Vertical Heterophoria

Did you know that vision is an essential part of keeping your balance? About 20% of the nerves from the brain to the eyes also control parts of the inner ear and brain called the vestibular system that control balance. This means that problems with your eyes can also cause problems with your balance. These symptoms can include dizziness and motion sickness. 

One big cause for problems with the vestibular system come from a misalignment of the eyes known as vertical heterophoria. Even slight misalignment between the two eyes causes there to be a significant enough difference in the visual information sent to the brain by each eye that your eye muscles are forced to make constant corrections to help you see clearly. Over time this can lead to severe eye strain, headaches, dizziness, and loss of balance. 

What Causes Vertical Heterophoria?

Most often, vertical heterophoria is something that a person is born with. When we are young, we may not notice it because our bodies and brains are good at compensating for it. With aging, the eye muscles get weaker, and the problem becomes more apparent. A traumatic brain injury can make the symptoms worse. 

What Are Symptoms of Vertical Heterophoria?

We have already discussed strain, dizziness, headaches, and loss of balance. Other symptoms include:

-Pressure or feeling of heaviness in the crown of the head


-Motion sickness

-Pain on eye movement

-Sensory overload

-Trouble driving

How is it Diagnosed and Treated?

A vertical heterophoria can typically be diagnosed at a normal eye exam. To treat it, the misalignment needs to be corrected. Prism glasses can reduce or eliminate symptoms. The prism will bend light rays that enter the eye so that it is redirected to the right place on the retina in each eye. The brain will then be able to put the images together to produce a single, clear image. However, this treatment only works for the time the glasses are worn.

Vision therapy can provide a long-lasting solution. This is where different eye exercises are used to help strengthen and coordinate the eyes so that the visual system can work more accurately and efficiently.

Vertical heterophorias can be misdiagnosed very easily, so it is important to have your eyes examined every year even if you don’t think you have any eye problems.  

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