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Vertical heterophoria (VH) is a type of binocular vision disorder that occurs when the eyes are misaligned and can lead to a number of symptoms you may not immediately connect with your eyes. This misalignment, which can be very small, leads to the straining and overuse of the eye muscles. This leads to headaches and dizziness. Patients are often misdiagnosed as having vertigo and migraine disorder.


Vertical Heterophoria Treatment Explained

Your VH symptoms can come in waves throughout the day, leading you to feel 100 percent one moment and as if you’ve been locked in a centrifuge the next. Your headaches and dizziness can be brought on by:

  • Quickly standing from a seated position

  • Moving your head from side to side

  • Rapidly straightening yourself after bending over

  • Riding in the passenger seat

  • Rounding curves while in a car

  • Driving at high speeds with other cars whizzing by on the side

In addition to these triggers, you could also be experiencing nausea, an unsteady walking stride or motion and car sickness. You might also find yourself drifting as you’re walking down down a hallway or feeling as though you’re being pulled into someone else’s stride when walking next to them, as if by a magnet. 

Shoulder, Head and Neck Pain Symptoms

Unfortunately, the above symptoms aren’t the only ones linked to VH. Additional indications that you might have a binocular vision disorder include headaches pounding at your temples, forehead or at the back of your head. These headaches can vary in both intensity and general location. You could also experience pain whenever you move your eyes.

Additionally, those with VH often report experiencing pressure or a sensation of heaviness at the crown of their heads. This pressure can be compared to a sinus pain and can also throb its way down to your jaw region. Reports also include aching in your neck and shoulders due to a head tilt. This head tilt can be frequently quite obvious.

Driving and Anxiety

Many patients with binocular vision dysfunction such as VH experience problems while driving or have anxiety in the car. Specifically, you may experience the following while behind the wheel:

  • Perceiving stationary objects at the edges of your vision as moving images.

  • Trouble coming to a complete stop at lights and signs. Your dizziness can make it seem as though the sign is moving or that your vehicle is rolling backward while your foot is on the brake.

  • Growing concern about experiencing a bout of dizziness while you’re driving due to the anxiety caused by VH, which can be alleviated through treatment for dizziness.

Other indications associated with the anxiety triggered by VH are:

  • Feeling uneasy while in a space with tall ceilings, can lead to sensory overload or disorientation due to the flood of visual stimuli.

  • The faces of people in a packed crowd cause you to become dizzy.

How is vertical heterophoria treated?

Treatment of VH involves correction of the misalignment. There are a few ways your eye doctor may go about helping with this.

Therapeutic prism glasses may help reduce or eliminate symptoms such as headache, dizziness or eye strain. However, for prism glasses to be effective, they need to be worn most of the time and symptoms can be expected to return if the prism glasses are removed.

A more permanent solution for VH is vision therapy. 

Vision therapy is a doctor-prescribed eye training regimen that involves both in-office and at-home exercises meant to strengthen the connection and coordination of the brain with the eyes.

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