PEI Balance Evaluations
The complexities of the systems that control an individuals balance requires that diagnostic measures go beyond the measurement of simple movement. Balance solutions at the Pennsylvania Ear Institute provides a comprehensive evaluation investigating vestibular, visual, postural, and neurologic systems using the most advanced technology available in the region to determine the cause of the disorder.

Balance Solutions: 

  • Videonystagmography
  • Rotational Chair Analysis
  • Dynamic Visual Acuity
  • Computer Dynamic Posturography

What is a Vestibular Disorder?

A disturbance that causes an individual to feel unsteady, giddy, woozy, or have the sensation of movement, spinning or floating. An organ in our inner ear, the labyrinth, is an important part of our vestibular (balance) system. The labyrinth acts with other systems in our body, such as the visual (eyes), and skeletal (bones/joints) systems to maintain the body's position. These three systems, along with the brain and nervous system an be a source of balance problems.

What are the symptoms?

  • A sensation of dizziness or vertigo
  • Falling or feeling of falling
  • Lightheadedness or feeling woozy
  • Visual Blurring
  • Disorientation

Testing Beyond the Standard of Care Balance Solutions

Rotational Chair Analysis

This test allows us to evaluate the vestibular system at head movement speeds more realistic of daily living than traditional tests. The patient sits in a computer-controlled chair and their eye movements are recorded while the chair is moved in circles and from side to side at various speeds. The results can be useful in determining the extent of vestibular dysfunction, as well as diagnosing pathology when other tests are inconclusive. 


This is the most common test used to evaluate the vestibular system  (the balance portions of the inner ear). The vestibulo-ocular reflex (VOR)  is a reflex between the vestibular system and the eye muscles that keeps our vision in focus as we move our head. This reflex allows eye movements to be used to evaluate the vestibular system. The patient wears goggles with infrared cameras that record their eye movements while watching lights, in different head and body positions, and when warm and cool water are introduced into the ear canals. The results can identify vestibular dysfunction, as well as central nervous system pathology so that appropriate recommendations can be made.

Computer Dynamic Posturography

Tells your physician which parts of the balance system you rely on most and which parts may be causing your balance problems. You will stand on a platform and simply keep your balance under various conditions while your vestibular, visual and postural systems are assessed.

Our balance is maintained with a combination of 3 systems: vestibular, visual, and proprioceptive (sensors in the feet, legs, muscles and joints). The patient stands on a small platform surrounded on 3 sides by a wall, wearing a safety harness for support, as the platform and walls move slightly and the patient is asked to maintain their balance. The results indicate which system may be causing a patient's balance problem and which system the may be over-relying on to compensate.

Dynamic Visual Acuity

Assesses the ability of an individual to perceive objects accurately during movement. Keeping objects visually stabilized in your environments while you move is critical to maintaining your balance and reducing the risk of falling. This test looks specifically at the VOR to determine how well the patient can see a visual target while they move their head side to side.