5018 NE 15TH AVE · PORTLAND, OR 97211 · FAX: (503) 229-8064 · (800) 837-8428 ·
[email protected] · VESTIBULAR.ORG Vision Challenges with Vestibular Disorders By Michael C. Schubert, PT, PhD with the Vestibular Disorders Association, and contributions by Kenneth Ciuffreda, O.D., PhD, FCOVD-A and Allen H. Cohen, O.D., FCOVD A common complaint for people with patients consult with an optometrist who vestibular disorders is that they have specializes in Neuro-optometric difficulty with their vision. They may Rehabilitation. The neuro-optometric experience problems focusing on an object evaluation specifically assesses the visual, or perceive that objects are moving from ocular motor and focusing skills important side to side or revolving around them for stabilizing the sensory motor (vertigo). They may see their visual field components of the vestibule-ocular reflex jiggle or bounce during head motion (or “VOR”). (oscillopsia) or have double vision (diplo- pia). When they hold their heads still, HOW DO VESTIBULAR DISORDERS these visual instability problems might AFFECT VISION? resolve. The vestibular system and the visual Many people with vestibular disorders system coordinate with each other through consult an eye care professional due to brain pathways in order to control visual their visual symptoms. The typical eye fixation. The ‘ear to eye’ connection is examination is done while the patient’s known as the vestibulo-ocular reflex head is resting against a head rest, (VOR). The VOR has a critical role of thereby reducing the head motion, which keeping the eyes still during head motion. may mask the visual symptoms. With a This is known as gaze stability.