Visual Vertigo

Dr. James Prueter, DO

Southwest Ohio ENT Specialists

Visual vertigo is characterized by having vertigo symptoms that are triggered by visual stimuli or motion.  Many people experience visual vertigo in the setting of a busy supermarket or large department store. Others experience visual vertigo with excessive computer screen time, scrolling on cell phones and playing video games. These symptoms may develop in individuals with other vestibular disorders (i.e. vestibular neuritis, Meniere’s disease, Benign paroxysmal positional vertigo (BPPV), migraine).

Visual vertigo was first described in the late 1970s. It can be referred to as visuo-vestibular mismatch, sea sick syndrome, visually induced motion sickness or Space and Motion disorder. Patients with decreased vestibular function, decreased proprioceptive function, and certain CNS insults are more visually-invoked into an episode of vertigo. Persons who are visually dependent (depend on visual system for balance) orient their posture according to information from their eyes to a greater extent than others are also at higher risk. Visual vertigo does not occur in every patient with vestibular or proprioceptive dysfunction and may occur in isolated circumstances.  The exact cause of visually-invoked vertigo, is not yet known but appears to develop in patients with elevated levels of stress. Anxiety and depression are often observed in these patients, but they have not been shown to play a direct role in the development of visual vertigo.

Symptoms

Visual vertigo may present as dizziness, swaying and tilting, disorientation, unsteadiness, spinning, and a possible pull to one direction. Other symptoms that may present with visual vertigo is headache, sweating, nystagmus, nausea and vomiting, and tinnitus. All of these symptoms are triggered by visual stimulation.

Treatment

The treatment of visual vertigo is often done with vestibular and/or occupational therapy which utilizes exercises to enhance the relationship between the balance and visual system. Vestibular rehabilitation includes compensation, habituation and adaptation.  These training regimens consist of progressive visual and postural movements (twisting, turning) along with balance exercises. Occupational therapists attempt to develop or improve visual skills and abilities; improve visual comfort, ease, and efficiency; and change visual processing or interpretation of visual information. This type of therapy helps to enhance the function of eye tracking, convergence, visual perception, eye-hand coordination and visual motor integration.

Sometimes, patients will need adjustments to their glasses. A prism lens changes the virtual location of an image in your eyes to reduce visual strain. Prism can also help with double vision by aligning the two images into one.

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