Visual Vertigo and Vestibular Rehabilitation Therapy: Optokinetic Stimulation and Virtual Reality-Based Rehabilitation

Abstract

Background: Visual vertigo is a condition in which patients experience dizziness, unsteadiness, disorientation and imbalance in visually complex or moving environments. It is closely related to visual-vestibular mismatch, where the brain over-relies on visual cues over vestibular and proprioceptive cues. Vestibular rehabilitation therapy aims to reduce dizziness and improve gaze stability, postural control and daily function. Optokinetic stimulation and virtual reality are important rehabilitation approaches because they provide graded exposure to provocative visual motion and real-life visual environments.

Aim: This review article aims to summarize the essential points from the chapters on visual vertigo and vestibular rehabilitation therapy, focusing on the definition, mechanisms, clinical manifestations, assessment and rehabilitation of visual vertigo using optokinetic stimulation and virtual reality-based approaches.

Conclusion: Visual vertigo represents a disabling manifestation of visual-vestibular mismatch and visual dependence. Clinical evaluation depends mainly on history, symptom triggers and questionnaires. Vestibular rehabilitation, especially customized visual desensitization, optokinetic stimulation and virtual reality-based training, can improve tolerance to visual motion, decrease dizziness and support better postural stability. Virtual reality may add motivating and real-life training situations, but cost, availability and cybersickness should be considered.