Binocular vision dysfunction (BVD) and Vertical Heterophoria (VH) are two vision issues which may surface after someone suffers a traumatic brain injury, such as a stroke. Both of these conditions can have significant impacts on one’s quality of life. Fortunately, effective treatment options are available.
Binocular vision is the ability of the eyes to work together as a team, so the term binocular vision dysfunction means that there is a misalignment between the lines of sight of each eye. This misalignment can be horizontal, vertical, or both. If the misalignment is severe enough, the patient will experience double vision or diplopia, while minor misalignments will have the patient still see a single image, but still cause eye strain, which can lead to other problems.
Vertical heterophoria is a type of binocular vision dysfunction which is believed to be caused by a lack of proper coordination between the two main vertical eye alignment mechanisms; the balance (vestibular) system and the vision (oculomotor) system.
Vertical heterophoria can lead to a number of symptoms, some of which might not be immediately associated with vision.
These include:
Feelings of dizziness can come and go for someone with vertical heterophoria, and it can be triggered by a range of actions, such as”
Other signs you have vertical heterophoria include head pain (specifically at the temples, forehead, and the back of the head). The intensity of these headaches can also vary. Those suffering from vertical heterophoria may also experience a feeling of heaviness near the crown of the head, comparable to the pressure from sinus pain.
Neck and shoulder pain can result from head tilting to compensate for the vision difficulties caused by the misaligned eyes.
Anxiety, specifically while driving, is also a common symptom of vertical heterophoria.
Particular issues that may occur include:
The dizziness caused by vertical heterophoria can also lead to trouble balancing, which can make everyday actions like going up the stairs dangerous.
There are two main causes of vertical heterophoria: traumatic brain injury (such as an accident or a stroke), and congenital causes.
A diagnosis of a binocular vision dysfunction, such as vertical heterophoria, can be made following a comprehensive vision evaluation performed by a neuro-optometrist. Basic eye tests may not detect these, and some of the symptoms may not lead people to suspect a vision issue.
Prism lenses can provide relief from symptoms such as double vision, as they help you compensate for the misalignment. However, these more provide short term relief than proper treatment.
Vision therapy, on the other hand, helps you (re)develop the visual skills necessary to maintain proper eye alignment, and once this ability is gained, the problem, in most cases, is completely resolved.
Surgery is in most cases not recommended for these conditions.
If you suspect you might be suffering from a binocular vision dysfunction, reach out to a listed practice for a comprehensive vision exam. They are ready and equipped to provide you with the care you need.