Gaze Stabilization Exercises

This page is intended to be a reference for patients who have been referred for vestibular rehabilitation therapy. 

Timothy C. Hain, MD • Page last modified: March 2, 2021

Gaze stabilization exercises.

An very simple illustration of the "Gaze Stabilization Exercises" is shown above. These are exercises aimed at improving vision while the head is moving, generally while viewing an earth stationary object. They consist of daily practice of exercises such as shown above, with many variants described below.

Why exercise ?

Common sense says that it is a good idea to learn to adapt to conditions that you can't fix.

There is evidence that they help people overcome chronic dizziness. Studies have particularly shown that it is helpful in bilateral vestibular loss (Herdman et al, 2007), and it is our opinion that gaze stabilization is clearly indicated in bilateral loss. Not all agree though -- in a blinded study, strengthening exercises worked as well as more specific exercises (Krebs, 1991). See the main VRT page for a more general discussion of how these exercises work.

Who should do these exercises ?

Indications for gaze stabilization:

Conditions in which indications for gaze stabilization exercises are tenuous:

Procedures of Gaze Stabilization Exercises:

Begin with simpler exercises, progress to harder ones. So what does it mean harder ?

These exercises as incorporate many "dimensions" -- protocol, speed/frequency, target distance (near/far), background, orientation of head on trunk, and orientation of head with respect to gravity. Of course, this defines a gigantic multidimensional treatment space.

The goal is to find the relevant areas in this space which are not working well and practice them. A vestibular physical therapist can be very helpful in selecting the appropriate variation.

These exercises are not "done" just at the (weekly) PT session - - you do them EVERY DAY. We usually recommend doing them for at least 30 minutes (which may be split over several sessions). The duration needs to be carefully adjusted so that it is enough to make a person "dizzy", but not enough to make them "sick".

Exercise dimensions -- how exercises are made more complex and difficult:

Measuring outcome.

Visual acuity while active and subjective symptoms are the main measures. Recently, the "VHIT" test is an excellent method of measuring VOR gain and can be helpful if available.