Vertical Heterophoria and Mal de Debarquement Syndrome

Mal de Debarquement Syndrome (MdDS) is a rare condition that can occur when a person gets off a ship or plane.  Basically, the person still feels a rocking, swaying, or bobbing motion even after a length of time. This feeling can persist and never go away.  When the patient is in a moving vehicle or riding in a car, they actually feel better. It is usually diagnosed by an ENT when all vestibular testing proves to be negative. Until recently, there has been no treatment for this condition. Mt. Sinai Hospital in New York has made some great strides in a new kind of treatment which retrains the vestibular system and eye muscles to work together. They are doing great work but a portion of these patients do not get better.  This was the case of one young lady I treated last week.

There was also a binocular vision dysfunction occurring at the same time. She had vertical heterophoria. In vertical heterophoria, typically the patient feels worse in a car or with movement. This is in contrast to Mal de Debarquement. However, these two conditions can occur at the same time. I believe this young lady always had vertical heterophoria but she was not showing symptoms until something happened to her vestibular system causing the MdDS. With the proper prism correction in her glasses, her symptoms decreased significantly. The visual component to her symptoms was resolved.

I find it very interesting how two conditions that affect the balance system can be related and so often be misdiagnosed. For more information about Vertical Heterophoria please visit my website www.nvcofny.com