I think I may have Vertical Heterophoria not anxiety.

A quick post today about people who are told they have anxiety disorder. If you get panic attacks in the car, mall, supermarket, big box store, or any space with tall ceilings and you get vertigo symptoms  at those places you may have visual vertigo stemming from your visual system. It is a slight misalignment of your eyes - Vertical heterophoria.  The ENTs actually call these patients "Mall Patients" !  We can help you align your eyes and you are back to a normal life.  I am hoping this blog along with a new website will be constructing soon will start educating patients and practitioners of this common but under diagnosed  condition.

I woke up one morning and the world was spinning!

I have heard this complaint many times. Frequently, from someone who was pregnant or just given birth.  The story of a woman,  I saw recently is very typical.

L was so happy after finally having a baby girl after 2 sons.  One morning shortly after coming home with her baby, she woke up with the world spinning.  She went to her primary care who sent her to ENT,  then neurologist.  All MRI's were fine.  They told her she had postpartum depression.  When she reported that she was not depressed at all, she was dizzy,  her doctors just dismissed her.

She happened to find Vision Specialists of Michigan website and then the link to me.  I was the closest doc to her in the country.  It turns out that she had a decompensated phoria due to the stress of the birth.  That means that her eyes were always slightly misaligned but her brain was always able to take the 2 images from the eyes and fuse them together to get one.  The stress of giving birth probably took that ability away.  Her slightly vertically misaligned eyes lead to her seeing a ghost image because the images were on non corresponding points on her retinas.  The eye muscles were trying to fuse the images giving the brain signals of movement but the inner ear signaled no movement.  This lead to the dizziness.  As soon as we aligned her eyes the dizziness went away.  No drugs, no therapy,  just glasses.

Tomorrow,  I will describe what the ENT's  call their Mall patients.

Prism vs. Prozac

Could the cause of your dizziness, headache, anxiety be coming from your eyes? Many people who suffer from these symptoms have a relatively unknown binocular vision disorder called vertical heterophoria. Symptoms can also include light sensitivity, neck ache, head tilt, facial pain, unsteady feeling while walking, and motion sickness.  Patients often have gone to neurologists, ENT, ophthalmologists, etc.  When all testing comes our normal they are sent to a psychiatrist. The good news is that this can be treated with the proper  prismatic correction in a simple pair of glasses.

I came to learn about this condition while reading an optometric journal about Dr. Debby Feinberg.  People travel from all over the world to be seen by Dr. Debby. ( Just google her. She is called the headache guru of Michigan.) She is currently doing research with the pain management specialists at the University of Michigan and has been published in a number of medical journals.  I thought her work was so interesting that I emailed her.  I am proud to say that I am one of the first doctors in the country trained in her very specific and effective technique to diagnosis and treat this condition.

I will be posting different case histories here so people can read about others with VH.  Today, I will talk about one of my most gratifying cases. A woman who came to me for a routine eye exam complaining of headaches around her eyes.  She was told that she had sinus headaches for the past 29 years. The pain started 29 years ago when her son was born. (Often, symptoms begin after a major stress on the body such as pregnancy, illness, or brain injury.)  I started asking her other questions and had her fill out a vertical heterophoria symptom questionnaire. This questionnaire helps to determine if the symptoms are caused by a vision problem. She scored very high.  After a month of wearing  prism prescription glasses she came for her follow up visit a new person. She reported that her "sinus headaches" were gone. It was her eyes all along. She started to cry and gave me a hug.

In the future, I will describe other cases and discuss the different ways this subset of binocular vision disorders develop in detail.  Please feel free to contact me at drcbisraeloff@gmail.com if you think you may be suffering from VH.