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How to Spot and Treat Binocular Vision Dysfunction: A Comprehensive Guide

Updated: Jan 31

Do you struggle with unexplained dizziness, blurred vision, or discomfort daily? These unexpected challenges may be signs of a condition known as Binocular Vision Dysfunction (BVD). Throughout this knowledge-packed guide to binocular visual dysfunction, we'll unravel the mysteries of BVD, shedding light on its symptoms, causes, and effective treatment options. If you're seeking clarity and relief from these vision-related issues, read on to discover how to regain control of your visual comfort. Let's dive deeper into BVD!

What Is Binocular Vision Dysfunction (BVD)

BVD is a condition in which the eyes struggle to work harmoniously, even when they appear physically aligned. Unlike many vision disorders, which focus on the clarity of individual eye functions, BVD is all about the coordination between both eyes.

In individuals with BVD, each eye sends two slightly different images to the brain, causing vision disruption and various symptoms. Let's explore the underlying causes of this intricate condition.

Causes Leading to BVD:

Here are the reasons that triggers Binocular Vision Dysfunction:

Misalignment of the Eyes:

One of the primary causes of BVD is the misalignment of the eyes, where they do not cooperate seamlessly. Even a slight misalignment can disrupt the brain's ability to merge the images received from each eye, leading to vision disturbances.

Neurological Factors:

BVD can also develop as a result of neurological factors. Conditions such as strokes, brain injuries, concussions, or other neurological disorders can affect the brain's ability to process visual information accurately. This can manifest as BVD, with symptoms usually appearing around the age of 40.

Facial Asymmetry:

In some cases, facial asymmetry can contribute to the development of BVD. Over time, a situation may arise where one eye sits higher than the other or exhibits an abnormality in its nerves or eye muscles, potentially eyes are misaligned. Many individuals with these characteristics may begin to experience BVD as their eye muscles weaken and become overworked.

Distinguishing BVD from Other Vision Disorders:

It's essential to differentiate BVD from other vision disorders because BVD primarily concerns the coordination of the eyes rather than their clarity. Standard eye tests may not always detect the subtle misalignment associated with BVD, leading to misdiagnoses.

Other conditions often mistaken for BVD include:

  • ADD / ADHD

  • Agoraphobia

  • Anxiety / Panic disorders

  • Persistent Post-Concussive symptoms

  • Cervical misalignment

  • Meniere’s Disease

  • BPPV (Benign Paroxysmal Positional Vertigo)

  • Psychogenic dizziness / Chronic Subjective Dizziness

  • PPPD (Persistent Postural-Perceptual Dizziness)

  • Vestibular Migraine / Migraine Associated Vertigo (MAV)

  • Migraines

  • Multiple Sclerosis

  • Reading & learning disabilities

  • Sinus problems

  • Stroke

  • TMJ disorders

  • Traumatic brain injury (TBI)

Signs And Symptoms Of Binocular Vision Dysfunction (BVD)

Binocular Vision Dysfunction (BVD) is a complex condition that can profoundly impact daily life. Recognising the typical indications and effects of BVD holds great significance in achieving an early diagnosis and successful control of the condition. We'll investigate a range of symptoms and explore how BVD can intricately cause vision problems and affect your daily activities.

Here are the common symptoms faced by many people suffering from BVD:

1) Blurry Vision: Individuals with BVD often struggle with blurry or shadowed vision. This visual distortion can make it challenging to see clearly, especially when reading or focusing on objects.

2) Dizziness is a prevalent symptom of BVD, particularly in visually stimulating environments or activities requiring sustained focus. The brain's struggle to process conflicting visual input can lead to a sensation of instability.

3) Double Vision: Double vision is a hallmark sign of BVD. This occurs when the brain receives conflicting images from both eyes, resulting in overlapping and distorted vision.

A woman watching a train pass- the perception of motion sickness

4) Motion Sickness: BVD may lead to feelings of nausea during activities such as car journeys or viewing a dynamic screen. The mismatch between visual and vestibular input can trigger nausea and discomfort.

5) Light Sensitivity: Those with BVD may encounter light aversion, finding well-illuminated settings discomforting. Bright lights can exacerbate their symptoms and cause eye strain.

6) Eye Strain: Constant efforts to align the eyes and resolve double vision can strain the eye muscles. This can lead to eye discomfort, fatigue, and, in some cases, headaches.

7) Difficulty Concentrating: BVD can interfere with one's ability to maintain focus and attention, particularly during tasks that demand prolonged concentration. Individuals may find concentrating on reading, studying, or working challenging.

A lady suffering with headaches

8) Headaches: The strain on eye muscles and the brain's attempts to reconcile conflicting visual information can result in persistent headaches.

Impact on Daily Life and Activities:

The signs and symptoms of BVD can permeate various aspects of daily life, significantly impacting daily activities:

  • Reading: BVD makes reading a challenging endeavour. Text can become chaotic, unclear, or drift on the page, hampering easy reading. This can result in slower reading, reduced comprehension, and eye strain.

  • Driving: For those with BVD, driving can be problematic, particularly at night or in low-light conditions. Accurate judgment of distances and road signs can become a challenge, potentially compromising safety.

  • Concentration and Learning: BVD-related difficulties in maintaining focus and concentration can affect academic and professional performance. Individuals may experience increased distractibility, reduced comprehension, and difficulty retaining information.

  • Physical Comfort: Constant realignment efforts can lead to neck and shoulder pain, discomfort in the cheeks and sinus area, and even a tendency to tilt the head or close one eye to alleviate symptoms.

Diagnosing Binocular Vision Dysfunction (BVD)

Accurate diagnosis of Binocular Vision Dysfunction (BVD) is essential for effective treatment and symptom relief. It requires specialised tests that go beyond standard eye exams. These tests are designed to detect the slightest misalignment and assess how well the eyes work together.

While standard eye tests may appear normal, specialised evaluations can reveal the presence of BVD. These assessments may include:

  1. The BVDQ, or Binocular Vision Dysfunction Questionnaire, aids in pinpointing individuals who could potentially have BVD and would find value in a comprehensive assessment. It gathers information about the patient's symptoms and their impact on daily life.

  2. Prism Cover Test: A straightforward yet crucial test that measures the extent of squint misalignment, enabling precise prescription of prisms and other treatments.

  3. Ocular Motility Assessment: This evaluation involves monitoring eye motion as they track a moving light, gauging the effectiveness of eye movement and pinpointing factors that might lead to double vision.

  4. Stereopsis Testing: A comprehensive assessment of depth perception to pinpoint reading and eye strain difficulties.

  5. Evaluating Your Vision: While a familiar test, assessing your overall vision using an eye chart remains essential.

Treatment Options To Help With Binocular Vision Dysfunction (BVD)

Effectively managing Binocular Vision Dysfunction (BVD) is crucial for enhancing one's quality of life and visual comfort. There are various treatment options to address BVD and its associated symptoms, including vision therapy, prescription glasses, prismatic lenses, and specialised exercises.

Vision Therapy:

Vision therapy is a personalised regimen crafted to enhance the synchronisation of your brain and eyes, strengthening your visual capabilities. This therapy involves a series of exercises and activities aimed at enhancing eye coordination and alignment.

Vision therapy is particularly beneficial for individuals with BVD, as it targets the underlying issues causing misalignment and discomfort.

A man holding prescription glasses

Prescription Glasses:

Prescription glasses play a pivotal role in managing BVD. Optometrists and ophthalmologists may prescribe eyeglasses tailored to each patient's unique needs.

These glasses often incorporate prismatic lenses, which can bend light as it enters the eyes, correcting image misalignment. By aligning the images each eye receives, prismatic lenses allow the brain to merge them into one clear, focused image.

Prismatic Lenses:

a prism

As mentioned above, Prismatic lenses are a key component of many treatment plans for BVD. These specialised eyeglass lenses manipulate incoming light to reduce misalignment and alleviate symptoms.

By "tricking" the brain into perceiving proper eye alignment, prismatic lenses prevent eye muscle strain and discomfort. They effectively address symptoms like headaches, dizziness, double vision, and eye strain.

Specialised Exercises:

In addition to vision therapy, specific exercises can benefit individuals with BVD. These exercises aim to strengthen eye muscles and improve coordination. Your eye care specialist may recommend specific exercises tailored to your condition to help retrain your visual system and reduce discomfort.

Comprehensive Management:

Sometimes, a combination of these treatment options may be recommended to manage BVD effectively. A comprehensive approach tailored to individual needs can significantly reduce or even eliminate symptoms associated with BVD, allowing individuals to lead more comfortable and fulfilling lives.

Note: Seeking expert guidance from an experienced eye doctor or ophthalmologist is vital for a tailored treatment plan. Early intervention enhances symptom relief and overall visual well-being.

The London Private Orthoptist - Your Expert BVD Clinic

Welcome to Eyesquint our London private Orthoptist- Mr Jayesh Khistria, offers specialised clinics for Binocular Vision Dysfunction (BVD) in the UK and London. At our clinic, we are committed to offering specialised assistance to children and adults facing difficulties associated with BVD.

Our Specialised Approach to BVD

At our clinic, we recognise that BVD affects each individual uniquely. Our skilled team is dedicated to tailoring treatments that suit your specific needs:

  • Personalised Eye Exercises: Strengthen your eye muscles with tailored exercises to enhance binocular vision.

  • Precision Prism Correction: Enjoy clearer vision with precise prism adjustments incorporated into your glasses.

  • Surgical Guidance: We provide expert advice on surgical options and botulinum toxin injections for more complex cases to improve visual comfort.

Your First Appointment:

During your initial visit, our team will conduct assessments, including visual acuity, cover tests, ocular motility, and stereopsis tests. These help us create a tailored plan just for you.


In Binocular Vision Dysfunction (BVD), clarity and comfort can often seem out of reach. But armed with the knowledge about its symptoms, causes, and treatments, you're better prepared to face this visual challenge head-on. Whether it's the persistent blur, unsettling dizziness, or frustrating double vision, BVD's impact can be profound. However, there's hope and help available. Don't let BVD hold you back from the life you deserve. At Eyesquint, we support you on your journey to visual well-being. Our specialised approach for children and adults is tailored to address your unique needs.


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