Computer-based simulation of the Bielschowsky head-tilt test using the SEE++ software system.

Introduction: Latest measurements of the vestibulo-ocular reflex (VOR) allowed the integration of the simulation of the Bielschowsky head-tilt test (BHTT) into the SEE++ software system. SEE++ realizes a biomechanical model of the human eye in order to simulate eye motility disorders and strabismus surgeries. With the addition of the BHTT it can now also be used for differential-diagnostic simulations of complex disorders (e.g., superior oblique palsies).

Methods: In order to simulate the BHTT in SEE++, the user can freely choose the desired head-tilt angle from -45 degrees to +45 degrees. The chosen angle is shown in the 3D view with a human body model and is also used in the calculation of the Hess-Lancaster test.

Results: The integration of the BHTT offers an additional improvement of the possibilities for simulating eye motility disorders. Moreover, SEE++ allows the creation of a video of the "virtual patient" while tilting the head from one side to the other, which shows dynamic changes in the simulated Hess-diagrams.

Discussion: Comparisons of simulation results with patient-measured data showed a good correlation between the simulated and the measured data. Further comparisons with patient data are planned.