Are your eyes really the problem? Three ways to tell the difference between binocular vision dysfunction and vestibular dysfunction related dizziness.

Are you experiencing dizziness and struggling to pinpoint the root cause? Today we’re going to discuss how binocular vision dysfunction can  be contributing to your dizziness, it isn’t always from your vestibular condition! In this blog post we well explore what binocular vision dysfunction is and why this can contribute to dizziness. Resources are included at the end to learn more and find a provider to see if treatment is right for you. 

Binocular Vision Dysfunction with Dr. Eliza Whatley, O.D.

Vestibular Group Fit members are getting a 6 part video interview with Dr. Madison Oak, DPT and optometrist Dr. Eliza Whatley, O.D. These two get into what binocular vision dysfunction is, the different types, treatment options, and how to request accommodations at the eye doctor with a vestibular condition! In this blog post, we’ll cover what binocular vision dysfunction is, the different types, how binocular dysfunction and dizziness go together, and seeking treatment. 

What is BVD?

Binocular vision dysfunction is when your eyes are misaligned, making it challenging for your body to interpret the input from the eyes to form 1 clear image in your brain. Binocular vision dysfunction can cause dizziness, headaches, and light sensitivity. The 3 main types of BVD are phorias, tropias and fusional vergence dysfunction.

What about when you go to an eye doctor and they say your eyes are fine but you aren’t convinced? They may be talking about accommodative disorders (blurry vision or astigmatisms). Binocular vision dysfunction goes beyond if your eyes are picking up clear images. Our eyes are positioned at slightly different angles; and binocular vision dysfunction can arise if we’re having trouble taking those two separate images (one from each eye) and forming one complete picture in our brain. 

3 types of BVD

Phoria: If a phoria is occuring, the eyes are misaligned in their natural resting state. When your eyes have a target to focus on, this misalignment is not seen.  This is identified with a cover uncover test. Your provider will cover one eye at a time and look for any changes in eye alignment when both eyes are no longer focusing on the same target.  

Tropia: Tropias are also known as strabismus or eye turn. Typically the eyes sit in a deviated position and can be seen when looking at both eyes simultaneously. People with tropias tend to be more symptomatic because the eyes are having a hard time working together and focusing on targets. 

Fusional vergence dysfunction: your eyes are aligned, but they are not working together.

How does BVD and dizziness go together

The VOR (vestibular ocular reflex) is the vestibular and visual systems working together to help keep images stable when we are moving. Having a vestibular disorder we rely more on vision to help with balance. If there’s an underlying issue with our visual system then it becomes more challenging to control vestibular symptoms (dizziness, imbalance, spinning sensations). 

If our VOR is impaired both via vestibular and visual systems, this impaired VOR can result in bouncing eyes/nystagmus and reduce peripheral vision.


Vestibular conditions do no create vision dysfunction. Typically, people already have a binocular vision dysfunction but have learned to compensate for it and the dysfucntion is masked. Once a vestibular condition arises, the body has a more difficult time masking visual dysfunction. This can be due to the impaired VOR mentioned above, and the increased reliance on the visual system that is so common in those with vestibular disorders. 

BVD treatments

Prisms. Prisms use different lenses to help move the image to a different location on the retina. This improves the position for image interpretation to reduce eye fatigue and double vision. Over time, your provider may adjust the prisms to gradual reduce the number of prisms needed for the desired effect. Some may no longer need prisms, some may need prisms as part of their glasses prescription, but are able to wean down the number of prism lenses over time. 

Vision therapy and vision exercises. This is discussed in more detail with with 6 part interview provided to Vestibular Group Fit members. Below you can access resources to connect with a provider to help assess and determine exercises that are right for you. ….they exercise, check out VGF and find a provider/BVD Q to see what’s best for you. 

Other Considerations

Other factors that can impact binocular vision dysfunction are accommodative disorders (trouble focusing on close or far objects). This is why it’s important to make sure your eye prescription is up to date. 

Having light sensitivity? This can sometimes be due to a refractory issue call astigmatism. Make sure you’re letting your eye doctor know about light sensitivity so they can evaluate for this. 

Are glasses or  contacts are more helpful? This can depend on the type of binocular vision dysfunction. This is discussed more in Vestibular Group Fit! 

Nervous about going to the eye doctor because of your dizziness? Ask an optometrist about different methods to get your eye glasses prescription than just flipping between lenses. They exist! Or ask to flip between lenses slower, or take breaks!

Other Resources

The Neurovisual Institute is a great resource for additional information: here’s some quick links below. Check out their homepage here for additional information on binocular vision dysfunction. 

Find a provider here that can assist with binocular vision dysfunction and determine a plan with you. 

Unsure if you have binocular vision dysfunction? Take the BVD-Q! This list of questions helps determine if you would benefit from BVD treatment and can help with finding a provider to assist.  


Looking for first hand accounts? Check out Susan Barry! She wrote a book about her experience with vision therapy and includes the history and science behind vision. Check out her book or her Ted Talk on Youtube!

Join us for more at Vestibular Group Fit

Want to learn more about binocular vision dysfunction and catch the 6 part video interview with Dr. Elize Whatley? Check out  Vestibular Group fit where there’s additional vestibular tools from the experts and you can be a part of a supportive community to get back to your daily life!  Find out more at this link: https://thevertigodoctor.com/about-group/


Remember: this post is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here.

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