From Assessment to Treatment in One Visit: A Streamlined Vestibular Clinic Workflow

In many vestibular and concussion clinics, assessment and treatment do not happen in the same place or the same visit. A clinician scores a balance test in one tool, writes the findings in the chart, decides on a plan afterward, builds an exercise program somewhere else, and books the patient to come back before treatment actually begins. Every handoff in that chain is a point where time leaks, plans drift, and two clinicians seeing the same presentation end up doing different things.

For a clinic manager, that fragmentation is not an abstract quality concern. It shows up on the schedule as a second appointment that could have been avoided, as charting that runs past closing, and as treatment rooms that sit idle in the gap between the evaluation and the first real session.

The Eye Rehab Pro Portal closes that gap by running assessment, treatment, and documentation as one connected loop inside a single visit. The portal even names the phases of that loop directly: assess, treat, prescribe. Here is what each step does and why the connection between them is the part that matters operationally.

What “one connected loop” means

The loop is not a single screen. It is four steps that hand off to each other without the clinician leaving the patient or re-entering data: a validated assessment bundle produces scores, the scores produce a proposed treatment protocol, the protocol plays on an in-clinic display, and the session writes its own note. The work that usually falls into the gaps between visits happens while the patient is still in the room.

1. Start the visit with a validated bundle

The portal groups validated clinical instruments into five bundles, each built around a common clinical scenario:

• Initial vestibular evaluation: VOMS, DHI, mBESS, DVA
• Concussion evaluation: VOMS, PCSS, Buffalo Concussion Treadmill Test, DHI
• Balance and fall-risk screen: mBESS, FGA, TUG, ABC
• Dizziness follow-up: DHI, VOMS, DVA
• Return-to-activity reassessment: Buffalo Concussion Treadmill Test, Buffalo Concussion Bike Test, PCSS

These are established, published instruments, not house-built questionnaires: VOMS (Vestibular/Ocular Motor Screening), DHI (Dizziness Handicap Inventory), mBESS (modified Balance Error Scoring System), DVA (Dynamic Visual Acuity), FGA (Functional Gait Assessment), TUG (Timed Up and Go), ABC (Activities-specific Balance Confidence), PCSS (Post-Concussion Symptom Scale), and the Buffalo exertion tests.

A clinician picks the bundle that fits the visit, selects the patient, and the portal sequences the instruments back to back. A progress panel shows which step the staff member is on, for example step two of four, and which assessments still remain. That means a rehab assistant can run the full battery in the right order without holding the protocol in their head, and nothing in the bundle gets skipped because someone forgot it.

2. Let the results draft the protocol

When the last instrument in the bundle is scored, the portal reads the combined results and proposes a treatment protocol. The proposal is concrete: a named protocol, the key findings it is responding to (for example, abnormal smooth pursuit on VOMS or a raised DHI emotional subscale), and a suggested sequence of on-screen exercises, each with a duration and a short clinical rationale.

This is the step that usually disappears into the space between two appointments. Instead of the clinician carrying findings in their memory until they find time to build a program, the program is drafted from the actual scores while the patient is still in the chair. The clinician stays in control: they review the suggestion, adjust the sequence or the timings, and accept it. Accepting creates the protocol and enrolls the patient in it.

3. Treat on the screen in the same visit

The accepted protocol opens in the Visual Therapy Studio, the portal’s in-clinic display engine. It drives a laptop screen, an external monitor, or a wall projector, and renders the exercise patterns the protocol calls for:

• Static fixation targets for saccades and gaze holding: center target, saccade targets, cardinal points, grid, and bullseye.
• Moving targets for smooth pursuit and gaze stability: horizontal and vertical sweeps, circle, figure-8, random walk, and diagonal cross.
• Optokinetic backgrounds for visual-motion tolerance: scrolling stripes, dot fields, checkerboards, and concentric rings, with a photosensitivity safety check that blocks unsafe flicker rates before a session can start.
• Real-world video with optional fixation and gaze-guidance overlays for busy-environment exposure.

The clinician runs the sequence and adjusts speed, amplitude, target size, or a metronome in real time while watching how the patient tolerates each block. Before and after the session they record symptom scores on a 0 to 10 scale across dizziness, brain fog, headache, eye strain, and nausea.

4. The session documents itself

When the clinician stops the session, the portal assembles a session note without a separate charting step: the patterns that ran and their parameters, total session time, the pre- and post-session symptom scores with the change for each, and a tolerance read of whether symptoms improved, stayed stable, or worsened. The note saves to the patient’s record. If the visit ends with a home program, the clinician prescribes it from the same place, and the patient runs it in the Eye Rehab mobile app, which is free for patients.

That is the full loop: assess, treat, prescribe, and document, in one sitting.

An illustrative visit

The following is an illustrative example to show the sequence. It is not a specific patient and not a claim about clinical results.

A patient arrives with three weeks of dizziness in busy visual environments. The clinician opens the Initial vestibular evaluation bundle and works through VOMS, the DHI questionnaire, mBESS, and dynamic visual acuity, following the progress panel from step one to step four. When the final score lands, the portal proposes a protocol built around the smooth-pursuit and visual-motion findings: a short fixation warm-up, horizontal pursuits, then a low-density optokinetic background. The clinician trims the optokinetic block, accepts the protocol, and moves to the wall projector. The patient works through the sequence while the clinician watches tolerance and dials the speed down once. Afterward, the dizziness score has come down and the patient tolerated the visual-motion block. The clinician adds a short note, prescribes a home program, and the session note is already written. The patient leaves with treatment started and a plan on their phone, instead of a second appointment booked to begin.

Why this matters for clinic operations

The clinical instruments in this workflow are not new. What changes the operating math for a clinic is that they are connected, so the work between them stops falling on the floor.

One visit instead of two. The assessment visit and the first treatment visit collapse into a single appointment. The patient starts care the day they are evaluated. That removes a booking from the schedule and closes one of the most common drop-off points in rehab, the gap between being assessed and actually starting treatment.

Consistency that does not depend on who is working. Because the bundle fixes the set of instruments and the portal drafts the protocol from the scores, a newer clinician or a rehab assistant runs the same validated battery and starts from the same evidence-based proposal as your most experienced clinician. The protocol stays editable, so clinical judgment is never removed, but the floor is the same across every staff member and every shift.

Documentation that writes itself. The session note is generated from what actually happened during the session, not reconstructed from memory at the end of the day. That shortens after-hours charting and produces a uniform record for every in-clinic session, which also helps when those records are reviewed later.

Better use of rooms and clinician time. Assessment flows directly into treatment, so a treatment room or a projector is working for more of the visit instead of waiting on a separate session that has to be scheduled, staffed, and set up again. Capacity you already pay for is used more fully.

What the workflow does not do

The portal does not diagnose, and it does not replace clinical judgment. The bundles deliver validated instruments and the portal proposes a starting protocol from the scores, but the clinician confirms the findings, edits or rejects the protocol, and decides how to progress care. The assessments and the treatment patterns are tools for a licensed clinician to use, not an automated diagnosis or a device that decides on its own.

This article is operational and educational information for clinic teams. It is not medical advice, and clinical decisions remain with the treating clinician.

Getting started

Assessment bundles and the Visual Therapy Studio are available on the Professional tier and above in the Eye Rehab Pro Portal. If your clinic already evaluates vestibular and concussion patients, the fastest operational win is usually the simplest one: stop splitting the assessment and the first treatment across two visits, and let one connected loop carry the patient from scores to started care before they leave the room.