Your Guide to Binocular Vision Dysfunction (BVD) and Vertical Heterophoria (VH)

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.

American Family Vision Clinic

What are Binocular Vision Dysfunction and Vertical Heterophoria?

Binocular Vision Dysfunction

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

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.

Symptoms

Vertical heterophoria can lead to a number of symptoms, some of which might not be immediately associated with vision.

These include:

Dizziness

Feelings of dizziness can come and go for someone with vertical heterophoria, and it can be triggered by a range of actions, such as”

  • standing up quickly
  • moving the head from side to side 
  • straightening up quickly after bending over
  • Rounding curves in a car
  • Driving at high speed in traffic
  • Riding in a car as a passenger

Head, Neck, and Shoulder Pain

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

Anxiety, specifically while driving, is also a common symptom of vertical heterophoria.

Particular issues which may occur include:

  • Perception that signs and stoplights are moving or that your vehicle is moving backward even while you are pressing the break, which makes it hard to come to complete stops when required.
  • Generally anxiety regarding driving, due to concerns about experiencing dizziness while behind the wheel.
  • The perception that stationary objects at the edges of your vision are moving.
  • Uneasiness if places with high ceilings, due to sensory overload or disorientation due to a high level of visual stimuli.

Trouble Balancing

The dizziness caused by vertical heterophoria can also lead to trouble balancing, which can make everyday actions like going up the stairs dangerous.

Symptoms
What Causes Vertical Heterophoria?

What Causes Vertical Heterophoria?

There are two main causes of vertical heterophoria: traumatic brain injury (such as an accident or a stroke), and congenital causes.

What Causes Vertical Heterophoria?

How is Vertical Heterophoria Diagnosed?

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.

 

How are Binocular Vision Dysfunctions Such as Vertical Heterophoria Treated?

  • Prism Lenses

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

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. 

Symptoms
Dr. Zurcher cartoon

Summary

Binocular vision dysfunctions such as vertical heterophoria can have extremely negative impacts on your quality of life, with the symptoms of dizziness, anxiety, and others making day-to-day tasks difficult or even dangerous. However, vision therapy by certified neuro-optometrists can effectively treat the condition. Book an Appointment today if you suspect you might be suffering from a binocular vision dysfunction so we can schedule a comprehensive vision exam.

Related Articles

Testimonials


  • Such a nice optician. My grandson is only 4 and needs glasses. We were so sad, but he explained the issues, and we will follow up as he suggested.


    Anna P.

  • I had such a good experience with the clinic. Very friendly staff and doctor, did not have to wait for long to be called, and was treated respectfully. Thanks, American Family.


    June S.

  • Dr. Zurcher has gone above and beyond what any other eye doctor has ever done to figure out what is going on with my eyes. Very happy with American Family Vision.


    Christine R.

  • Family Vision Clinic changed our lives! My daughter was frequently car sick, and she was getting headaches every day, often painful enough that they brought her to tears. We saw a string of doctors and therapists, but we made no progress. Finally, we found Dr. Levi Zurcher and his eye therapist Rain. After ten weeks of eye therapy my daughter no longer gets headaches, and she no longer gets car sick. Daily tears are a thing of the past. I really can’t say enough about this clinic. It was fascinating to watch Dr. Zurcher work. For the first time, someone who knew what they were doing was intently studying my daughter, really trying to figure out all of her eye issues, and his therapist Rain is one of the most patient and lovely people that I’ve ever had the good fortune to meet. We’re finished with eye therapy—yay!—and I have switched to American Family Vision Clinic for all of my family’s other eye health needs.


    Lars Wulff

  • Very professional, yet kind and helpful. They do what they can to make the appointment comfortable. I was running a bit late, I made sure ti call. They were able to switch me with a patient who was already there, they treated me with respect, and helped my son have confidence by getting him the eye care he needed that day. Thank you so much! Would recommend to anyone. It's a blessing that they care enough to work with people who have all different types of insurance from work to state coverage.


    Justin E.

Blog

Atkinson Hyperlegible Font (1)

Atkinson Hyperlegible Font

Named after Braille Institute founder, J. Robert Atkinson, Atkinson Hyperlegible font is great for low vision readers.  In contrast to […]

Read More
displeased-grey-haired-man-suffers-headache-keeps-hands-head-reveal-pain-needs-painkillers-has-migraine-after-noisy-party-wears-formal-shirt-isolated-brown-wall

Binocular Vision Dysfunction (BVD)

Binocular vision refers to the ability of the eyes to work together. The term binocular vision dysfunction describes a misalignment […]

Read More
woman-putting-eye-drops-sore-eyes (1)

Contact Lens Discomfort Caused by Dry Eyes

Dry eye symptoms are the main reason that most people stop wearing contact lenses. There are many causes and reasons […]

Read More
see all blogs

Contact Us To Amplify Your EyeCare

American Family Vision Clinic Logo

Working Hours

Monday-Thursday
8:30AM-5:00PM

Friday
8:30AM-3:00PM

Saturday-Sunday
Closed

Location
400 Yauger Way SW. Bldg 1, Ste A Olympia, WA 98502
Fax
(360) 459-1097
Website Accessibility Policy
Safety protocols page
privacy policy
Cancellation Policy
For Patients
appointment
Call Us
Referrals
Assessments
eyefile-adduserphone-handsetcalendar-fullarrow-uparrow-right linkedin facebook pinterest youtube rss twitter instagram facebook-blank rss-blank linkedin-blank pinterest youtube twitter instagram