What is it?

Vertical heterophoria is a form of binocular vision disorder that occurs when the eyes are misaligned and can be the cause of a number of symptoms in other organs. This mismatch, which can be very small, leads to the straining and overuse of the eye muscles. This leads to the symptoms of binocular vision dysfunction such as headaches and dizziness. Many patients are diagnosed wrong as suffering from vertigo or migraine disorder.

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Signs & symptoms

Most common symptoms of vertical heterophoria are headache and dizziness and they are triggered usually by: quickly standing from a seated position, shaking your head from side to side, rapidly straightening yourself after bending over, or riding in the passenger seat.


There are 4 screening tests for vertical heterophoria: 1. The Binocular Vision Dysfunction Questionnaire (BVDQ) - it is used by a doctor to screen for vertical heterophoria. 2. 5-minute cover test - alerts the patient that they may have a binocular vision dysfunction. 3. Near Point of Discomfort (NPD) - patients are following an object with their eyes, and they are told to tell when they feel discomfort or if they experience blurry vision. 4. Detailed case history - this screening tests include 6 clinical findings: vertical orbital asymmetry, furrowed brow, head tilt, pain of trapezius muscle, gait instability and balance impairment.


The main objective to treat vertical heterophoria is correcting the misalignment of the eyes. Therapeutic prism glasses are a good temporary treatment, but they only fix the problem when they are worn. In contrast, vision therapy provides a long lasting solution. The treatment takes place both in the doctor's clinic and at the patient's home.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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