BVD Testing: What It Is, Why It Matters, and How to Get Help

Overview

Binocular Vision Dysfunction (BVD) is a surprisingly common but often misunderstood condition affecting how your eyes work together as a team. BVD is a type of binocular dysfunction that affects eye alignment. Even a minor misalignment between your eyes can lead to significant symptoms—headaches, dizziness, blurred vision, difficulty concentrating, and more. Many people with BVD don’t realize their eyes are the problem, often going through years of misdiagnoses or ineffective treatments.

Standard eye exams typically focus on vision clarity (like determining if you need glasses or contacts for nearsightedness or farsightedness) but do not assess for subtle eye misalignments, which are at the core of BVD. That’s why it’s essential to take a dedicated Binocular Vision Dysfunction Test if you’re experiencing symptoms that haven’t improved despite consulting various specialists.

This guide will help you understand what BVD is, why it can affect your quality of life, what to expect from a BVD test, and how to find relief.

Curious if you have Binocular Vision Dysfunction?

Take the assessment to get your score and get relief.

Learn more

Symptoms: Why You Should Seek a Binocular Vision Dysfunction Test

Living with BVD can feel overwhelming. The symptoms often mimic those of other conditions, leading many people down frustrating medical journeys without finding real answers. You might have been told you have migraines, anxiety, trouble focusing, or even ADHD, but treatments just haven’t worked.

Common Symptoms of BVD Include:

• Chronic headaches or migraines, especially after reading or screen time
• Blurred or double vision, even if your standard eye test is normal
• Dizziness, lightheadedness, or vertigo
• Difficulty with balance or coordination
• Anxiety, especially in large, open spaces or crowded environments
• Neck and shoulder pain, due to constant strain from compensating for vision issues
• Eye strain or fatigue, particularly at the end of the day
• Problems with depth perception, making driving or playing sports challenging
• Reading difficulties, such as skipping lines or losing your place
• Difficulty focusing, which can be mistaken for ADHD
• Convergence insufficiency, which is difficulty with eye coordination during near tasks like reading

These symptoms can disrupt work, school, social activities, and even simple daily tasks like driving or walking in a busy area. Some people become so accustomed to the discomfort that they don’t even realize their symptoms aren’t normal.

Why Take the Test?

You should consider taking the Binocular Vision Dysfunction Test if:

• You’ve visited multiple doctors or specialists without improvement.
• You’ve been diagnosed with ADHD, dyslexia, or another learning disorder, but suspect vision plays a role.
• You’ve had a concussion or other traumatic brain injury (TBI).
• You experience symptoms that interfere with daily life but aren’t explained by other conditions.
• A friend or healthcare provider recommended it based on your symptoms.
• You have a family history of BVD.

Taking the test can be the first step toward identifying BVD as the true cause—and starting treatment that works.

Conditions Diagnosed Through BVD Testing

While BVD itself is the primary focus of this test, understanding what the condition encompasses can help clarify its role in other health issues. Other vision conditions can complicate the diagnosis and treatment of BVD by affecting how the eyes focus light onto the retinas, which can further exacerbate vision problems.

BVD May Be Misdiagnosed As:

• Migraine Disorders: Chronic headaches are a hallmark of BVD.
• Anxiety Disorders: Visual instability can make environments feel unsafe, leading to panic or avoidance.
• ADHD or Learning Disabilities: Difficulty focusing, reading, or concentrating might stem from eye misalignment.
• Balance Disorders: Trouble with gait, balance, or dizziness can suggest vestibular problems, but may actually originate from vision.
• Lazy Eye (Amblyopia): This condition, often involving misalignment, can be mistaken for BVD and requires early diagnosis and treatment to prevent permanent visual processing issues.

BVD Linked to Other Conditions:

• Post-Concussion Syndrome: Head trauma can cause or worsen BVD symptoms.
• Vestibular Disorders: The eyes and vestibular system work together to maintain balance and clear vision during movement. When one is disrupted, it can cause symptoms like dizziness or visual instability that often mimic each other.
• Reading and Learning Challenges in Children: Kids may struggle in school due to untreated BVD, which can severely affect their academic performance.
• Vertical Heterophoria: This specific type of binocular vision dysfunction involves a subtle misalignment of the eyes, often missed in standard eye exams. Symptoms can include feelings of disorientation, movement while stationary, and significant discomfort or anxiety in certain environments.

Because BVD overlaps with so many conditions, getting properly diagnosed can transform your treatment plan and quality of life.

Testing Details: How the Binocular Vision Dysfunction Test Works

The BVD Test is a symptom-focused self-assessment designed to identify whether you might be suffering from BVD. It’s tailored for different age groups and is quick and easy to complete from the comfort of your home.

Additionally, the ‘five-minute cover test’ is a simple at-home method for detecting signs of Binocular Vision Dysfunction (BVD).

Test Overview:

• Adults (14 and older): Takes about 7 minutes
• Youth (9–13 years): Also about 7 minutes, depending on reading ability
• Children (4–8 years): Roughly 6 minutes, with parental help

Additionally, a self-test for Binocular Vision Dysfunction (BVD) can be done in five minutes by covering one eye and observing an object to assess changes in pain levels.

What the BVD Test Involves:

• A series of questions regarding the frequency of your symptoms
• How severe are these symptoms
• How long you’ve experienced them
• Possible health history that might be connected to your symptoms

Once completed, your answers analyzed and you are provided a BVDQ™ Score. If you have a high enough score, you’ll qualify for a virtual consultation with a BVD Specialist to discuss your results and available treatment options.

Understanding Your Results

Your test results will be shared with you instantly after completing the assessment. They’ll indicate how likely BVD is contributing to your symptoms and whether further evaluation is needed.

It is crucial to accurately diagnose BVD, as severe symptoms can lead to prolonged suffering, preventing you from living a full and enjoyable life. 

What the Results Mean:

• Positive for Possible BVD: You’ll be advised to schedule a free virtual consultation and discuss neurovisual treatment options.
• Unlikely BVD: Your symptoms may stem from another condition, and further assessment by a BVD Specialist will not be recommended.

The test itself doesn’t confirm a diagnosis—it’s a screening tool to help you and your healthcare provider determine if specialized testing is needed.

Next Steps & Follow-Up

Step 1: Neurovisual Evaluation

If your test suggests BVD, the next step is a comprehensive neurovisual exam. This detailed assessment looks at:

• Eye alignment and coordination
• How your eyes track and focus
• Subtle misalignments not detected in regular eye exams
• The direction of eye deviations during evaluation

Unlike standard eye tests, a neurovisual evaluation is specifically designed to detect BVD and offer immediate relief when BVD is the primary cause.

Step 2: Diagnosis and Treatment Plan

If BVD is confirmed, your specialist will create a treatment plan, typically utilizing microprism glasses.

Developing a treatment plan for BVD involves a comprehensive evaluation to tailor specific solutions and interventions that improve visual coordination, reduce symptoms, and address individual needs.

What Are Prism Glasses?

Prism lenses gently bend light, aligning the visual images your eyes see so they work together properly. This alignment reduces or eliminates the strain your eyes and brain experience from misalignment, leading to rapid symptom relief. Prism glasses can also correct vertical misalignment, a condition often associated with Binocular Vision Dysfunction (BVD), by improving eye alignment through the use of microprism lenses.

Additional Treatments:

• Vision Therapy: Exercises to strengthen visual coordination (less commonly used than prism lenses)
  • Binocular Function: Vision therapy can improve binocular function through exercises aimed at enhancing coordination and muscle strength. These exercises, such as the pencil pushup and specialized computer programs, are most effective when combined with professional treatment.
• Lifestyle Adjustments: Recommendations on screen time, reading, and driving, if needed

Many patients notice improvement within minutes of wearing specialty prism lenses, while others experience gradual relief over days or weeks.

Real Patient Experiences

Daria’s Story:

Daria, a bright young child, struggled at school despite having 20/20 vision. Her comprehension was far beyond her grade level, but her reading ability lagged significantly. Before treatment, she might have relied on one eye more than the other, which could have contributed to her difficulties. After receiving special prism glasses, she not only improved academically but also felt more confident and stopped bumping into objects as often.

Christine’s Story:

Christine suffered from daily headaches and nausea starting in elementary school. Despite seeing multiple specialists, her symptoms persisted. It was later understood that neurological issues might have contributed to her symptoms, complicating the diagnosis. After being diagnosed with BVD and wearing prism lenses, she experienced a dramatic decrease in headaches and anxiety.

These stories illustrate how BVD treatment can change lives—especially when conventional methods fail.

Common Questions About Binocular Vision Dysfunction (BVD)

1. How long does the Binocular Vision Dysfunction Test take?

The Binocular Vision Dysfunction Test is designed to be quick and accessible. For adults and children aged 9 and older, the test typically takes about 7 minutes to complete. For younger children between the ages of 4 to 8, the test takes just over 6 minutes with the assistance of a parent or guardian. 

Even though the test is short, it provides valuable insights into your symptoms and helps determine whether a more detailed neurovisual examination is necessary.

2. Can my child take the BVD test?

Yes, absolutely. NeuroVisual Medicine offers age-appropriate versions of the BVD test for children. Since BVD can significantly affect reading, concentration, and classroom performance, early detection is crucial. Facial asymmetry can contribute to BVD in children by causing misalignment of the eyes, which may lead to various vision-related symptoms and complications.

• Ages 4–8: Parents are encouraged to help read and explain the questions. Children at this age may not fully understand or be able to articulate their symptoms without guidance.
• Ages 9–13: Older children can typically complete the test independently, though some may still need help if reading is difficult due to BVD symptoms.

Taking the test with your child ensures more accurate responses, which can lead to quicker diagnosis and treatment.

3. What happens after I complete the BVD test?

Once you submit your BVD test responses, you or your child will receive a BVDQ™ score.  If your score is over the symptom threshold (different for each age group), you’ll qualify for a free virtual consultation with a BVD specialist.

If the results suggest that you may have BVD:

• You’ll be contacted to discuss scheduling a neurovisual evaluation.
• Additional information may be requested to better understand your symptoms.
• You will receive guidance on the next steps, including what to expect from an in-person exam. 

If your results do not indicate BVD, you may be referred for further evaluation of other potential causes of your symptoms.

4. What is a NeuroVisual® evaluation, and how is it different from a regular eye exam?

A NeuroVisual® evaluation is a specialized examination that goes beyond a typical vision check. While a standard eye exam focuses on visual acuity (how well you see at various distances), a NeuroVisual evaluation looks at:

• Eye alignment: Detects subtle misalignments that can cause BVD.
• Coordination between the eyes: Assesses how well your eyes work together.
• Visual tracking and focusing: Evaluates how your eyes follow objects and shift focus.
• Specific types of eye misalignments: Identifies subtle alignment issues that may require targeted treatment—such as microprism lenses—for accurate diagnosis and long-term relief.

This evaluation is specifically designed to diagnose BVD and is performed by a specialist trained in NeuroVisual® Medicine. It involves advanced techniques and tools not used in general optometry.

5. How do prism glasses treat BVD?

Prism glasses are the primary treatment for BVD. These lenses contain special prisms that bend light before it enters your eyes, effectively realigning the images seen by each eye so your brain can merge them into one clear picture. This helps in merging the two images caused by misalignment into a single, clear image.

Here’s how prism glasses help:

• Reduce eye strain: No more overcompensating for misalignment.
• Alleviate symptoms: Headaches, dizziness, and visual fatigue often improve quickly.
• Enhance focus: Reading and concentration become easier.

Many patients experience immediate relief upon wearing prism glasses, while others notice steady improvement over days or weeks as their visual system adjusts.

6. How quickly will I notice improvements after starting treatment?

Most patients report noticeable improvement within minutes of wearing prism glasses for the first time. Symptoms like dizziness, blurry vision, and headaches often decrease significantly. Many also experience an improvement in their sense of balance shortly after starting treatment.

However, everyone’s experience is different:

• Some people feel better right away.
• Others notice gradual improvements over the course of a few days to weeks.
• Your specialist will monitor your progress and make refinements to your lenses as necessary.

The key is consistent wear and follow-up to ensure the treatment is as effective as possible.

7. Can BVD come back after treatment?

Once treated, many patients find long-term relief from their symptoms. However, ongoing care is important:

• Periodic checkups are recommended to adjust prism lenses as your visual system adapts or changes over time.
• In some cases, symptoms may re-emerge if treatment is stopped, but reintroducing prism lenses typically restores relief quickly.
• New injury can also cause symptoms to surface. A new NeuroVisual evaluation to address the harm caused by this new injury is recommended and proper treatment will be discussed based on the specialist’s findings.

BVD management is often a lifetime commitment, but with proper care, it doesn’t have to disrupt your life.

Curious if you have Binocular Vision Dysfunction?

Take the assessment to get your score and get relief.

Learn more

8. Is vision therapy necessary if I wear prism glasses?

Prism glasses are the most effective and commonly used treatment for BVD. Vision therapy—a series of eye exercises designed to improve eye coordination—may be recommended in certain cases, particularly if:

• You have significant visual processing issues.
• You’ve had a recent traumatic brain injury.
• Your specialist believes additional strengthening of eye muscles or visual pathways will enhance your recovery.

However, in some cases, vision therapy exercises can exacerbate symptoms of BVD.

Most patients achieve sufficient symptom relief with specialty prism glasses alone, without needing vision therapy.

9. What causes BVD?

BVD is typically caused by subtle eye misalignments, which can be:

• Congenital: Present from birth but worsen over time.
• Acquired: Due to trauma, such as a concussion or TBI
• Age-related: As muscles weaken with age, previously manageable misalignments can become symptomatic.

The exact cause may not always be clear, but identifying the presence of BVD allows for effective treatment regardless of its origin.

10. What if I’ve already been diagnosed with another condition?

Many BVD patients have been previously diagnosed with conditions such as:

• ADHD
• Anxiety disorders
• Migraines
• Vertigo or vestibular disorders

BVD symptoms often mimic or overlap with these conditions. Symptoms related to eye movement, such as those affecting how nerves control specific muscles associated with eye movement, can also be mistaken for other neurological issues. Even if you’ve been diagnosed elsewhere, it’s possible that BVD is contributing to or exacerbating your symptoms.

Getting tested for BVD can help you refine or reassess your diagnosis, leading to better, more targeted treatment.

11. Will my insurance cover the cost of testing and prism glasses?

Insurance coverage for BVD testing and treatment varies widely depending on your provider and plan. Many insurance policies cover:

• Diagnostic tests, including certain procedures within the neurovisual evaluation.

It’s best to:

• Contact your insurance provider to confirm benefits.
• Ask your vision specialist for assistance with insurance pre-authorization. Your vision specialist can refer you for insurance pre-authorization to ensure that all necessary steps are taken.

Many patients may have out-of-pocket expenses for the specialty prism lenses, but many find the relief from symptoms well worth the investment.

12. Can BVD affect my driving?

Yes. BVD can make driving particularly challenging due to:

• Poor depth perception
• Difficulty focusing on moving objects
• Anxiety, especially on freeways or in heavy traffic
• Sensitivity to bright lights on the road at night

Eye doctors, particularly those specialized in diagnosing and treating BVD, play a crucial role in improving driving safety by providing appropriate treatments.

After treatment with prism glasses, many patients report:

• Feeling more confident behind the wheel.
• Fewer accidents or close calls.
• Better ability to judge distances and stay in lanes.

If driving has become stressful or dangerous for you, BVD treatment may help restore your confidence and safety.

13. Can BVD symptoms worsen over time?

Yes. Left untreated, BVD can lead to:

• Increased frequency and severity of headaches
• Worsening balance problems
• Heightened anxiety or avoidance behaviors
• Reduced quality of life

That’s why early diagnosis and treatment are so important. Taking the BVD test is a simple step that could prevent years of discomfort and frustration.

14. Can BVD affect academic or work performance?

Absolutely. BVD can make reading, computer work, and concentration difficult, leading to:

• Poor academic performance in children
• Decreased productivity in adults
• Frustration and fatigue from struggling with tasks that rely on visual coordination

Refractive errors can complicate BVD, further affecting performance by making it harder for the eyes to focus light correctly onto the retinas.

Treating BVD can result in better focus, improved performance, and a greater ability to handle daily responsibilities without discomfort.

Find Relief From BVD

If you’ve been dealing with unexplained symptoms and haven’t found answers, BVD could be the missing piece. Take the Binocular Vision Dysfunction Test today and take the first step toward better vision alignment, fewer symptoms, and a more enjoyable life.

For more information and to schedule your appointment, visit NeuroVisual Medicine today.

Curious if you have Binocular Vision Dysfunction?

Take the assessment to get your score and get relief.

Learn more