Define BVD: Understanding Binocular Vision Dysfunction
BVD, also known as binocular vision dysfunction, is a fairly common yet misunderstood condition that affects the visual system. It can dramatically affect a person’s life if left untreated and often goes misdiagnosed. The purpose of this article is to clearly define BVD, what causes it, and available treatment options. This information will allow you to get the right help on the first try.
Define BVD
Binocular vision dysfunction (BVD) occurs when the eyes are not aligned and don’t function together as a single unit. Examples are heterophoria, strabismus, and amblyopia. These can happen from genetic causes, trauma, or simply a consequence of natural aging. Regardless of the reason, BVD is a subtle yet troublesome issue that often goes undiagnosed in a traditional eye exam. A more specific exam procedure is required to identify the type and cause of BVD accurately. More on that later.
Symptoms of BVD
The severity and frequency of symptoms varies from person to person. Generally, BVD will cause the following symptoms.
- Eye strain when trying to focus on something for an extended time
- Cervicogenic headaches and tension headaches around the eyes
- Reading challenges
- Trouble gauging depth perception
- Difficulty tolerating large crowds or driving
- Light sensitivity
- Dizziness and mild vertigo induced by visual stimuli
- Nausea and motion sickness
These symptoms overlap with several other conditions, including post-concussion syndrome and vestibular disorders. This is one reason they’re so commonly overlooked in traditional eye exams.
Causes of BVD
- Brain Injury or Concussion
- Genetics
- Normal Aging
- Vascular Events (stroke/aneurysm)
- Degenerative Neurologic Conditions
Identifying the source of symptoms is essential, as the treatment options for the above can vary from case to case. In general, the treatment will include the same steps. Still, you want to ensure the underlying issues are identified and cared for first.
Diagnosing BVD
Accurate diagnosis of BFD requires a comprehensive neurologic examination containing the following pieces:
- Detailed patient history
- Assessment of eye alignment and movement
- Evaluation of how the eyes work together
- Testing of depth perception and spatial awareness
- Use of specialized equipment to measure subtle eye misalignments
The Western medical model is very “peripherally minded” in diagnosing ocular conditions, meaning it tends to look very closely at the eyes themselves. Other practitioners will also examine the brain regions that control the eye muscles to see if the condition is more of a “central” issue vs. a “peripheral” issue, as described above.
Treatment Options for BVD
Most people’s first option for BVD is something called a prism lens. These are special lenses an eye doctor will put in your glasses to compensate for what the eyes can’t do on their own. Think of these like visual training wheels. They can help essential functions for a while but are not a long-term permanent solution.
Some may prefer a more long-term solution or less of a “band-aid” approach to correcting BVD. With this in mind, many people will opt for visual exercise in the form of vision therapy or functional neurology to address the underlying ocular dysfunction. A popular strategy is to get a prism lens prescribed, perform vision exercises with the prism, and then re-assess shortly after to adjust the strength of the prism. The goal is to exercise the eye until you don’t need the prism anymore.
Another factor that goes undiagnosed in BVD is underlying vestibular dysfunction. Trying to perform complex visual exercises with a skewed vestibular system is like driving a car at 100 mph with a bent axle. Before beginning a vision-heavy program, ensure the issues aren’t vestibular. This will save you significant time, money, and discomfort.
Finding the Right Help
Living with BVD is challenging, especially if you’ve been to a doctor who isn’t familiar with it and was told you’re OK or that you’re making it up. BVD comes with a whole list of complications, from eye strain to headache, brain fog, and neck pain. Finding a qualified specialist to address this can be challenging, costly, and frustrating.
To ease the struggle, start with an optometrist or a functional neurologist. If only the eyes are at fault, an optometrist will be a great fit. If it’s more than just the eyes, a functional neurologist specializes in integrating these sensory systems together.
The Future of BVD Research and Treatment
It’s an exciting time in the world of visual problems. New studies are coming out every day that support new and more effective rehab options. Clinics everywhere are also using this new information to devise novel ways of treating BVD. If you’re reading this and have lost hope regarding BVD struggles, be optimistic that the world is finally catching up with how to address this complex problem. Better help is on the way.
Conclusion
Binocular Visual Dysfunction is a troublesome yet common complication that millions struggle with. It comes in many shapes and sizes and thus often requires a multi-disciplinary approach to get relief. A good rule of thumb is if it’s isolated to just the eyes, a neuro-optometrist is a good option. A functional neurologist is a good first step if it’s more than the eyes. Although the world of BVD has had its shortcomings in the past, it’s an exciting time with a plethora of new research emerging as we speak.
If you have questions about where to turn, click here to schedule a complimentary consultation with one of our doctors. We’ve treated hundreds of complex neurologic cases and can help piece together the missing pieces in your recovery.
*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.
