Can an optometrist diagnose vertical heterophoria

Vertical heterophoria ,“Can an optometrist diagnose vertical heterophoria”

Do you often experience headaches, dizziness, nausea, or eye strain or you have trouble reading, driving, or focusing on near objects? Do you feel unsteady, disoriented, or anxious in crowded or busy environments? If you answered yes to any of these questions, you may have a condition called vertical heterophoria.

what is vertical heterophoria?

Can an optometrist diagnose vertical heterophoria

Vertical heterophoria (VH) is a type of binocular vision dysfunction (BVD) that occurs when the eyes are slightly misaligned

In order for your eyes to “see,” the brain has to be able to take the two images you’re seeing and combine them into one clear image. The eye muscles do the extra work and as a result get strained and cause headache and problems with coordination and balance.

Vertical heterophoria thus is a binocular dysfunction which can result in headache, double vision, dizziness, anxiety while driving.

Many patients who suffer from Vertical Heterophoria (VH) find themselves extremely anxious in large, open spaces with high ceilings.

symptoms of vertical heterophoria

How do I know I may have Vertical Heterophoria/ vertical misalignment of the eyes?

If you feel bouts of dizziness, nausea and motion or car sickness, anxious in large place, pounding headaches, particularly at your temples or back of head at varying intensity. and double vision you may get your eye checked by an Optometrist or an ophthalmologist. Some people experience Nausea that makes it seem that the sign is moving or the car is rolling backward even if your foot is on the brake.

The symptoms of vertical heterophoria can vary from person to person, depending on the severity of the misalignment and the individual’s sensitivity. Some common symptoms include:

  • Headaches: VH can cause tension headaches, migraines, or sinus-like pain in the forehead, temples, or back of the head.
  • Dizziness: VH can cause a feeling of spinning, swaying, or tilting when moving the head or changing positions.
  • Nausea: VH can cause motion sickness, especially when riding in a car, boat, or plane.
  • Eye strain: VH can cause blurred vision, difficulty focusing, dry eyes, or eye pain when reading, working on a computer, or watching TV.
  • Balance problems: VH can cause a feeling of instability or unsteadiness when walking or standing.
  • Anxiety: VH can cause a feeling of nervousness, panic, or claustrophobia in crowded or busy places.

vertical heterophoria causes? what causes vertical heterophoria?

Vertical heterophoria can be caused by various factors, such as:

  • Genetics: Some people are born with a slight difference in the size or shape of their eyes, which can cause vertical misalignment.
  • Trauma: A head injury, concussion, stroke, or surgery can damage the nerves or muscles that control eye alignment, resulting in VH.
  • Aging: As people get older, their eye muscles may weaken or lose flexibility, making it harder to maintain eye alignment.
  • Stress: Emotional or physical stress can affect the eye muscles and cause them to spasm or tighten, leading to VH.

Vertical heterophoria Diagnosis

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Diagnosing Vertical Heterophoria can be challenging, as it is often misdiagnosed as other conditions such as migraines or sinus problems. However, there are some key signs that eye doctors look for when diagnosing this condition. One of the most important diagnostic tools is the Maddox Rod Test, which measures the degree of vertical misalignment between the eyes. Other tests may include a cover test, in which one eye is covered at a time to assess how the eyes work together, and a prism test, which uses prisms to measure the degree of misalignment.

If the patient has double vision, dizziness, anxiety while driving inspite of correct refractive correction, this may point to symptoms of Binocular vision disorder and should be assessed for Vertical heterophoria. The patients can be referred to a neuro optometrists.

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Who can diagnose Vertical heterophoria?Can an optometrist diagnose vertical heterophoria

Usually opthalmologist miss Vertical heterophoria. You can visit a  The Neuro Visual Center  if any or ask your opthalmologist if he can advice about your binocular vision dysfunction. This is because generally an ophthalmologist just checks each eye for its visual acuity. Only a comprehensive eye exam done by a qualified eye doctor will assess how your eyes work together – called binocular vision. Even the tiniest amount of misalignment can cause the disturbing symptoms of BVD.

A neuro-optometrist is an eye doctor who has advanced training and experience in diagnosing and treating binocular vision disorders like VH. A neuro-optometrist will perform a comprehensive eye exam that includes:

  • A detailed medical history and symptom questionnaire
  • A visual acuity test to check your vision at different distances
  • A refraction test to determine your prescription for glasses or contact lenses
  • A cover test to check for any eye deviation when one eye is covered
  • A Maddox rod test to measure the degree of vertical misalignment using a red line and a white light
  • A prism test to measure how much prism power is needed to correct the misalignment and eliminate double vision
  • A near point of convergence test to measure how close you can bring an object to your nose before seeing double
  • A fixation disparity test to measure how well your eyes maintain single vision when looking at a target
  • A stereopsis test to measure your depth perception and binocular vision

Vertical heterophoria Test:

Cover test, Fixation disparity test

The identification includes a cover test that makes it easier for small lid movements up and down vs. looking at the actual site. 

Fixation disparity is a technique that measures the direction and magnitude of the vertical deviation under conditions with fusion. The amount of prism required to reduce vertical alignment can resolve the patient’s symptoms. Testing results to determine distance and near-associated heterophoria is another alternative way of checking for vertical heterotrophic

Vertical heterophoria Treatment

If your doctor performs tests and diagnose Vertical Heterophoria, they may provide you a correction called Micro-prismatic aligning lenses 

Vertical heterophoria glasses: Prism glasses for vertical heterophoria

Prism glasses may have a stick on prism called fresnel prism. It is generally used as trial.These are made of vinyl and are attached to your regular lenses. These are not visual acuity correction but have zero power and can help your eyes focus.

Once it’s clear that you need prisms and that the prisms are correcting your double vision, your ophthalmologist will prescribe prism lenses for long-term use. These prisms will be ground into your regular eyeglasses. Your eyeglasses will look just the same as before, but one of the glasses might be thicker.

What are prism lenses?

When your eyes are misaligned, they don’t move accurately together. The images are formed on different parts of your retinas and you see double. Prism glasses compensate for eye misalignment by redirecting the light rays to make the two images align.

Micro-prism lenses are specialized lenses that work to realign the images sent to your eyes, instead of requiring your eye muscles to strain in order to realign what you see.

Prism lens correct double vision and headache.

Prism glasses are successful in 68% to 88% of people with diplopia and are a valuable non-surgical treatment option. Strabismus surgery is an option if prism glasses don’t work.

Vertical heterophoria
pic credit- hellomath

How do prismatic lenses in glasses work?

Prism glasses work by bending light as it enters the eye, which helps to correct the misalignment of the eyes that occurs in vertical heterophoria. The lenses in prism glasses are thicker at the top or bottom, which causes the light to bend and shift the image seen by one eye so that it aligns with the image seen by the other eye. This allows both eyes to work together properly, reducing eye strain and improving visual acuity.

Prism glasses can be prescribed in different strengths depending on the severity of the condition. They can also be combined with other types of lenses, such as those for nearsightedness or farsightedness, to provide a complete vision correction solution. It is important to note that prism glasses do not cure vertical heterophoria, but they can significantly improve symptoms and quality of life for those who suffer from this condition.

Benefits of Using Prism Glasses for Vertical Heterophoria

Prism glasses have been found to be an effective treatment for individuals with vertical heterophoria. By correcting the misalignment of the eyes, prism glasses can alleviate symptoms such as headaches, dizziness, and eye strain.

When the eyes are not properly aligned, it can be challenging to focus on objects in the environment. Prism glasses help to correct this issue, allowing individuals to see more clearly and with greater detail.

It reduces eye strain and fatigue. When the eyes are misaligned, they must work harder to maintain focus, leading to increased strain and fatigue. By correcting the alignment, prism glasses can reduce the workload on the eyes, resulting in less strain and fatigue.

Prism glasses can also help to alleviate headaches and dizziness associated with vertical heterophoria. These symptoms are often caused by the misalignment of the eyes, which can lead to visual disturbances and difficulty processing information. By correcting the alignment, prism glasses can reduce these symptoms and improve overall comfort.

Treatment of Vertical heterophoria

  1. Prism lens

Vertical heterophoria can be a challenging condition to manage, but there are several treatment options available. One of the most common treatments is the use of prism lenses, which help to correct the misalignment of the eyes and reduce symptoms such as headaches and dizziness. These lenses work by bending light in a way that compensates for the eye misalignment, allowing the brain to process visual information more effectively.

2. Vision Therapy

vision therapy involves a series of exercises designed to improve eye coordination and strengthen the muscles responsible for controlling eye movement. This type of therapy can be particularly effective for individuals with mild to moderate cases of vertical heterophoria.

3. Surgery

In some cases, surgery may be recommended to correct the underlying issue causing the eye misalignment. However, this is typically only considered in severe cases where other treatments have been unsuccessful.

Living with Vertical Heterophoria: Tips and Strategies

Living with Vertical Heterophoria can be challenging, but there are several tips and strategies that can help you manage your symptoms and improve your quality of life. Here are some things to keep in mind:

  1. Be mindful of your posture: Poor posture can exacerbate the symptoms of Vertical Heterophoria. Try to sit up straight and avoid slouching or hunching over.
  2. Take breaks: If you spend a lot of time reading or working on a computer, take frequent breaks to rest your eyes and prevent eye strain.
  3. Use proper lighting: Bright lights or glare can make symptoms worse. Make sure your workspace is well-lit but not too bright.
  4. Wear the right glasses: If you have been prescribed glasses for Vertical Heterophoria, make sure you wear them as directed. Wearing the wrong prescription or not wearing glasses at all can make symptoms worse.
  5. Manage stress: Stress can trigger or worsen symptoms of Vertical Heterophoria. Try to find ways to manage stress, such as meditation, exercise, or talking to a therapist.
  6. Get enough sleep: Lack of sleep can also exacerbate symptoms. Make sure you get enough restful sleep each night.
  7. Communicate with others: Let your friends, family, and coworkers know about your condition so they can better understand and support you.

Find Vertical heterophoria doctors

You can check this list of Specialist who are expert in Vision function disorders.

More information here : Webmed

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