Binocular Vision Dysfunction (BVD) is a condition that can significantly impact children’s ability to function normally. It is crucial to understand the symptoms, potential causes, and the importance of diagnosis and treatment. BVD can lead to academic and social challenges for affected children, and its prevalence in children is notable. Various symptoms can be experienced across different age groups, making it essential to recognize and address this condition early.
Overview
Binocular Vision Dysfunction (BVD) in children occurs when the eyes do not work together properly, causing eye misalignment and leading to symptoms that can disrupt learning, behavior, and everyday life. Even slight misalignment between the eyes can cause discomfort, confusion, and developmental challenges. Sensitivity to bright lights is another BVD symptom that can severely impact children’s daily activities, leading to behaviors such as covering one eye to see better or sitting too close to screens.
BVD is often missed during routine eye exams because those tests focus on visual clarity—not how the eyes coordinate. As a result, children with binocular vision problems may be misdiagnosed with conditions like ADHD, anxiety, or reading/learning disabilities when the true issue lies in their visual system. Understanding and treating BVD early can dramatically improve a child’s quality of life at home and at school.
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BVD Symptoms & Causes
Children don’t always know how to describe their symptoms, and what they experience may seem normal to them. That’s why parents and educators must be aware of the signs. Double vision or tired eye muscles are two popular symptoms that children may experience.
Common Symptoms of Binocular Vision Dysfunction in Children:
- Frequent headaches or nausea, especially after reading or screen time
- Difficulty concentrating in class or during homework
- Avoidance of reading or near tasks
- Skipping lines or losing place when reading
- Poor handwriting or writing fatigue
- Difficulty with depth perception or clumsiness
- Dizziness or feeling off-balance
- Anxiety, especially in crowded or noisy environments
- Tilting the head or closing one eye to see better
- Easily overwhelmed in visually complex spaces (like malls or hallways)
- Difficulty completing homework
- Attention difficulties
- Frequently bumping into objects
- Motion / car sickness
Causes of BVD in Children:
- Congenital eye misalignment (present from birth)
- Delayed development of eye muscles
- Neurological conditions that impact visual processing
- Facial asymmetry, which may affect alignment
- Birth trauma or injury that affects visual pathways
- Concussions / head injuries that can lead to visual dysfunction and associated symptoms
Risk Factors
Some children are more likely to develop BVD due to a combination of biological and environmental influences, including traumatic brain injury (TBI).
Risk factors include:
- Family history of eye alignment issues or BVD
- Diagnosed or suspected learning disabilities
- Diagnosed with ADHD, dyslexia, or sensory processing disorders
- History of concussion, even mild
- Developmental delays or speech/language issues
Because many BVD symptoms resemble other conditions, it’s essential to include a BVD screening alongside an eye exam when evaluating unexplained difficulties in school or behavior.
Diagnosing BVD
Standard eye exams typically test for how well a child sees—but not how well their eyes work together. Standard vision screening in schools fails to assess for subtle binocular vision, and identify subtle eye misalignments, which can lead to significant learning and attention issues, particularly in children diagnosed with conditions like ADD/ADHD. That’s why diagnosing BVD requires a different approach.
Steps in Diagnosing BVD in Kids:
- BVDQ™ Pediatric Assessment – A symptom-based questionnaire designed for children, with parent assistance for younger kids
- NeuroVisual Evaluation – A detailed, child-friendly exam to assess alignment, coordination, tracking, and visual acuity
- Cover-Uncover and Tracking Tests – Helps detect subtle misalignment missed in general vision checks
- Behavioral and Academic Observations – Reviewing how vision impacts school performance and daily activities
If your child struggles with reading, attention, or coordination and no one can explain why, a NeuroVisual Evaluation could provide long-awaited answers.
Treatment
The most effective treatment for BVD in children is custom-fit prism glasses, which gently adjust how the eyes process images. These glasses can provide rapid symptom relief and help children focus, feel better, and succeed in school. Additionally, they can significantly reduce symptoms such as headaches, difficulty reading, and coordination problems, thereby improving the overall quality of life for children with BVD.
Primary Treatment: Microprism Glasses
- Align the images from both eyes so they work together properly
- Reduce eye strain and eliminate the need to compensate visually
- Alleviate symptoms such as headaches, anxiety, poor focus, and neck pain
Additional Treatment Options:
- Vision Therapy: While usually not required in those children who respond to prism lenses, in some cases, simple exercises may be recommended to further improve coordination
- Classroom Accommodations: Adjusting lighting, seating, or print size to reduce visual stress. For children experiencinglight sensitivity, ensuring that classroom lighting is not too harsh can help manage symptoms like fatigue, anxiety, and headaches, thereby improving their quality of life and daily activities.
- Routine Monitoring: As children grow, lens adjustments will be needed
Many kids report:
- Feeling calmer in class
- Reading more fluently
- Reduced anxiety and headaches
- Better balance and confidence in sports and daily movement
Common Misdiagnoses
Because the symptoms of BVD overlap with so many pediatric conditions, misdiagnosis is common. Conditions often mistaken for BVD include ADHD, dyslexia, and learning disability.
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Learn moreBVD in children may be mistaken for:
- ADHD or ADD
- Dyslexia or reading disorders
- Generalized anxiety disorder
- Migraines
- Behavioral problems
- Vestibular disorders
- Motion sickness / car sickness
If your child has received these diagnoses but treatments haven’t worked—or symptoms remain unexplained—BVD may be the missing piece to the puzzle.
Frequently Asked Questions About BVD in Kids
1. Will my child outgrow BVD?
Not typically. Without treatment, BVD symptoms often persist or worsen as school demands increase. Children with untreated BVD may continue to struggle with the same issues, such as repeatedly reading the same things over and over, indicating difficulty with reading comprehension. However, children usually respond quickly to treatment, especially with prism glasses.
2. How soon will we see improvements with prism glasses?
Some children experience relief within minutes. For others, improvements come gradually over several days or weeks as the brain adjusts to better eye alignment. Symptoms such as blurred vision and tired eyes can improve significantly, enhancing their ability to perform academically and participate in daily activities.
3. Are prism glasses hard for kids to wear?
Not at all. Most kids adapt easily and are excited by the symptom relief they feel. Frames are chosen for comfort and style, just like regular glasses. Activities such as reading, writing letters, and playing sports can be significantly improved with the use of prism glasses.
4. Can BVD affect my child’s confidence?
Yes. Struggling with reading, coordination, trouble concentrating, or feeling different can impact self-esteem. Treating BVD often improves academic performance and emotional well-being.
5. Is vision therapy necessary?
Vision therapy is not routinely needed. Most kids find relief with prism lenses alone. However, your specialist may recommend simple exercises for additional support. Vision therapy may improve various skills, including hand eye coordination, which is crucial for children’s visual skills and their ability to perceive the distance of objects accurately.
6. Is BVD linked to autism?
While BVD is not caused by autism, visual processing difficulties are common among children on the autism spectrum. Some children with autism may also have BVD, and treating the visual misalignment can help reduce sensory overload, anxiety, and improve focus. A NeuroVisual Evaluation can help determine whether BVD is contributing to a child’s symptoms.
7. At what age does BVD start?
BVD can be present from birth or develop early in childhood. Some children begin to show symptoms as they start school and are expected to focus on reading and classroom tasks. Because kids often don’t know how to explain what they’re feeling, early signs like avoiding reading or frequent headaches may be the first clues.
8. Is BVD testing covered by insurance?
Coverage varies. While the exam and diagnostic testing may be reimbursed, specialty prism glasses often require an out-of-pocket investment. BVD evaluations may include other tests to ensure a thorough diagnosis. The NeuroVisual Specialists’ staff can help navigate insurance questions.
9. How can I tell if my child should be evaluated for BVD?
If your child shows signs of poor focus, avoids reading, has frequent headaches, struggles in school despite other interventions, or exhibits reading comprehension sensitivity, a BVD evaluation may be worth exploring.Take the Pediatric BVDQ™ assessment and see if a NeuroVisual Evaluation is indicated.
Help Your Child Thrive
If your child is facing unexplained challenges in school or daily life, don’t overlook the role of vision. Binocular Vision Dysfunction can lead to significant learning problems focusing, which can impact their educational experiences. Take the Kids BVDQ™ assessment and find answers today.
Curious if you have Binocular Vision Dysfunction?
Take the assessment to get your score and get relief.
Learn more