Oculomotor dysfunction is a fancy term that is used by many, but understood by very few. And in order for patients to understand whether or not they have it, it’s often necessary to ask questions before seeking answers.
- Have you been left dealing with blurry vision, eye strain, or dizziness that won’t go away, even after treatment?
- Are you still looking for answers to your symptoms, even after you’ve seen eye specialists, had scans, and tried glasses?
- Have you had a previous concussion, neck injury, or whiplash diagnosis?
- Do you get headaches and visual tension with busy visual environments?
If you’re still dealing with symptoms after answering yes to these questions, there’s a high chance you might be dealing with oculomotor dysfunction. This unique, yet common condition, affects how your eyes move and work together, and it can impact everything from reading and driving to simply feeling balanced while walking through the aisles of a grocery store.
As frustrating as that may be, the good news is that with the right kind of care, you can overcome these issues and get back to living your life.
What is Oculomotor Dysfunction?
Oculomotor dysfunction refers to a disruption in the way your eyes move and coordinate together. After a concussion or whiplash injury, the delicate neural systems that control eye movements can become disrupted. In turn, these changes can affect your ability to track moving objects, shift your focus, or keep both eyes working together as a team.
Your eyes often act like a GPS system for your brain, and when they’re off, everything else can feel off, too. Symptoms like headaches, visual tension, eye pain, cognitive disconnect, dizziness, and brain fog are often reported by patients dealing with oculomotor dysfunction.
Research shows that oculomotor problems are common after mild traumatic brain injuries and may linger if not adequately addressed with personalized visual, vestibular, and neck-based therapies.
You’ve most likely been told that your vision is “fine” by your optometrist after an examination, but standard eye exams often only focus on visual acuity (how clearly you see) rather than how well your eyes move. And if your eyes and brain aren’t communicating efficiently, it can lead to a range of frustrating symptoms seen with oculomotor dysfunction.
If this sounds like you, know that there are answers out there.
Common Symptoms of Oculomotor Dysfunction
Symptoms of oculomotor dysfunction can vary, but they often include:
- Blurry or double vision, especially during reading and in busy visual environments
- Dizziness or general floating sensations
- Eye strain or fatigue during screen time and while watching television
- Trouble focusing or tracking objects
- Light sensitivity or visual overload in active sensory environments
- Headaches or difficulty concentrating
While these symptoms may come and go throughout the day, most patients feel as though they’re always present, lurking in the background. In our clinical experience, individuals dealing with oculomotor dysfunction often report that their vision still feels “off,” even after passing regular eye tests in their optometrist’s office.
Studies have shown that oculomotor deficits after concussion are associated with persistent symptoms like reading difficulty, headaches, and poor concentration. Patients also note that feeling “off”, disconnected, and confused are commonly reported symptoms, which provides further evidence of potential issues with integration between the inner ear system (vestibular system) and the cervical spine.
Diagnosing Ocular Issues
Diagnosing oculomotor dysfunction requires more than a typical eye exam from an optometrist. Optometrists often focus on examining the “hardware” of the eye, like the cornea, retina, and lens, which rarely change with ocular issues. These traditional eye tests often overlook the functional “software” problems in how your eyes move or coordinate, which is why consulting a functional neurologist or neuro-ophthalmologist is essential for obtaining a proper diagnosis.
In our experience, this is why so many patients feel frustrated after being told “everything looks normal” when they’re still dealing with symptoms.
At The Neural Connection, our team of highly trained and experienced clinicians use specialized assessments and tests to evaluate oculomotor dysfunction and visual issues. These tests, when paired with a comprehensive bedside neurological and orthopedic examination, often provide us with a clear understanding of what needs to be done for treatment.
The most common tests that we run in the office include:
- Objective eye movement testing, also known as Videonystagmography (VNG) testing, allows us to assess visual tracking and quantify specific eye movements. Within VNG testing, we assess the following visual mechanisms:
- Visual fixation, a simple yet sometimes difficult task to perform, where patients focus on keeping their eyes fixated on a static target.
- Saccades and pursuits, which are visual assessments that measure quick and smooth eye movements, respectively.
- Convergence and divergence, an important mechanism that allows your eyes to work together at near and far distances, which are often affected by oculomotor dysfunction and binocular visual disorder.
- Vestibular function, like looking for patterns of nystagmus, visual intrusions, and vestibulo-ocular reflexes (VORs), to evaluate how your balance and vision systems interact together.
These types of evaluations are supported by tools such as the Vestibular/Ocular Motor Screening (VOMS) protocol, which is widely used to detect eye movement and vestibular problems following concussions and traumatic brain injuries. When necessary, we will also utilize symptom-provocation techniques, such as the Supervised Exercise Challenge (SEC), to reveal hidden deficits and elicit underlying symptoms.
By taking an integrative approach to testing and assessing symptoms, we can deploy a range of clinical tools to identify the root causes of symptoms and create a personalized treatment plan for our patients.
Treatment Options for Oculomotor Dysfunction
As dire as your symptoms may seem, oculomotor dysfunction is treatable. Even if you’ve been told to “wait it out” or been falsely informed that “time will heal your symptoms,” many patients benefit from integrated and targeted therapies that help retrain the visual, vestibular, and cervical spine systems.
Depending on your unique needs, treatment options may include the following modalities:
Vision Therapy & Oculomotor Training
Structured and personalized eye movement exercises can rebuild your ability to focus and track moving targets, while improving visual movements and coordination of both eyes. Research has shown that these therapies can significantly improve symptoms such as eye strain, reading fatigue, headaches, visual tension, and even dizziness.
Vestibular Rehabilitation
Balance and movement-based therapies can also help your brain recalibrate altered visual and balance signals over time. Vestibular rehabilitation has been shown to effectively reduce dizziness and improve stability. When also paired with visual therapies, symptoms can improve much faster than with singular approaches to care alone.
Prism & Corrective Lenses
In some cases, providers will choose to use temporary prism glasses to relieve double vision or support eye alignment during recovery. While this can play a role in recovery, it’s essential to address the underlying neurological deficits to treat the root cause of visual dysfunction. We believe that prisms are often used as a band-aid, and if left untreated, the underlying neurological issues will continue to cause negative changes in the brain, further promoting visual issues down the road.
Personalized Home-Based Exercises
As crucial as in-office treatments are, home exercises and therapies play a pivotal role in reinforcing new patterns and behaviors, especially while changing the brain and promoting new movement patterns. The principles of neuroplasticity are reinforced through the notion that “neurons that fire together, wire together”. With that said, the more often patients perform therapies and tasks at home, combined with sleep and quality nutrition, the more those therapies become permanent.
Multisensory Integration Techniques
Personalized exercises and integrative treatments that connect head, neck, and eye movements with body position and balance therapies can help the nervous system work more efficiently. It’s a core principle of our treatment paradigm at The Neural Connection, and clinically, it has made all the difference for our patients, enabling us to achieve the outcomes we do.
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In one study, nearly 90% of patients with brain injury–related visual symptoms showed improvement after completing a structured integrative vision therapy program. And another study found that even short-term vision training improved convergence, reading speed, fatigue, and quality of life scores.
It’s evident that integrative training and therapies can play a pivotal role in finding answers to oculomotor dysfunction symptoms. Unfortunately, not all providers are created equally in this arena, which is why it’s crucial to find clinicians with experience treating these debilitating conditions.
How The Neural Connection Can Help Treat Your Oculomotor Dysfunction
If you’re reading this, chances are you’ve already tried prolonged rest, glasses, or even traditional physical therapy approaches, without lasting relief.
That’s not your fault.
Oculomotor dysfunction is complex, and as we’ve laid out, it often requires a team that understands the whole picture.
At The Neural Connection, we specialize in treating people who often feel “stuck” in recovery and have tried “all the treatments,” with little to no change. There’s a reason we take an integrative approach to care, combining neuro-optometry, vestibular rehabilitation, cervical spine modalities, and body-based therapies to address the root causes of your symptoms.
You deserve answers. And we want to provide that to you.
If you’re still struggling with persistent oculomotor dysfunction and seeking answers, schedule a complimentary 15-minute consultation with our clinical care team to explore how we can help you regain your life.
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*Note: The information provided in this article is for educational purposes only and does not constitute a doctor-patient relationship. Patients should consult their medical provider or primary care physician before trying any remedies or therapies at home.
