bvd binocular vision disorder

What is Binocular Vision Dysfunction/BVD disorder?

when the eyes do not work smoothly together and are not perfectly synchronized, this is called Binocular Vision Dysfunction. People with BVD struggle to see one clear image. This leads to discomfort such as headaches, dizziness, double or overlapping vision, and even problems reading.

In other words, Binocular Vision Dysfunction (BVD), a condition where the eyes have trouble working together as a team to create one clear image.

BVD is more prevalent in children than any ocular disease. In fact, the prevalence is almost 10 times greater than that of ocular disease in children 6 months to 5 years old, and 8.5 times greater in patients 6 to 18 years old.

Symptoms of BVD

If you have headaches, blurred vision, anxiety, balance problems, and dizziness, you may have binocular vision dysfunction.

“If I have 20/20 vision, then why do I still have headaches, dizziness, and anxiety?”

20/20 vision only tells us the sharpness and clarity of vision in each eye; it does not give us any information on the binocular status of your eyes. Binocular Vision Dysfunction (BVD) includes convergence insufficiency, convergence excess, divergence insufficiency, divergence excess, vertical heterophoria, superior oblique palsy, and vertical heterophoria. These BVD diagnoses are some of the most common.

BVD- binocular vision dysfunction
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Headache due to migraine or BVD?

Usually, headache due to binocular vision problems is less intense or absent in the morning after a night’s sleep and gets worse as the day wears on. Refractive error is a risk factor for headache in children.

On average, patients with migraine have a slightly higher than usual prevalence of heterophoria/ BVD , fixation disparity, and reduced stereopsis

Why does my eyes feel tired at all time with BVD?

 If you have binocular vision dysfunction, your eyes transmit two images in slightly different positions to the brain. Your brain can’t process and combine this information and responds by forcing your eye muscles to re-align temporarily to solve the problem. But this fix is short-lived, and misalignment continues to happen. Each time the brain attempts realignment, it stresses your eye muscles and leads to a range of unpleasant symptoms.

How do I know if I have binocular vision dysfunction?

If you have most of these symptoms, You should check with an Optometrist and get a Vision therapy.

  • You tend to tilt your head for focussing
  • Sore eyes and eye strain
  • Painful vision, aching face
  • Trouble with night vision
  • Difficulty with close-up vision
  • Blurry vision at near or far distances
  • Eye fatigue when reading
  • Blurry, shadowed, or double vision
  • Light-headedness or dizziness
  • Anxiety when driving
  • Trouble judging when to stop, due to difficulty estimating distance
  • Unsteady gait, trouble walking straight
  • Motion sickness
  • Lack of coordination
  • Nausea
  • Disorientation
  • Trouble holding eye contact
  • Poor hand-eye coordination
  • Poor depth perception
  • Light sensitivity
  • Difficulty with glare or reflection
  • Covering or squinting one eye to enhance vision
  • Trouble concentrating
  • Difficulty with reading comprehension
  • Skipping lines when reading
  • Seeing letters shimmering or moving
  • Words appearing to run together
  • Headaches
  • Eye movements hurt


Sometimes BVD can be misdiagnosed as ADHD.

It’s important to note that BVD and ADHD are distinct conditions with different underlying mechanisms. While vision issues can affect attention and concentration, ADHD is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity.

The challenge arises because some symptoms of BVD, such as difficulty sustaining attention or experiencing headaches, can overlap with symptoms commonly associated with ADHD.

It is essential to get evaluated by an Optometrist who measure your vision including binocular vision (eye teaming), eye movements, and accommodation (focusing)aswell as Visual pathway integrity – including refractive status, visual acuity, and ocular health

Causes of BVD, binocular vision dysfunction causes:

There are several different factors that can cause BVD;Binocular Vision Dysfunction can be caused by a variety of factors.It is important to identify the underlying cause in order to determine the most effective treatment plan. A thorough eye examination by a qualified optometrist or ophthalmologist can help diagnose the root cause of Binocular Vision Dysfunction.

Some of the causes of binocular vision dysfunction are-

1 Facial Asymmetry – Where one eye is physically higher than the other.

2. Nerve or Eye Muscle Dysfunction – Many people are born with reduced functioning of their eye muscles or ocular nerves. The eye muscles become more strained, from trying to constantly realign the images being sent to the brain. This constant effort results in fatigue and makes the BVD symptoms even worse over time.

3. Traumatic Brain Injury –stroke, concussion, brain injury, or similar neurological disorder can cause damage to functioning of the visual system resulting in a misalignment of the eyes.

“Why didn’t my last doctor check for binocular vision dysfunction?” 

Unfortunately, about 90% of the time, they don’t. Most ophthalmologists are not trained in binocular vision dysfunction and are more concerned about the health of the eye itself (i.e., Retina and optic nerve). The eye’s health is important and allows us to know why there may be reduced visual acuity, but it does not tell us how the eyes work together, just how each eye sees. 

Test for BVD

In a typical eye examination, your optometrist conducts various tests to evaluate your visual acuity, screen for common eye disorders, and examine the overall health of your eyes.

In contrast, a Binocular Vision Dysfunction (BVD) examination specifically aims to detect visual misalignment, indicating a condition where an individual’s two eyes are directed in different directions. Even a minor misalignment can be a potential cause of BVD.

Most Doctors cannot diagnose binocular vision dysfunction through standard eye tests because those tests are not sensitive enough to find the very small amount of misalignment that is causing the symptoms. With such tests, both eyes may appear to be functioning correctly.

If you suspect that you have BVD, Make sure you go prepared with a complete list of your symptoms, how long they have persisted, and why you believe the problem is related to BVD and not to another medical condition.They may refer you to a neuro visual optometrist.

Binocular vision dysfunction, BVD treatment

Treatment Options for Binocular Vision Dysfunction

There are several treatment options available for binocular vision dysfunction, depending on the severity and underlying cause of the condition. One common treatment is vision therapy, which involves a series of eye exercises and activities designed to improve the coordination between the two eyes. This can help alleviate symptoms such as double vision, eye strain, and headaches.

In some cases, your eye doctor can prescribe prism lenses to correct the alignment of the eyes and reduce visual discomfort. These lenses work by bending light in a way that compensates for the misalignment of the eyes, allowing them to work together more effectively.

Another option is surgery, which may be recommended for more severe cases of binocular vision dysfunction. This can involve procedures to realign the muscles that control eye movement or to correct structural abnormalities in the eyes themselves.

It’s important to note that treatment for binocular vision dysfunction should always be tailored to the individual patient’s needs and goals. A comprehensive eye exam and consultation with an experienced eye care professional can help determine the most appropriate course of action for each patient.

Binocular vision dysfunction glasses, BVD glasses

Binocular vision dysfunction glasses or BVD glasses are designed to correct the alignment of the eyes and help them work together more effectively. They can be prescribed by optometrists or ophthalmologists who specialize in treating binocular vision dysfunction.

BVD glasses are typically made with a prism that helps to realign the eyes and reduce the strain on the visual system. They can be prescribed for both children and adults who experience symptoms related to binocular vision dysfunction.

Prism lenses in BVD

Prism lenses for BVD enable your eyes to work together to produce an image that your brain can process more effectively.

These specialized lenses will alleviate eye strain and blurred vision, and thus eliminate the tension that is causing your headaches.

Your eye doctor may also recommend vision therapy to strengthen your visual skills and improve your visual function,

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