Troubleshooting Difra VNG Equipment

An overview of common VNG equipment technical issues

Over the years, we've assisted many health care professionals to troubleshoot their VNG equipment via remote access online and over the phone. Issues range from very easy fixes, changing settings or other software or hardware corrections that need a straightforward adjustment. However, at times, it is necessary to have the hardware professionally evaluated due to years of handling and use. I've compiled an overview of common technical issues to help troubleshoot as well as links to service bulletins that are also included in your online manual.

SOFTWARE ISSUES - BASICS

The most common issue that we encounter has more to do with driver compatibility and not software per se.  All of the computers we have supplied with our VNG devices in the last several years utilize the most current Windows 10 operating system. As you likely know, Microsoft continually runs updates for Windows 10. Most of the time these are security updates to thwart malicious hackers from accessing our computers.  

Occasionally, after an update, your video camera that is housed with the goggles does not show up.  Everything seems to be fine otherwise, but there is no eye view visible.  A large portion of the time this is related to a driver being out of date or deleted during the Windows 10 update.  The solution is for the driver to be reinstalled. It is best to contact us for assistance via online remote access.

#1 HARDWARE ISSUE: NO IMAGE OR VERY DARK IMAGE

CHECK LENS CAP FIRST

While it is rare, we do encounter some hardware issues. I suggest one simple premise in diagnosing any technical issue, look for the most obvious and basic problem first. If that does not resolve your issue, try the next obvious and so forth.  Do not assume it is the most extreme problem right away.

An example of checking the most basic problem first: the highest incidence of tech support we get calls about is a dark image on the computer screen of the eye/s. The first and most basic issue is to make sure the lens cap is removed from the camera lens. For monocular cameras, there may be a small black cap that slides over the lens to help keep it clean and protected. And yes, this does happen more than you would think, so I'm not judging or making fun of anyone, it just happens sometimes. As the old saying goes, never assume.

CHECK LUMINANCE NEXT

Secondly, try to adjust the luminance and focus of the camera. It is less likely this will be the problem, but again, let's not assume. Depending on the camera model, the focus knob may vary. The NysStar I monocular assembly requires focusing the camera by twisting the camera itself slightly clockwise or counterclockwise.  It does not take much to adjust, so don't overdo it.

The Headstar and NysStar II binocular camera assemblies have a knob that facilitates the adjustment.  Again, small movements are best.

If you want to make sure you have the correct adjustment method, refer to your Difra product manuals for directions.  If you can't locate your manuals, contact us.

UNPLUG USB PORT

If the issue still exists, one last thing to try on your own is to unplug the camera USB cable and reinsert it in another USB port.  Sometimes, the USB ports will become faulty or go to sleep and switching to another USB port will possibly clear up the image problem.

FINALLY, CONTACT US

Now, if the issue still exists, it's time to contact us.  At this point, we will likely need the camera to be shipped to us for repair. We will need your model information and serial number, which are located on the decal tag on your product. We will issue you a Repair Order with shipping instructions and a general estimate of repair charges or if the unit is under the manufacturer's warranty or not.

Once received, our highly qualified technical team will conduct diagnostic tests to identify the problem.  Prior to any repair being completed, we will send you a revised Repair Order with actual repair costs and/or warranty information.  We require payment with your approval prior to completing any repair that is not a warranty issue. 

With your Repair Order, we will send you a credit card authorization form to complete and return with your payment and approval. Turn-around times are dependent on the type of service you select and the number of repairs ahead of yours. Generally, once we receive your product, standard repairs are completed in business five days.  We do not always have loaner units available, but if we try to do what we can to accommodate your request.

WHEN TO ASK FOR HELP

Please contact us anytime you have questions or problems that arise.  We are typically always available and want your equipment to function properly.  We will do our best to keep your downtime to an absolute minimum.  We do understand the importance of you and your patient's time.

SERVICE BULLETINS

Look for future blog posts where I will devote some time to various Service Bulletins explaining how to complete different software adjustments, fixes and other troubleshooting procedures.  In a future post, I will include a link to our Dropbox folder to reference for PDF's of the service manuals and other pertinent information to help make your experience with Difra and Secure Health the very best.  

ADDITIONAL TRAINING IS AVAILABLE

We offer live hands-on training several times a year as well as private training in person or online. Please contact us for additional information, rates, and schedules.

For more information on all of the products or discuss a specific application,  please contact me at premiumvng@gmail.com or by calling 260.804.4041.  I would appreciate hearing from you.

--Dan Scherer, CEO

Secure Health, Inc.

260.804.4041 or premiumvng@gmail.com

FRENZELS, VIDEO FRENZELS or VNG?

A guide to basic Frenzel goggles, video Frenzel goggles and VNG Equipment

Many clients call to discuss VNG technology, only to be astounded at how expensive videonystagmography VNG devices are.  I  usually ask, "Are you really interested in video Frenzel goggles rather than VNG equipment?"  Most often, the answer is yes, or they want to know more about video Frenzel goggles.

This guide explains the differences to make sure you have the best information to make a good buying decision and, more importantly, receive the product you really need.

OVERVIEW OF BASIC VS. VIDEO FRENZEL GOGGLES

Frenzel goggles range in capabilities and price. Basic Frenzel goggles simply light and magnify the eye for observation. Video Frenzel goggles also have a camera to easily observe and record eye movements. Video Frenzel goggles offer a huge step up from basic Frenzels, but that advanced technology does have a direct cost effect. VNG testing equipment is most expensive of all the options. It is used as a diagnostic tool that tracks and records eye movements and nystagmus, using an algorithm to produce a diagnosis.

Frenzel goggles are typically used for the evaluation of patients with vestibular disorders and generally are not used as a diagnostic tool. Basic and video Frenzels are used as a balance assessment and vestibular rehabilitation tool, especially in the administration of various Canalith repositioning procedures (the most popular being the Epley maneuver) for the treatment of benign paroxysmal positional vertigo, BPPV. 

Basic Frenzel goggles do not track the eyes, produce tracings of the eye movements, or generate a report of any kind, although the clinician can observe nystagmus as the patient undergoes various procedures including smooth pursuits, random saccades and Dix Hallpike.

Video Frenzel goggles allow the technician to record a video file of eye movements for a reference point during and post-therapy, including Canalith repositioning procedures. Video Frenzels provide far better capabilities for more positive vestibular rehab outcomes.  

VideoStar™ video Frenzels, manufactured by Difra Instrumentation, include another important feature not found on most competitive products.  With VideoStar™ Frenzels, you can record and project the image of the patient's movements onto a wall-mounted monitor or on the laptop in real-time, for improved patient treatment.

VideoStar™ Frenzels also include audio recording so the technician can see and hear the commands and review the session at a later time. As with basic Frenzel goggles, video Frenzel goggles do not produce a report of any kind, only video files of the patient encounter.

BASIC FRENZEL GOGGLES

--Used as a balance assessment and vestibular rehabilitation tool

--Optical magnifying glasses with lighting

--No camera or ability to record the eye movements

--Cost is around $500

--Not available from Secure Health, Inc.

VIDEO FRENZEL GOGGLES

--Used as a balance assessment and vestibular rehabilitation tool

--Optical magnifying glasses with lighting

--One-camera (monocular) or two-camera (binocular) configurations

--Record a video file of eye movements, but do not produce a report of any kind

--VideoStar™ Frenzel goggles offer exclusive feature with video recording projected onto a monitor or laptop

--Cost is around $4,000, depending on features

--VideoStar™ Frenzel goggles are manufactured by Difra Instrumentation and available from Secure Health, Inc. 

VNG TECHNOLOGY

--Used to identify, diagnose and treat vestibular disorders

--One-camera (monocular) or two-camera (binocular) configurations

--Produces automatic reports marking nystagmus

--Cost starts at $20,000, depending on features

--HeadStar™, HeadStar E-Z™ and NysStar™ VNG devices are manufactured by Difra Instrumentation and available from Secure Health, Inc.

VNG technology is the gold standard for vestibular diagnostics.  As with VideoStar Frenzels, VNG devices are available in both one-camera (monocular) or two-camera (binocular) configurations. In addition, many VNG devices offer a wide range of features, including the video recording of the eye/s as the patient undergoes diagnostic tests.

Unlike basic or video Frenzels, VNG technology tracks the eye movements and plots the results on reports where the report is then interpreted by a qualified physician.  VNG technology helps diagnose vestibular or central nervous system CNS issues.

Every VNG system uses complex algorithms to plot eye detection and movements.  Some VNG brands do not automatically identify the nystagmus, but rely on the technician to mark the data by manually reviewing the eye tracings and selecting the extremes examples of nystagmus. Manual marking of test reports is time consuming and subject to human error. We offer VNG products manufactured by Difra Instrumentation, including automatic computerized marking or manual marking of nystagmus. Most everyone uses the automatic feature for its accuracy and time-savings benefits.

Most VNG devices offer smooth pursuits, random saccades, OPK, spontaneous nystagmus, gaze, Dix-Hallpike, body positioning, and positional and caloric irrigation testing.  Other tests that may be offered include the active head rotation test and vHit technology.  The Difra products we offer automatically compile each test into a report once all test sequences are completed.  The reports require a qualified physician who has been trained to interpret the results for an accurate diagnosis.

VNG technology is significantly more expensive than basic or video Frenzels and for good reason.  The eye-tracking software is extremely complex and the costs of hardware are much higher than the technology used for video Frenzel goggles.

We offer three versions of VNG technology manufactured by Difra Instrumentation. Prices start around $20,000 and go up from there, depending on features added.

The right choice: One or Two Camera VNG?

In conclusion, if you are interested in an assessment tool for rehabilitation and treatment of vestibular disorders, consider video Frenzel goggles. If you need vestibular diagnostics and the ability to produce test reports, then VNG technology is your best option.  

The information offered here is a brief comparison and is by no means a complete look at these technologies.  For more information on all of the products or discuss a specific application,  please contact me at premiumvng@gmail.com or by calling 260.804.4041.  I would appreciate hearing from you.

--Dan Scherer, CEO

Secure Health, Inc.

260.804.4041 or premiumvng@gmail.com