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An overview of vertical heterophoria with Dr. Scott Irvine
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- Опубликовано: 19 авг 2024
- Vertical heterophoria can be a small misalignment that causes our brain to work harder at receiving visual signals.
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I just came across Vertical heterophoria the other night. I've been experiencing dizziness for over 10 years and headaches even longer than that. I've tried everything. Botox, physical therapy, acupuncture, medications for anxiety. My driving anxiety has gotten soooo bad this year. I really hope this can be fixed with a pair of glasses. Thank you for your video!
Please make sure you see a neuro-optometrist who can assess for vertical heterophoria and other conditions that may be related to what you're experiencing. There are different ways of testing/interpreting the information, and it's not uncommon for some eye care professionals (optometrists or ophthalmologists) to either miss it, or conclude it's not actually a problem.
Then when it comes to glasses, the specifics of how they are made can impact how helpful they are- or if they may make it worse in some ways.
COVD.org (USA) or Vision Therapy Canada are great ways to find a doc close to you.
@@opto-mization thank you so much! I see my regular eye doctor soon but I am wondering if I need to see somewhere else
Thank you for this video. I’ve been going crazy going to doctors and nothing has helped. I’m a truck driver and I can’t drive more than an hour when I get this big sensation of being dizzy, which gives me terrible anxiety. I’ll be making a trip to my eye doctor.
I suffered from the described syptoms. Theses symptoms startet in a light way years before, but they did not really bother me. In a period of intense work, when I wrote my masters thesis I started to get dizzyness and headache every day. I thougth that it's just a reaction to the stress, but even after my masters thesis symptoms stayed. Aftter months of searching for the cause of my problems an optometrist prescribed me prism classes, which helped me. The problem with these prism classes ist that they are really addictive, meaning that once your visual system gets used to them, the symptoms come back even stronger. For me as I like to do different kind of sports like soccer and wrestling this is a problem. So I started visual therapy around 6 months ago. I take it really serious and do my exercises every day. For working I use my prism classes, after work I take them off. However after 6 months of training, a change of my diet to more healthy food, a better sleeping rythm I sill suffer from dizzyness after taking off the classes or when I try to work without them. It seems that vision therapy is quite a long road. Also a lot of optometrist claim that there's no way to get rid of vertical heterophoria with visual training.
You bring up some really good points. Being able to train the vertical range to compensate for a vertical phoria is really limited. You can often gain a few prism diopters (angle measurement), but it’s not something that we usually do vision therapy for as a stand alone issue. That said, most people with vertical phorias also have other binocular anomolies that respond well to treatment.
The main issue is the most vertical phorias are anatomical in nature, or due to issues with signalling to the muscle (or muscle itself).
The prism glasses aren’t so much addictive, your brain gets used to stable vision again and is more aware when it’s unstable.
Even the different ways of prescribing vertical prism can have a very different effect on outcome and progression.
Please bring exactly these concerns to your doc. We often sit and draw this stuff out for patients and walk them through it all so they are truly empowered in their own care.
Thank you for the detailed Information. Do you know any strategy how people who wear prism glasses can practice contact sports? Actually there is no chance on contacts
Its quite strange that there are so may people where you can see clearly that there is a vertical heterophoria, but they don’t suffer from any symptoms. Whats the reason behind that?
Great question. What do you mean by see clearly? If you mean your testing shows a vertical but they have no symptoms, it usually means they have really good vertical vergence ability and easily compensate for it. The symptoms really align with how well (or not) the persons visual system can maintain stable binocular fusion. This is more related to their ability to compensate then whether or not they have a vertical phoria or how large it is.
Hope that helps.
Hey doctor.
When i read from afar i see the words dripping down.
In the mirror i can see at the top of my iris that, the whites of my eyes are slightly covering my iris.
I hear from many others this doesnt get worse, i hope it doesn't get worse.
What is the average prism required?
1prism Diopter?
The average amount of prism for a vertical heterophoria just depends on the alignment of that persons eyes. It’s not a one size fits all approach, it’s about measuring what gives the person the best function and least symptoms.
I have a slight misalignment vertically in both eyes. Vertical hetraphoria wasnt mentioned. Ive been doing vision therapy since 2021 and i didnt feel any better. From ehat im researched vision therapy cannot bring the eyes up or down, only side to side so i tjink VT is only good for horizontal issues.
Sometimes vision therapy can help with some level of vertical, but usually vertical prism is also required. If vertical alignment is off, it can take away from other progress you have made. Many patients have had huge gains from vision therapy that they have not been able to realize until the lenses also balance the vertical.
When you say it can develop later on in life, what ages do you mean exactly?
I’m 38 and started having weird heatwave like vision when focusing on things in the distance. It feels like my eyes are strained and overworking everyday
That can be a symptom of general binocular dysfunction as well. Definitely find someone good to see.
Can this be mistaken for astigmatism as well?
I only have it in one eye. And my eyes are misaligned.
Yes. That’s why I found a new doctor. I have misaligned eyes that’s been missed. I just got my prism glasses three weeks ago. Still adjusting but my headaches are gone. I’m still dizzy but not to the extreme I was. My anxiety has lessened. Unfortunately my anxiety from my vision has taken on a life of its own. Working on that.
can wearing small amout of priam .5 diopters only can be bad in the long run?
It totally depends on the case. If prescribed and used properly it should be beneficial for you.
I have had minor prism in my glasses the last 5 years to correct for this. Now I’d like lasik but they said I’d still need glasses due to vertical heterophoria. Can therapy correct this issue?
Great question! Sometimes vision therapy can help compensate for a minor vertical heterophoria. What is your prescription?
Trying contact lenses is an easy way to test what lasik would be like.
I don’t recall the exact prism number but I recall my optometrist saying it’s minor. Do you recommend decreasing slowly over time or if minor is it better to rip off the bandaid all at once? Thanks for your response and content!
Can therapy help or only prisms? So hard when every specialist says the opposite.
It can often be a combination of both, or one or the other. Completely depends on the case and the goals. I wish I could give you a more distinctive answer.
@@opto-mization thank you! My neuro opt says he will only give prism as a last resort, i went to the one who first gave me the smallest prism rx and she said therapy would never help vertical misalignment at all. Very conflicting! Lol
@@user-zk8ck3my3l can you please update me on your treatment. did anything help you?
@@KasymAbdyllayev hello :) therapy has helped some, the more i do exercises the better my tracking gets. Im still having issues- A- i cant get into therapy regularly enough- time and cost. B- im working on a computer 40hrs a week, which is why my eyes are having more issues than ever. C- i think a lot of my issues are from muscle dysfunction and tension, i think tmj and upper neck problems are effecting the nerves to the eyes and muscles around my eyes. The worse my muscles spasm, the worse my eyes feel. So i am actually trying to figure that out a bit right now, get all that by o settle if possible, then go back to vision therapy. Even the eye dr said check those muscles also, as they can contribute. I got better with my CI but it is still not normal- again, computer work counter acts my vision therapy. If your eyes are too tired, they therapy isjt really effective. I have a Con/Div tool thtey use in therapy i now use at home. I dont do it enough, should be 15min daily but again, i skip days work makes my eyes feel dizzy and tired. It does help though. My dr felt the CI was my main issue, not the slight vertical misalignment. However, some could disagree… it seems whomever prescribes prisms or who doesnt is what info they give about it. So overall yes its helpful but im still having the same issues but again… i have a lot of neck jaw and face muscle issues. Which i know connects with the eyes.