BVD & NeuroVisual® Medicine

Have you ever experienced dizziness, vertigo, motion sickness, blurred vision or anxiety in large crowds or open spaces? Have you ever had panic attacks while driving, or stopped driving altogether due to discomfort? Do you experience neck tension, stiff shoulders, frequent headaches, or migraines. Did you ever had strange sensations while driving, such as feeling like the car is moving backward when it isn’t, or like the floor is shifting beneath even though it’s not, yet your eye doctor says your eyesight is perfectly fine? If so, you might be dealing with a condition called Binocular Vision Dysfunction, or BVD which is a lesser-known visual problem that affects how both eyes work together.

What is Binocular Vision Dysfunction (BVD)?

Binocular Vision Dysfunction occurs when your eyes are slightly misaligned, meaning they don’t work together in perfect harmony. Each eye may see clearly on its own, but together, they send two slightly different images to the brain. The brain then has to work hard to “fuse” these images into one.

This constant effort can overwhelm your visual system, leading to a wide range of physical, visual, and even emotional symptoms, many of which often go misdiagnosed or misunderstood. Surprisingly, even slight eye misalignments that go undetected in a routine eye exam can still cause noticeable symptoms.

What Causes Eye Misalignment?

Your eyes are controlled by muscles that help them move in sync. If one of these muscles is slightly stronger, weaker, or not functioning properly, a tiny misalignment can occur.

This might be due to:

• Congenital or developmental issues like facial asymmetry, strabismus etc.

• Genetic factors

• Concussions or traumatic brain injuries

• Stroke or neurological conditions

Signs and Symptoms of BVD

Binocular Vision Dysfunction doesn’t present in just one way. It’s a complex condition with a wide array of symptoms that may include:

Visual Symptoms:

• Blurry or double vision

• Difficulty seeing clearly in dim environments

• Trouble with depth perception

• Visual fatigue, especially after reading or screen use

• Sensitivity to light or glare

• Sore eyes or strained eyes

Reading Symptoms:

• Struggles with reading fluency or accuracy

• Becomes easily fatigued while reading

• Frequently skips lines of text

• Tends to cover one eye while reading

• Reports that words appear to blur or run together

• Often needs to reread passages to understand the content

Neurological Symptoms:

• Migraine disorder

• Headaches (especially behind the eyes or forehead)

• Vertigo

• Seizures

Physical Symptoms:

• Dizziness or unsteadiness

• Balance and coordination issues

• Motion sickness

• Neck or shoulder pain due to head tilt/neck tilt (from posture compensation)

Cognitive and Psychological Symptoms:

• Difficulty concentrating or focusing

• Agoraphobia

• Panic attacks

• Anxiety with driving, particularly on highways

• Shows reduced ability to maintain eye contact

• Overwhelm in crowds

• Restless sleep pattern

​​​​​​​Many people with BVD are initially misdiagnosed with conditions like migraines, dyslexia, ADHD, anxiety disorders, or inner ear problems because their symptoms overlap.

Treatment Options for BVD

Binocular vision dysfunction encompasses several types, including Vertical Heterophoria (VH), Superior Oblique Palsy (SOP), Inferior Oblique Palsy, Esophoria, Exophoria, and Convergence Insufficiency. Each type requires a slightly different approach to treatment. Fortunately, these conditions can be successfully managed with the appropriate treatment, most individuals report noticeable improvements, and many experience substantial relief.

One of the great advantages of this testing is that, often during the exam, you’ll be able to tell if our Neuro Visual treatment will benefit you. Once Dr. Kanukuntla determines the precise amount of prism needed, she will create a pair of demo lenses for you to wear during your appointment. Many patients’ experiencing dizziness and headaches report feeling a 50% reduction in their symptoms within just 10 to 20 minutes of wearing the demo glasses and 80% improvement within 4-6 weeks. While some notice immediate relief, others may require additional time to fully adjust.

Microprism Lenses

The most common treatment is microprism glasses, which are specially customized based on individual measurements during the exam. These microprism lenses slightly alter the path of light entering your eyes. This adjustment helps align the images from each eye, making it easier for your brain to combine them.

Patients often report almost instant relief after trying on their first pair of customized lenses.

Who Can Develop BVD?

BVD can affect people of all ages, from children who are learning to read to adults coping with daily work pressures or recovering from a concussion. Children who are affected typically have the congenital or developmental form of BVD and often misdiagnosed with ADHD or learning disorders. Teens might struggle with schoolwork, especially reading and computer-based tasks, Hand-eye coordination, participation in sports, and motion sickness.

Adults are most commonly impacted by either: A congenital/developmental form that begins to show symptoms in mid-life (often around age 40) like trouble driving, focusing at work, or managing daily tasks or a concussion or brain injury that triggers the condition later in life.

Recognizing BVD Among Other Conditions

Many people receive diagnoses for a variety of conditions before discovering that Binocular Vision Dysfunction (BVD) is the actual underlying cause. Identifying BVD can be challenging and often involves first ruling out other serious medical issues. If your symptoms continue without a clear explanation, consider whether you or your healthcare providers have explored the possibility of BVD.

Common underlying conditions that may lead to BVD include:

• Post-Concussion Syndrome

• Cervical Spine Misalignment

• Meniere’s Disease

• Multiple Sclerosis (MS)

• Stroke

• Traumatic Brain Injury (TBI)

• TMJ (Temporomandibular Joint) Disorders

• Ehlers-Danlos Syndrome (EDS)

Misdiagnosis of BVD

BVD is often misdiagnosed as one of the following conditions before the true cause is identified:

• ADHD/ADD

• Agoraphobia

• Anxiety or panic disorders

• BPPV (Benign Paroxysmal Positional Vertigo)

• Chronic Dizziness

• Chronic Sinus Issues

• Dyslexia

• General Migraines/Ocular Migraines

• Learning and Reading Disabilities

• PPPD (Persistent Postural-Perceptual Dizziness)

• Vestibular Migraine / Migraine-Associated Vertigo (MAV)

Why Getting the Right Diagnosis Matters

Living with undiagnosed BVD can be exhausting. It affects not just how you see, but how you function in daily life. You might feel clumsy, anxious, or constantly drained without ever realizing your eyes are the cause.

Getting the right diagnosis can lead to effective treatment that truly makes a difference. Whether it's finding relief from chronic headaches or finally being able to read comfortably for more than five minutes, recognizing and addressing BVD can greatly enhance your quality of life of life.

If your symptoms persist, and doctors can’t explain or treat issues like dizziness, pain, or light sensitivity, it may be time to explore further and get a BVD evaluation.
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