One beautiful, spring morning you get up and get ready for work just as you do every day. With a fresh cup of steaming coffee in hand you step out onto the porch, breathe in the fresh air and bend down to pick up the newspaper. A car horn honks somewhere on the street so you stand up quickly and turn your head; suddenly everything begins to spin around you, threatening to go blank.
A quick visit to your primary care physician results in normal blood tests; your electrolytes and blood count are excellent. Your next stop will be an Ear Nose and Throat specialist. A few weeks and several tests later yield even more normal test results. Then your ENT informs you, “I’m going to refer you to an Ophthalmologist.”
An ophthalmologist? For dizziness and vertigo? These days it makes perfect sense. As medicine advances, so does our understanding of the complexities of the human body. No one system operates completely independent of all others. Everyone knows that dizziness and vertigo (the sensation that the room is spinning around you) are often related to problems of the inner ear canal, but can the eyes cause it as well?
Vertical Heterophoria is a condition of the eyes and neurological system that is currently working its way into the spotlight. People who have this condition experience episodes of dizziness and headaches because their eyes see images at different levels. The brain tries to interpret the two separate images, which results in the spatial disorientation leading to symptoms similar to inner ear disorders.
Because the eyes are seeing two images, one higher and one lower, the eye muscles may strain in an attempt to counterbalance the varying perspectives. This may be a result of an issue with the eye muscles themselves or the physical placement of the eyes. An injury may be to blame, or it may be something that you were simply born with.
Several tests need to be performed to rule out other, more common causes of dizziness and vertigo. Your ENT will likely schedule an Audiogram to test your hearing as well as an Electronystagmography (ENG) to test your balance and eye movement. Both of these tests will help to narrow down the possible causes of your dizziness and light-headedness. The audiogram and ENG together take approximately an hour to perform.
If the results from the audiogram and the ENG present no abnormalities, it is at this point you will most likely be tested for Vertical Heterophoria. An ophthalmologist experienced in treating Heterophoria can test you right in the office, even during the same visit for an updated lens prescription. He or she will test the movement of your eye muscles and see if any double vision is present.
The positive news about Vertical Heterophoria is that it is overall easily treated. The addition of prism to the eyeglasses allows the eyes to see at different angles at the same time, thus aligning the problem and relieving eyestrain. The eyes relax and dizziness disappears as the brain no longer has two different images to decipher. Most patients will experience relief from their dizziness almost immediately upon switching to their new glasses.
Here are the symptoms to look for if you suspect you may have Vertical Heterophoria: headaches, dizziness and lightheadedness, noticing that you tilt your head often (in an unconscious effort to align your eyes), or double vision. You may also find that you have a difficult time reading because the lines of the page tend to run into each other, or you may also have poor depth perception. Motion sickness is another common symptom.
If you struggle with these symptoms, your first step should be to call your doctor. Episodic dizziness and poor coordination may seem a minor nuisance now, but imagine how serious it could become if you had an attack while driving your car or holding a small child.
While still uncommon, further research into Vertical Heterophoria and continued awareness provides hope to many of us. Just when we’d thought we’d have to take life-long medication or face potential surgery we discover that all we needed was to wear some new shades. And the best part of all is, no more newspapers ruined by spilled coffee.
Works referenced:
http://www.visionspecialistsofbirmingham.com/
http://www.internalmedicinenews.com/article/PIIS1097869006732644/fulltext
http://www.menieresinfo.com/diagnosis.html
http://www.ncbi.nlm.nih.gov/pubmed/11840793
