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Vertical Heterophoria? Now you’re just making shit up.

I’m not, but I understand why you feel that way. There are (by my exaggerated estimate) roughly a million comorbid conditions that are related to ADHD from restless leg syndrome, to sleep apnea, now to vertical heterophoria. I think vertical heterophoria is my favorite of all the comorbid conditions. Why? Because it has the most interesting sounding name, and it is easily solved. Living with ADHD is complicated stuff. We don’t need anymore to manage.

So what is vertical heterophoria, you ask? It is an eye condition that is caused by the misalignment of the eyes. That means there is a slight imperceptible difference in your eyesight that could be causing you an array of unpleasant symptoms.

Is Vertical Heterophoria ADHD related?

It is closely related to ADHD. According to the Neurovisual Center of New York, “Up to 50% of children with ADHD have a vision problem which contributes to reading and learning difficulties. Often, the vision problem is an eye misalignment so small that it’s missed on routine vision exams.” That means if you are living with ADHD you could be experiencing the symptoms of vertical heterophoria and not even know it.

What was your experience with ADHD?

I have been an eyeglass wearer all of my life. I learned about vertical heterophoria on an episode of the See in ADHD podcast.  In that episode, I learned that the disorder is something that cannot be detected in the average eye exam. I also learned that the disorder is an ADHD comorbid. At the time, I was living with chronic neck pain, constant dizziness, and a headache that never seemed to go away. I was frequently nauseous and anxious. The doctor had prescribed various painkillers, muscle relaxers, and even a custom mixed prescription pain cream to help me manage the constant neck pain. Some days I couldn’t even go to work because the pain was so bad. When I heard that episode, I began to recognize myself in the symptoms described.

When I showed up for my eye exam, I was very nervous. Regardless, my symptoms were awful and I needed to see if I could find answers. We went through the normal eye exam that I am used to, and from there we proceeded to the portions of the exam that were specific to vertical heterophoria.

One of the exams that stands out to me still was when the doctor had me walk down a hallway. I started in the center and by the end of the hallway, I was completely off to the side, though I intended to walk in a straight line. It was a bizarre experience. By the end of the exam, I was given a pair of test glasses where I could sit and stare out the window waiting for my eyes to adjust. As they did, I could feel the anxiety lessen and my neck pain began to fade away. Once I got my glasses I was living in a new pain-free world.

What are the signs and symptoms of vertical heterophoria?

The symptoms of vertical heterophoria can be quite debilitating. They definitely interrupted my daily life. They are included but not limited to:

Symptoms of vertical heterophoria include not only migraines and severe headaches, but dizziness, nausea, anxiety, neck pain and balance issues. Situations where you may experience the VH symptoms include:

  • Moving your head from side to side (dizziness)

  • Standing up straight after bending over (dizziness)

  • Standing up from a sitting position (dizziness)

  • Riding in the passenger seat of a vehicle (dizziness and anxiety)

  • Rounding curves while in the car (dizziness and anxiety)

  • Driving on the freeway (anxiety and panic)

These symptoms are also similar to those endured by individuals suffering from an inner ear disorder, Meniere’s disease or MS. With so many possibilities, it’s essential that your condition be properly diagnosed to determine if your eyes are indeed the problem. Regular eye doctors won’t be able to pick up VH during a routine eye exam, which is why you need the expertise of a NeuroVisual professional. (Source: Vision Specialists of Michigan)

How is vertical heterophoria treated?

You’re probably wondering what it would take to correct an issue like vertical heterophoria. Do you have to take medicine? Are there surgeries in your future? Will you need to see a specialist frequently? Don’t worry at all. The solution to vertical heterophoria is simple: your doctor adds a set of prisms to your eyeglasses that correct the vision issue.

Do I have vertical heterophoria?

If you see yourself in these symptoms and you’d like to know more, never fear. There is an online test that you can take to determine if you need to see a doctor to talk about vertical heterophoria.

Vertical Heterophoria is easily resolved. If only EVERY problem could be fixed with new glasses!

Learn more

Online Test For Vertical Heterophoria– take this online quiz to see if your eyes could be causing the problem.

Vertical Heterophoria Exposed – on this episode of See in ADHD, Jennie Friedman and I discuss the disorder and you can hear the actual audio recording of my eye exam and the huge reaction I had.

Why Other Doctors Can’t Test For Vertical Heterophoria– one of the common questions people have about Vertical Heterophoria is “why doesn’t this show up on my eye exam?” Here’s your answer.

What else is on Black Girl, Lost Keys?

Women Deal with ADHD Differently

Overcoming Feelings Of Shame With ADHD

ADHD Symptoms in Adults Aren’t Character Flaws


I had terrible neck pain, nausea, and a constant headache. I was on several meds for pain relief. An ADHD co-morbid called Vertical Heterophoria caused it.I had terrible neck pain, nausea, and a constant headache. I was on several meds for pain relief. An ADHD co-morbid called Vertical Heterophoria caused it.I had terrible neck pain, nausea, and a constant headache. I was on several meds for pain relief. An ADHD co-morbid called Vertical Heterophoria caused it.I had terrible neck pain, nausea, and a constant headache. I was on several meds for pain relief. An ADHD co-morbid called Vertical Heterophoria caused it.

12 thoughts on “Vertical Heterophoria: The ADHD Related Eye Condition You’ve Never Heard Of

  1. I’m not sure will “reach out to me” as I live overseas. Still, it is something to bring to my GP and optometrist. Goodness knows I would say I have weird eyes now; one is nearsighted and one is farsighted.

    1. Hi Nora, this is Dr. Marissa from the Neuro Visual Of New York. Please fill out the questionnaire on our website and either myself or Dr. Cheryl will be able to e-mail you back. Unfortunately, most optometrists are not trained to diagnose and treat vertical heterophoria.

      1. Hi Dr. Marissa! Thank you so much for reading and reaching out. I would absolutely love to interview you for a subsequent article if you’d be interested.

  2. Hi! I’m Ashley and I work with Dr. Debby Feinberg at Vision Specialists of Michigan and the NeuroVisual Medicine Institute that trains optometrists on how to find and treat VH. We would love to speak with you! You can reach me at Thank you!

  3. René, I’m Aspie curious… Are you ever aware of the parts of the world lurking outside the frames of your glasses? Maybe just as blurry movement that predicts when something may pop into view as you turn your head, or follows objects after you turn away from them? Most people I ask swear they never see anything outside their lenses, but I’m compulsively and often painfully aware of what is happening there.

    Trying to fit that part of the world to the glasses forced on me as a young child warped my sense of space and my body in ways most people never feel without LSD. And left traces of the “adaptations” in parts of my body and brain neuroscience is just beginning to explore. I can’t help suspecting this happens to many people who wear glasses – but the visual effects stay in their subconscious, only the effects on movement and balance get noticed.

    If the single prism adjustment to central vision works for you, I don’t want to trigger new complications. But I’m curious how long you’ve worn glasses, what kinds (+, -, astig, ?), and why? Did you wear them full time, or only for certain activities? Did you ever wear contacts or take breaks from lenses? When did you first notice the stress that the prism correction fixes, and what did you think it was about?

    1. Hey there! I have worn glasses since I was 8 or so because I couldn’t see the board. I also have a astigmatism. At first I only wore them to see the board, these days I wear glasses from dusk till dawn. I have worn contacts, I do not wear them now because there is no way to do prisms in contact lenses. As for stress, I have a stress problem anyway so I attributed it to the many many things that stress me out, lol.

      1. My first lenses were at 9 years, but they had the now discredited “Plus Lens Theory” bifocal adds – sort of like prism areas within the rest of the lens. Worn every waking moment.

        Sounds like you wear your prisms all day now, but only wore glasses or contacts when you really needed them before. And you didn’t relate your stress to vision until you discovered the prism option?

        So do you “live” entirely inside the prism-adjusted world now? Do you ever notice the unadjusted world outside the frames?

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