Vision, Dizziness and Imbalance 

Published April 12, 2020

Many people experience dizziness or balance issues following a mild concussion or other traumatic brain injury (TBI).

If the symptoms are caused by a visual defect, a neuro-optometrist can help.

The balance system

Maintaining balance is a complex process that is controlled by three different systems in the body:

  • The vestibular system is mainly located in the inner ear and is responsible for providing the brain with information about head position, spatial orientation and motion.
  • The visual system provides input from your eyes to your brain, and is the dominant system providing cues for maintaining balance and preventing dizziness.
  • Proprioceptors in the legs and feet provide the body with a stable platform as well as information on movement and motion.

How can impaired vision cause dizziness and a balance disorder? 

When the visual system is impacted, dizziness can often result.

The most common causes of vision-related dizziness include:

  • TBI
  • Eyestrain
  • Incorrect eyeglass or contact lens prescriptions
  • Binocular vision disorder (eye misalignment)

In many cases, dizziness is caused by binocular vision problems. If a TBI causes the eyes to be misaligned, the brain will receive conflicting signals from each eye, often resulting in a double image. This will cause eye strain as the brain attempts to put the images back together for a unified and clear view of their surroundings. The extra stress on the eye muscles can cause them to shake, which can lead to light-headedness or dizziness.

Eye misalignment that causes dizziness can be so slight that it is often overlooked in routine eye exams. For this reason, it is vital for anyone who is suffering from dizziness or balance problems to have a complete functional visual assessment to rule out visual dysfunction as a cause of the symptoms.

Vision and imbalance 

People suffering from a balance disorder can be in a still position but feel as if they’re moving. Additionally, they may find it difficult to walk straight, especially after standing up suddenly from a sitting or reclining position.

Vision problems can make it challenging to maintain proper balance. When someone has reduced vision, the eye muscles work harder to compensate for the decreased visual clarity, and eyestrain, headaches, and balance disorders can occur.

The most common causes of vision-related balance problems include:

  • Blurry or double vision
  • Binocular vision dysfunction (eye teaming)
  • Concussion
  • Hemianopsia (blindness in one half of the visual field)
  • Nystagmus (involuntary and repetitive eye movements)
  • Spatial disorientation
  • Vertigo
  • Visual midline shift syndrome

How are vision problems that cause dizziness and imbalance treated?

Dizziness and balance problems often go hand in hand, and if a visual problem is at the root, it is imperative that you schedule a comprehensive eye exam to assess your overall ocular health and visual skills.  Your doctor will assess your eye coordination skills, and check for blurry or double vision, as well as any other ocular condition that may be contributing to your problem. Once the cause of the condition is identified, your doctor will recommend a customized treatment plan based on your individual needs.

What is Neuro-Optometric Rehabilitation Therapy?

Neuro-optometric rehabilitation is a personalized program of weekly therapy sessions to improve, refine, or develop new or lost visual skills.

This specialized treatment involves various techniques and exercises that improve your visual perception and processing, thereby strengthening the eye-brain connection.

In many cases, vestibular therapy will also be recommended to complement the visual treatment. Vestibular therapy is a special type of physical therapy aimed at restoring correct balance to provide relief for symptoms of dizziness.

When should you seek treatment?

It’s important to be evaluated by a neuro-optometrist as early as possible, even following a minor TBI. The sooner you begin treatment, the greater your chances for optimal results. That being said, there is still hope for patients who suffer from symptoms caused by a head injury that occurred months or even years prior— your eye doctor can assess your situation and develop a course of treatment to help you recover now.

How long does treatment take?

No two patients are alike— each person experiences a unique degree of dizziness, balance issues, or vision problems. Some patients may require just a few weeks of treatment, while others may require a more long-term treatment plan. The good news is that the improvements achieved by neuro-optometric rehabilitation therapy are generally long-lasting.

It is important to note that not every optometrist is trained in this specialized field. Only a neuro-optometrist experienced in neuro-optometric rehabilitation should assess and treat a post-TBI patient with neuro-optometric vision therapy.

Make sure that your eye doctor has the expertise and latest technology to provide you with top-level care.

If you or a loved one is experiencing symptoms of dizziness or feeling off-balance, contact your eye doctor for a functional vision evaluation. Detecting the underlying cause of your dizziness/imbalance problem is the first step to enabling you to live the life you deserve.