How does vision and balance relate? In this clinic, we get frequent referrals for patients who are suffering from dizziness and are often surprised that vision contributes a major part to their symptom of disorientation, falling, or lightheadedness.

The Vestibular System

Every part of the body is a different organ system: eyes, ears, skin, stomach, etc. Each unique structure contributes to overall function in a specific way. Finding the cause of a specific clinical problem can be difficult as systems often interact with each other. Most patients who have balance difficulties will see an ear-nose-throat specialist, have their ears and hearing check, and/or get a vestibular workup to rule out infectious causes and mechanical deficits in the ears and vestibular system. Common conditions such as Meniere’s Disease, Benign Paroxysmal Positional Vertigo (BPPV) need to be ruled out.
The vestibular system within the inner ears consists of a system of fluid filled loops and pouches. The orientation of fluid stimulation sends signals to our brain about the orientation of movement or the orientation of your head in respect to gravity. Our visual system works with our vestibular system to keep objects from blurring when our head moves around. We also have receptors on our bodies to keep us aware of the position of our limbs when our body is in motion.
According to new research, When Your Eyes Move, So Do Your Ear Drums. Both systems are highly integrated to each other.

Not In Sync – Brain Confusion

Sometimes the systems are not in sync. For example, when one gets off a roller coaster, the vestibular system may still be motion due to the momentum of fluid in our ears, but our eyes and the receptors on our body tells our brain that we are no longer in motion. Confusion results from the discrepancy of these systems. This confusion can manifest itself as dizziness and disorientation.

Asymmetrical Input

Another common contributing factor to the lack of balance comes from having asymmetrical input. Having a left and right organ helps with localizati(determining where the sound or object is coming from) and results in summation (increased stimulation of hearing and visual processing). One of the classical examples is the disorientation and balance difficulties that comes with a sinus infection, often affects one side more than the other.
In this clinic, common causes of asymmetry in the visual system seen include long-standing one-sided eye turns (or strabismus or lazy eye), anisometropia (large difference in prescription between the eyes), and eye diseases that lead to low vision (such as diabetic retinopathy and macular degeneration). Many signs and symptoms of pre-existing asymmetries that were compensated well prior can be suddenly reawakened by acute health episodes of stroke or concussion.

Treatment

So is there any treatment for balance for patients who have pre-existing asymmetry in their eyes and/or ears? Our practice philosophy is that the dominating visual system needs to be brought to function with maximal efficiency so that it can provide a strong sense of orientation regardless of all mechanical asymmetries in the eyes, ears, and body. Prism glasses and tinted eyewear, may be needed initially to provide adequate support to the visual system. Vision rehabilitation is a frequent tool used to teach patients to improve the efficiency of visual skills and overall vision processing.