BIRS©: Biotoxin Test (Neurotoxin Test) Instructions (CFIDS, Fibro, Lyme and Mold Sickness)

Create an Acount or Log-In to Use Testing Features:

In order to take or purchase on-line tests, you first need to log-in or create an account.

Biotoxin Illness On-Line Risk Score (BIRS) ©2007 & VCS Test Instructions

Instructions To Take the On-Line Computer Based Test

The test is very simple. Users select which symptoms they are experiencing from a list and the take an eye test (after positioning their head 18 inches from the monitor). Although the test is fairly self-explanatory, we include the following step-by-step instructions for thoroughness:

First, you will need to do the following (in this exact order):

Create an account or if you already have an account log-in. [Note: you have to be logged-in to be able to purchase or take a test.]
Go to the Testing menu and purchase a test package.
Once logged-in you will be able to take a new test or if you have previously taken tests you can view those results under the ‘My Test Results’ menu.

To obtain optimal results from the Visual Contrast Sensitivity (VCS) test, please follow these basic instructions:

You must have adequate lighting to take the VCS exam, usually the same amount you need to read.
If you need glasses or vision correction to see 20:20 at 18 inches, continue to use the glasses or contacts for the test.
If you have a known vision problem in one eye (e.g., glaucoma, cataract) that reduces your visual acuity to worse than 20:50, do not take the VCS test with that eye but instead use your good eye again. Take the VCS test only with eyes that have visual acuity of 20:50 or better.
Use a measuring tape or calibrated string to position your eyes at a distance of 18 inches (46 cm) from the computer screen.
Cover your left eye before beginning the VCS test.
Once the first test pattern image appears select the button from the bottom of the screen to indicate your response. There will be four response buttons to choose from. They indicate that the bars are tilted to the right, straight up, tilted to the left, or that you are not sure (cannot see any bars). If you are not sure that you are seeing a pattern, indicate what you think you might be seeing. If you cannot see anything, press the "not sure" button.
After each response, a new test pattern will come up and the number above the image will change, indicating that the next test image is ready. IT IS VERY IMPORTANT THAT YOU WAIT UNTIL THE NUMBER CHANGES WHICH INDICATED THE NEXT IMAGE HAS LOADED BEFORE YOU MAKE YOUR NEXT RESPONSE.
After completing image forty-five, you will be instructed to cover your right eye and continue to take the test.

After completing image 90, your test results will be scored using our algorithm, and you will receive an immediate summary of your results. These results will include:

Your Biotoxin Illness Risk Score (BIRS ©2007), which ranges between 0 and 100, with larger scores indicating a higher risk of biotoxin illness.
Your overall “pass or fail” VCS test results along with the matrix of which images you scored correctly (green) and incorrectly (red).
If you click on the My Test Results you will then see the time trends of all your previous BIRS ©2007 values and lowest consecutive correct VCS image by column. If you have only taken one test, you will only see results for that single test.
Note: if you you would like to start the test over at any time simply close your web browser, re-open it, log-in again and restart the test. You will not use up a test until you completely finish scoring all of the images.

Additional Information

Many standard medical diagnostic tests are usually normal in patients who have biotoxin related illnesses. In order to help screen for the possibility of a biotoxin being present, we use a specialized test called visual contrast sensitivity (VCS), which can detect the effects of biotoxins on the visual system. The VCS test has been our most sensitive indicator of effects caused by biotoxins and other neurotoxins. The online VCS test is a screening version of the card test of visual contrast sensitivity that is used in a physician’s office.

The VCS test can be compared to a hearing test (audiometric test). The VCS test uses different size bars (spatial frequencies) because different physiology underlies perception of different size bars. Some toxic exposures can preferentially affect perception of the large or small bars. Biotoxins primarily affect perception of the mid-size bars, but can effect the smaller and larger bars as well. We measure the least amount of contrast (difference in light intensity between the light and dark bars) you need to see bars of 5 different sizes in order to generate you contrast sensitivity function across spatial frequencies. Criteria are applied to your test results to determine whether or not they are "positive" or "negative" for the potential presence of a neurotoxic effect.

The criteria for a positive result are set high to avoid false positive results so realize that a negative VCS test result does not necessarily preclude the presence of biotoxins. Also realize that the presence of key symptoms weights heavily in the BIRS analysis. Occasionally, people with biotoxins do pass the VCS test, thereby getting a false negative result on the VCS portion of the test. Most of these individuals still show a combination of symptoms that is consistent with Biotoxin Illness, which is reflected in the BIR score. Thus it is possible to have a negative VCS test result but still have a high BIRS © value. If this is the case, and you have had a thorough work-up to rule-out other causes, you should consider biotoxin involvement. Finally, a small percentage of individuals can test negative for the VCS and also have a low BIR score, and still be dealing with biotoxins.