This question has led me on a journey to understand dizziness in greater depth. There are 3 main systems that can cause dizziness, our eyes, our inner ear and our neck. Assessing each system is important in addressing an underlying cause to dizziness. The tests that I have found most useful in screening for problems in each system are convergence for vision and eye coordination, the Dix Hallpike with imaging or video oculography for vertigo, and upper cervical C1-2 motion testing to screen for neck involvement.
3 best tests to assess for the cause of dizziness
Convergent Gaze Testing
Dix Hallpike with Imaging
Upper cervical C1-2 Testing
Looking for eye coordination for convergent and divergent gaze is important to assess muscle and nerve function of the eyes. Neck issues can create muscle trigger points in ocular muscles pulling an eye way from midline and creating blurred vision and occasionally double vision. And yes, dizziness.
Symptoms to look for…
Blurred vision that changes
Double vision that is intermittent
Headache pain around the eyes
Eye fatigue and overall fatigue with cognitive function
Tips for testing
- Go slowly and do 3 repetitions looking at convergent and divergent gaze.
- Look for blinking and closing of the eyes. Look for eye drift.
- See if your testing reproduces dizziness or other symptoms.