Maintaining the quality of your vision is an important aspect of overall healthy living. However, taking care of your eyes goes beyond standard exams for nearsightedness, farsightedness, and astigmatism - there are other issues that prescription glasses can correct. What if you’re struggling with symptoms not clearly attributed to eyes and sight? What if your symptoms mimic other health issues, leading your eye doctor to misdiagnose your condition?.

You could be part of the 20% of people suffering with vertical heterophoria (VH). Your comfort and well-being do not have to remain interrupted by VH. You can find relief by first understanding what VH is, what causes it, what the symptoms and signs are, and how you can treat it.

What is Vertical Heterophoria (VH)?

Vertical heterophoria is a form of binocular vision disorder. Normally, both eyes match each other in alignment. But people who live with this form of binocular vision dysfunction have their eyes slightly out of vertical alignment with each other, and one line of vision doesn’t match the other – they struggle to see one clear image. The brain cannot tolerate these blurred, shadowed or doubled images, and overworks the eye-aiming muscles and strains them, which leads to headaches, migraines and the other symptoms of VH. There can also be issues with peripheral vision. 

Vertical heterophoria means the eyes aren’t working as a team, and when this occurs the eye muscles around them must compensate to realign your images. From morning to night, and if you have VH your eye muscles are constantly trying to correct your vision. No muscle can sustain such overwork, so eventually, your eye muscles get fatigued and overused — and that’s when you start feeling the associated symptoms. 

Those uncomfortable symptoms don’t usually pop up immediately. In fact, it may take years for you to start feeling the effects because of how slight the misalignment can be. However, as years go by, you’re going to start feeling discomfort elsewhere on your body, such as your face, head, and neck, as well as the other symptoms of VH.

What Causes Vertical Heterophoria?

Many people with this form of binocular vision dysfunction are born with it. However, you can acquire this disorder from traumatic brain injuries, such as a concussion or stroke. Standard eye exams most often miss a vertical heterophoria diagnosis because many optometrists aren’t trained to recognize your symptoms as a vision disorder. Furthermore, the tests used during a routine eye exam are just not sensitive enough to identify this very small misalignment. Vision Specialists’ vertical heterophoria self-test is a good place to start if you suspect you may have VH.

What Are the Signs and Symptoms of Vertical Heterophoria?

When you have VH, it is common to not realize that what you’re feeling is related to your vision. However, uncomfortable symptoms are not the same from case to case. Vertical heterophoria symptoms include: 

• Headaches
• Neck pain or back pain
• Dizziness/motion sickness
  • Moving your head from side to side (dizziness)
  • Standing up straight after bending over (dizziness)
  • Standing up from a seated position (dizziness)
• Nausea
• Pressure in the crown of the head 
• Poor hand-eye coordination 
• Anxiety
  • Riding in the passenger seat of a vehicle (anxiety and dizziness)
  • Rounding curves while in the car (anxiety and dizziness)
  • Driving on the freeway (panic and anxiety)
• Sensory overload
• Balance and spatial awareness problems

You may experience the above symptoms when you quickly stand up after sitting or bending down and swiftly moving your head from one side to another. Sometimes you can feel the effects when driving on the freeway, at high speeds and rounding sharp turns. Sometimes you can trigger these symptoms with visually stimulating / challenging carpet and wallpaper patterns, walking down a grocery aisle, in a very bright environment, or when using computers or hand-held devices.

Sometimes you can have these symptoms all the time without any triggers at all. Of course, many other health conditions lead to these symptoms. So, how would you know to suspect that you have vertical heterophoria? We recommend screening yourself for vertical heterophoria by taking the BVD questionnaire and paying close attention to any symptoms.   Signs and symptoms that may specifically indicate this form of binocular vision dysfunction include:

• Problems navigating your environment
• Inability to concentrate/focus
• Uneasy sensations while driving

Does Untreated Vertical Heterophoria Lead to Complications or Difficulties?

Vertical heterophoria can severely affect your quality of life. As time passes, symptoms will only feel worse.  When left untreated, vertical heterophoria can lead to:

• Headache Disorder. Over time, headaches and neck pain symptoms can intensify and lead to debilitating pain.
• Postural problems. Spine misalignment can result from your head and neck constantly tilting to help your eyes vertically realign the images.. 
• Increased anxiety. It’s not uncommon to withdraw from social activities when living with this disorder. Inability to function within complicated situations can cause anxiety and lead to panic attacks.
• Comprehension difficulties. If reading words on a page is a problem, understanding what you’re reading and associated learning can be difficult. Often, children with vertical heterophoria can mimic features of ADHD or dyslexia.

Don’t ignore your symptoms or feel resigned to a life with these challenges. There are specialized optometrists who can correctly recognize your signs and symptoms. You can, indeed, find appropriate treatment.

How Is Vertical Heterophoria Treated?

Vertical Heterophoria is treated by correcting your subtle vertical eye misalignment with prescription microprism glasses. These glasses can reduce or eliminate symptoms by syncing the images between the two eyes. Specifically trained eye doctors in NeuroVisual Medicine can recognize the signs of VH and provide correct diagnoses and treatment.

Prism Lenses 

Prism can be incorporated directly into the eyeglass prescription. Prism lenses alter your neuro-visual perception by changing the direction in which light (and the image that it contains) is reflected into your eye. Prism “moves” the image, allowing your brain to “think” that an object is exactly “where it needs to be” to be in alignment. If the brain believes everything is in alignment, there is  no eye muscle strain or overuse, and no additional symptoms. You may experience a significant reduction in your symptoms after your first use of the glasses. But you must wear the glasses all the time to continue feeling relief.

Another common treatment method is vision therapy; however, this doesn't offer the immediate and complete relief of prism glasses. It also may not fix the slight misalignment that causes vertical heterophoria symptoms.  

Get Relief from Vertical Heterophoria With the Right Care

You don’t have to waste one more minute living with the adverse effects of vertical heterophoria. Screen yourself using our vertical heterophoria self-test, and find treatment for your symptoms.  The NeuroVisual doctors at Vision Specialists are specially trained to correctly diagnose and treat vertical heterophoria in adults and children, whether they were born with it or acquired it from a traumatic brain injury. The quality of your life can start improving immediately.

Contact Vision Specialists of Michigan and get started with the right therapy for your symptoms, and see how much better your vision and overall well-being can be.