Peer Reviewed

Vision and Balance-What You Need to Know

Article Summary

To maintain balance and move around our world, we need to combine information from our eyes, body position (how we feel through our muscles and joints), and inner ear balance system. For people who have balance problems, recognizing the important role of vision is key. This knowledge can help them get the specific vision therapy they need. 

Balance, Vision & Hearing Working Together

Many people think of vision as just how clearly we see things. However, vision affects much more than just clarity. Vision is closely linked to our balance. To stay balanced, we must combine information from our eyes, our body position, and our inner ear. If any of these systems don’t work well, it can greatly impact a person’s ability to move safely. The relationship between our balance (from the inner ear) and vision starts at birth. The inner ear balance system is fully developed and functioning when we are born, guiding our balance and helping our vision develop in early life. As children learn to move, their movement helps their vision grow. Later on, as children gain visual skills, vision begins to help with balance. 

Vision & the Brain

Half to two-thirds of our brain is busy processing what we see. When our eyes are open, a large portion of our brain’s activity focuses on vision. Our vision is so strong that it can sometimes override information from our other senses, which can be both good and bad. If the visual system doesn’t work correctly, it can confuse our other senses and impact our quality of life. Thankfully, our brains can form new connections throughout our lives, known as neuroplasticity. This ability lets us improve control over our senses, enhancing how we interact with the world and improving our overall quality of life. 

Vestibulo-Ocular Reflex

Feeling dizzy or unbalanced can often come from a problem with the vestibulo-ocular reflex (which connects eye and head movement) and how well our eyes work together. Balance issues and feeling off-balance are common after a brain injury, which disrupts the connection between our inner ear and vision. This mismatch is similar to when the sound and picture on a TV don’t match up. Each works fine separately, but when combined, the timing off causes a negative experience. Luckily, using neuroplasticity, we can relearn to synchronize these systems. First, we need to identify the source of the mismatch to get the right treatment. With proper evaluation and skilled vision therapy, we can effectively address and improve visual problems. 

Vision Specialists 

It’s important to carefully choose an optometrist who specializes in vision therapy. Common titles for these specialists include Developmental Optometrist, Vision Therapist, or Neuro-Rehabilitative Specialist. You can check if the optometrist is a member of organizations like the College of Optometrists in Vision Development (COVD) or the Neuro-Optometric Rehabilitation Association (NORA). These organizations are leaders in the field of vision therapy. 

Functional Vision Exam

A functional vision exam from a Neuro-Rehabilitative or Developmental Optometrist is very different from a regular eye exam. Besides checking if the eyes are healthy and vision is clear, a functional vision exam looks at oculomotor skills. This includes tracking a moving target and quickly shifting focus between targets. The exam also checks the ability to focus, use both eyes together for depth perception, and assess eye alignment at different distances and in stressful situations. Flexibility is another important part; patients should be able to switch focus between near and far targets efficiently. After understanding how a patient’s vision works, we can provide tailored therapy to help improve their balance.

Treatment

To find the right treatment, we first need to identify the specific issues causing vision and balance problems. This involves a thorough evaluation by a vision specialist. Once we understand the root causes, vision therapy can help address these issues. Vision therapy includes guided exercises that improve how well the eyes work together and strengthen the connection between vision and balance. These exercises may involve eye tracking, focusing on moving objects, and adjusting to different visual conditions. The therapy may also include activities that help with depth perception and coordination. By consistently practicing these exercises, patients can regain their balance and improve their overall ability to navigate their environment, leading to a better quality of life. The goal is to make the visual and balance systems work together more effectively.

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References

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