Strokes presenting with acute dizziness (i.e., vestibular strokes) are four times more likely to be misdiagnosed compared with strokes presenting with typical symptoms such as weakness. The HINTS eye exam (Head Impulse test, Nystagmus, and Test of Skew) can improve the diagnostic accuracy for vestibular strokes with 98% Sensitivity and 97% specificity....
✦ The floor
Discussion
Signed responses from readers of the wire.
Preliminary feasibility only — smartphone-based skew deviation detection using EyePhone shows early promise but cannot yet replace clinical HINTS exam or specialist assessment; no practice change warranted until prospective patient trials are completed.
Affordable smartphone-based eye-tracking tools could eventually enable frontline clinicians and audiologists to rapidly distinguish dangerous vestibular strokes from benign causes of acute dizziness at the point of care.
- 01EyePhone smartphone app was tested for detecting simulated skew deviation, an eye sign of vestibular stroke.
- 02Study used simulated rather than real patient cases, limiting direct clinical translation.
- 03Skew deviation detection is a critical component of the HINTS bedside exam for acute dizziness.
- 04Feasibility study design means results are exploratory and hypothesis-generating only.
- 05Published in Frontiers in Neurology.
A smartphone eye-tracking app (EyePhone) can detect simulated skew deviation in a feasibility setting.
studypartially supported- PMID
- 42553253
- DOI
- 10.3389/fneur.2026.1860824.
- Journal
- Frontiers in Neurology
- Publication type
- research_article
- Evidence level
- 4
- Population
- Simulated skew deviation cases (not real patients)
- Intervention
- Smartphone eye-tracking application (EyePhone) for skew deviation detection
Primary outcomes
Feasibility of smartphone app to detect simulated skew deviation; Accuracy of EyePhone in identifying skew deviation