so the camera can record the movements of your pupil

--You will be asked to look at a dot on a monitor and follow the dot with your eyes

--Don't try to anticipate the pattern of the movements of the dot

--Each eye will repeat the same testing sequences and will be video recorded, one eye at a time*

--Please let your technician know if you are experiencing any adverse reactions to the testing procedures

*Unless your practice has a binocular VNG, in which case the eyes will be recorded at the same time

Second phase: Caloric Irrigator Tests

--A medical device called a caloric irrigator will be used for the second phase of testing

--A caloric irrigator is used to evoke your inner ear response to a stimulus

--You will be asked to wear headgear: goggles with the camera/s and lie down on an exam table

--A lighted tip connected to the caloric device will blow warm and cool air into your inner ear

--Keep your eyes wide open so the camera can record the movements of your pupil

--The camera/s will record the movements of your eyes, one at a time

--Expect a sequence of caloric testing, including physically changing movements while lying on the exam table

--You may need to lie on the exam table for a few minutes once testing is complete in order to recover from the dizziness you may experience

--Do not attempt to sit up, stand up, walk or drive unless you do not feel dizzy

--Please let your technician know if you are experiencing any adverse reactions to the testing procedures

For practices who are using ENG or older, outdated VNG testing equipment, consider upgrading to premium VNG devices and caloric irrigators manufactured by Difra Instrumentation. Difra's software is designed to reduce the time consuming aspects of testing. Difra software eliminates the need to mark up tests during during the testing procedures and therefore allows technicians to accurately test more patients with less labor for the tech and less time for the patient as well. For more information about Difra products, please contact Secure Health or review the product information contained on this web site.

If you have questions or just want to talk about this post or you have any other questions, please contact Secure Health, Inc.  We look forward to hearing from you.

Lana Scherer
Marketing Director, Secure Health, Inc.
260-418-6835 /

Secure Health, Inc. is the exclusive US agent for Difra Instrumentation, a world's leading manufacturer of diagnostic balance disorder technology for more than 48 years.


The opinions and information contained in this website are for general information purposes only. We make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability or availability with respect to the website or the information, products or services contained on the website for any purpose. Any reliance you place on such information is therefore strictly at your own risk.In no event will we be liable for any loss or damage including without limitation, indirect or consequential loss or damage, or any loss or damage whatsoever arising from or in connection with, the use of this website.


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Live Online VNG Training

Live Online VNG Training

Coming Soon!

Please check back or contact us in the meantime.

If you have questions or just want to talk about this post or you have any other questions, please contact me.  I look forward to hearing from you.

Stay Healthy,

Dan Scherer

CEO, Secure Health, Inc.

260.804.4041 /

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Why did the software freeze during a VNG test?


Why did the software freeze during a VNG test?

What causes a freeze and how to fix it

Check the Visiobox to laptop internet connection

On some occasions, you may experience software freezing. Typically this occurs during the Smooth Pursuit test, but may also happen on Random Saccades, Optokinetic, and rarely during calibration tests.  Let's look at what may be the cause and what you can do to fix it and complete testing your patient.

If you have a NysStar I, NysStar II, or Headstar, it includes the Visiobox module. Visiobox is a mini-computer that assists the laptop power calibration, peripheral stimulation and oscillating tracking tests.  Visiobox helps the screen from buffering or creating erratic screen images.

If you have Headstar E-Z VNG, it does not have Visiobox, but does have VisioX internally.  We will discuss Headstar E-Z systems in an upcoming post.

Two connection options

Difra Visiobox premium VNG

Difra's Visiobox functions as a mini computer

Visiobox has two connection options to connect the Visiobox to the computer.  The first is a wireless WiFi adapter that is used as an internet connection without internet access.  It only allows for communication between the laptop and the Visiobox.  Once set up properly, it will show up as WiFi-2 in your network and internet settings.  WiFi-1 is your standard internet access connection.

Consider a wireless extender

Typically, the wireless connection works great, but if you often experience freezing, erratic behavior or lose your internet connection on the laptop, you may need to consider a couple of options.  If you have several devices connected to your router or your building has heavy, thick walls, long hallways, concrete or brick walls, plus some distance from your router to the laptop, you may need to install a simple router extender to push a stronger signal to the Visiobox and laptop.

Most extenders plug into a wall outlet, then you simply follow the product's instructions to pair the extender to your router.  When connected, this will strengthen your signal, allowing your Visiobox to function much better.  Extenders can be purchased at many electronics stores or Amazon for between $25 to $100.  Personally, I use an extender in the $50 to $70 range, I find these work great while the more expensive ones tend to be more complicated to set up.

An ethernet cable directly connects Visiobox to the laptop

If an extender still does not completely help, then we can go to the second type of Visiobox connection, using an ethernet cable that directly connects the Visiobox and laptop.  First, check your laptop to make sure it has an ethernet port.  Most all of the newer computers have them, but make sure before going any further.  The ethernet port looks like a larger phone cable connection.

You will have another cable to manage, but you will also have much-improved connectivity and consistency to offset the inconvenience of another cable.

To complete a changeover to an ethernet connection, you will need to contact my office at 260.804.4041 or by email to and schedule a time that I can remote access your computer to complete the ethernet set up.

This process does not take long, maybe 15 minutes providing everything goes as planned. I will be changing your default from the wireless connection to the ethernet option, plus making a change to the IP address to facilitate the ethernet connections, then disconnecting your WiFi connection for Visiobox only.

It is best to schedule this during a time without patients.

Once the ethernet connection is completed, you should experience no further freezing due to the Visiobox connection. 

Other factors that may cause a freeze

There are other factors that may cause a freeze, mostly, one of which may be due to the overuse of the computer's RAM memory.  You can try to redo the test by stopping the test, then on the lower left of the software screen, click on the test to redo and start over.  Many times, this will help clear the test up, allowing for you to complete the test.  

If that does not clear things up, exit and reboot the system.  I know, not fun, but it might be necessary to clear the cache and RAM.  If Windows was in the middle of an update, it will need to finish before everything works properly again.  I highly suggest changing the schedule for Windows updates to happen overnight so as not to interrupt your testing schedule and for your best overall computer performance.  

If you have questions or just want to talk about this post or you have any other questions, please contact me.  I look forward to hearing from you.

Stay Healthy,

Dan Scherer

CEO, Secure Health, Inc.

260.804.4041 /

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