Maintaining balance is a complex process that is controlled by three different systems in the body. These are the vestibular system which is located in the inner ear, proprioception which receives information through joints and muscles in the legs and feet, and the visual system which provides input through the eyes to the brain. Vision plays a significant role in our ability to balance, orient ourselves in space and process the movement of things in our environment. Any disruption in the eye-brain connection or the visual system can result in dizziness or balance problems.
Symptoms of a Balance Disorder
People suffering from a balance disorder can be in a still position but feel as if they are moving. They may find it difficult to walk straight, especially after standing up suddenly from a sitting or reclining position. Other common symptoms include dizziness or vertigo, falling or feeling as if you are going to fall, lightheadedness, fainting, a floating sensation, blurred vision, confusion or disorientation, nausea and vomiting, and changes in blood pressure and heart rate. Anxiety or panic may be associated with balance problems.
Causes of a Vision-related Balance Disorder
There are a variety of visual dysfunctions that can cause dizziness and balance problems. Sometimes these are purely visual problems, and sometimes they are associated with disorders such as concussion, stroke, head injury or vestibular dysfunction. Sometimes an error in the glasses or contact lens prescription can cause eyestrain and dizziness.
In many cases, dizziness is caused by binocular vision dysfunction which is the inability of the eyes to work together as a team, leading to double vision, blurred vision or eyestrain and setting the stage for dizziness and balance problems. The brain receives conflicting signals from each eye and attempts to put them together for a clear and unified image, placing extra stress on the eye muscles.
Aneisokonia is a condition where an excessive difference in prescription between the eyes causes a significant difference in magnification of images seen between the eyes. The effects of this magnification difference can be disorientation, eyestrain, headache, and dizziness and balance disorders.
Normally the eyes work in perfect synchrony. Sometimes, for various reasons, one eye will aim higher than the other, causing a vertical imbalance. In an effort to adjust to the vertical misalignment of the eyes, the person will frequently tip their head to mechanically help align the eyes. This in turn can cause disruption in the fluid of the inner ear and resultant dizziness and balance disorders.
Double vision or strabismus is caused when the eyes do not align or work together and one eye turns in, out, up or down. It is among the most disorienting and devastating vision disorders. The disorientation from double vision will frequently trigger dizziness and balance problems.
Eye movement disorders typically show up as involuntary uncontrolled eye movements (nystagmus), jerkiness of eye tracking, or rapid eye movements that abruptly change fixation. Eye movement disorders may be congenital or acquired. The brain does not register that it is the eyes that are shaking, but rather interprets these movements as the world and objects in it that are moving. This frequently causes dizziness and balance problems.
Treatment for Dizziness and Balance Problems
Treatment for balance problems and dizziness related to vision is first aimed at correcting, if possible, the underlying cause for the disorder. A combination of neuro-optometric rehabilitative therapy and balance or vestibular therapy can be an effective treatment for reducing or resolving these symptoms. Neuro-optometric rehabilitation is a personalised programme involving various techniques and exercises to improve visual perception and processing, thereby strengthening the eye-brain connection. Special lenses prescribed by the neuro-optometric rehabilitation optometrist often offer considerable relief. Vestibular therapy is a specialised type of physical therapy aimed at restoring correct balance to provide relief for symptoms of dizziness.
It is important to be evaluated by a neuro-optometrist as early as possible. The sooner treatment is begun, the greater the chances for optimal results. Before the neuro-optometric rehabilitation programme begins, the optometrist will do a comprehensive eye examination to assess visual skills and determine whether visual dysfunction is present. Aside from visual function and overall eye health, he or she will also check for eye coordination, blurry or double vision, and any other ocular condition that could be causing symptoms of dizziness and imbalance.