Vertical heterophoria is a funny name, so I get it, but no, I’m not making it up. 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 this eye condition. I think vertical heterophoria is my favorite of all the comorbid conditions. Why? Because it has the most interesting sounding name, and it was the most easily corrected for me. Living with ADHD is complicated stuff. We don’t need any more to manage.
Vertical Heterophoria? Now you’re just making stuff up.
I never would have imagined in a million years that my ADHD could be related to anything that involved my eyes. Strap in guys, you’re going to learn all about what vertical heterophoria is, what causes vertical heterophoria, how it is related to ADHD, and what to do if you suspect that YOU have something wrong with your eyes.
What is vertical heterophoria, you ask?
It is an eye condition that is caused by the misalignment of the eyes. Vertical heterophoria is what’s known as a binocular vision dysfunction. That means there is a slight imperceptible difference in your eyesight that could be causing you an array of unpleasant symptoms. Your eyes are designed to work together to create one clear image to present to your brain. When there is dysfunction there, your eye muscles work overtime to help correct the misalignment with the images. People who have vertical heterophoria can experience increasingly debilitating symptoms as their eye muscles work overtime to compensate for the visual disturbances that vertical heterophoria can cause. Some of those symptoms can include motion sickness, anxiety, vertigo, neck pain, and more.
This video explains binocular vision dysfunction quick and painlessly
What causes vertical heterophoria?
Like most conditions, it can be difficult to narrow down exactly what causes vertical heterophoria. You could have been born with it. Symptoms tend not to appear until later in life after the eye muscles have been stained over a period of time. There is also the possibility of a traumatic brain injury, a stroke, or a neurological disorder having contributed to vertical heterophoria. All of these instances can affect the way that the eye muscles function and then you have the same scenario.
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. The fact that vertical heterophoria is not widely known amongst a community with such a high risk for developing it is something that we should work to change. It wasn’t until several years after my ADHD diagnosis that I learned about vertical heterophoria, and it was completely by accident.
What was my experience with vertical heterophoria?
I have been an eyeglass wearer for most of my life. I can remember the teachers, assuming it would help me pay attention in class more and stop the constant headaches I seemed to have, suggested that I go for an eye exam. That was about 4th grade, and they discovered that I have astigmatism which was no surprise as several people in my family have it. Life continued on, I grew up, and never gave another thought to my eyesight because glasses did everything I needed them to do.
Discovering Vertical Heterophoria was a stroke of luck.
I’d love to tell you that I spent hours circling the internet looking for answers because it is a way more interesting story, but the fact of the matter is that isn’t how it happened. Vertical heterophoria is something I discovered completely by chance. 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.
My binocular vision exam
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 had 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. The one thing I DO miss is the ability to wear contacts. Unfortunately, prisms don’t come in contact lenses, but maybe one day they’ll figure it out.
What are the signs and symptoms of vertical heterophoria?
The symptoms of vertical heterophoria can be quite debilitating. They definitely interrupted my daily life. The pain I dealt with on a daily basis was so excruciating that I missed days of work and lost wages because of the constant headaches, dizziness, and nausea.
“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 you take an assessment 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)
Why hasn’t this shown up on your eye exam?
As I mentioned before, I have been an eyeglass wearer since I was a young child. Why didn’t I know about vertical heterophoria sooner? Part of the reason is pretty simple: I wasn’t symptomatic enough yet. I had headaches and things, but those were attributed to the fact that I stared at screens frequently and I read a lot, etc. It is always easy to explain things away when we aren’t suffering enough to do something about it.
The other reason is just as important for the rest of you to know. This eye condition is not part of the routine eye exam. Vertical heterophoria is a condition that requires special equipment to test, and it also requires special training to diagnose it that the majority of eye doctors don’t have. In other words, your 24-hour eyeglass place isn’t going to catch vertical heterophoria because they aren’t looking for it.
Treatment for vertical heterophoria
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?
I remember how I felt when I first heard about vertical heterophoria. It was like somebody had handed me a gift that I hadn’t even known I needed. I wasn’t sure if I had it, but all of the symptoms were so familiar to me. The chronic pain I experienced on a daily basis was awful. It was frustrating and I was losing hope. Hearing about this random eye condition made me feel hopeful that I could get out of the chronic pain cycle and off all of the pain medication once and for all.
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. When I took my online test, within a day or so a friendly receptionist from the doctor’s office I still go to today rang me up and got me scheduled for an exam. The exam was scheduled, I got my glasses, and the rest is history. If only I could resolve every problem this easily.
Vertical Heterophoria Resources
There is a wealth of knowledge on the internet. You’re going to need some more resources to tap into the wealth of knowledge about vertical heterophoria. I’ve got a few great resources for you if you just gotta know 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.
Dr. Cheryl Berger-Israeloff explains Vertical Heterophoria
This is the woman who saved me from the pain. Dr. Cheryl Berger-Israeloff was the guest on the podcast where I first learned about Vertical Heterophoria. Her thoroughness and her passion really helped me to understand. It made me want to seek some answers for myself about vertical heterophoria.
Driving issues with Vertical Heterophoria explained
I’ve heard from so many people who have had driving issues they think could be vertical heterophoria related. This is an amazing testimonial from a lady who dealt with driving issues. This story is absolutely amazing
Vertical Heterophoria and Migraines
This young lady was a migraine sufferer. Like me, she had lost hope. The doctor finally told her that he couldn’t do anything but pray for her. She too happened upon knowledge of this condition by chance. This is such a powerful testimonial.
I have a binocular vision disorder
Hopefully, you’re not suffering from pain and nausea and headaches, but if you do, there may be hope for you. Take the test, and talk to a doctor about your eyes. Learning about this condition and getting treatment for it gave me my life back. In fact, this diagnosis was equally as life-changing as my ADHD diagnosis was. When I sat with those glasses on my face and felt the pain melting out of my neck, I started to weep because I knew I finally had an answer. I hope you find an answer too.
Until next time,
For more ADHD resources, please visit CHADD (children and adults with ADD)