iCapNYS vs HINTS Exam

This is an app that uses the iPhone’s built-in motion sensors to overlay head position animations onto videos of nystagmus. By using the front-facing camera, users can record their own nystagmus. In this mode, the screen itself serves as a light source. When using the rear-facing camera, the iPhone can be fixed in front of the eye with a stabilization device, allowing for shake-free recording of eye movements.  Settings such as exposure, zoom, and LED brightness can be retained. Videos are displayed in a list sorted by the exact date and time of recording (year, month, day, hour, minute, second). Tapping a video plays it, and swiping left deletes it. The videos are saved in an album named “iCapNYS.” The app can also transmit iPhone gyroscope data via Wi-Fi. This feature is designed for the Windows software “CapNYS,” which records nystagmus and head position; CapNYS receives and utilizes the data. Additionally, the app monitors the iPhone’s motion (pitch, roll, yaw), and if any axis exceeds a preset threshold, it triggers a beep and vibration. This function is used during vestibular rehabilitation.

This app was developed to enhance the HINTS exam by using a smartphone to better facilitate effective exam implementation and improve posterior CVA detection for enhanced patient outcomes within primary care, urgent care, and emergency care settings. This application allows for a streamlined screening process, with most full exams being concluded within five minutes from the start, and subjectively, being able to replay the exam video at half-speed allowed for a much easier and more confident assessment of nystagmus direction, skew deviation, and head impulse test corrective saccade with correct training and understanding of the exam's application. The smartphone application starts by taking the user through several screening questions to help determine if the application is appropriate or if a stroke workup is highly indicated. Videos are recorded for review and can be slowed down for optimal evaluation.