Vision plays a significant role in our ability to balance, orient ourselves in space, and process movement of things in our environment. The vestibular (inner ear balance) system and the visual system coordinate with each other through brain pathways in order to control the eyes’ ability to maintain a visual gaze on a single location. This connection, known as the vestibulo-ocular reflex, has a critical role in producing eye movements and stabilizing the image during head motion and helping us to maintain our balance.
“If the vestibular system is damaged by disease, aging, head injury, or sometimes for no apparent reason, persons with a vestibular disorder often experience extreme difficulty with balance and movement, as well as with their perception of space,” Cynthia Ryan, Executive Director, Vestibular Disorders Association (VeDA), said in a company news release. “As a result, functioning at work or school, or performing routine daily tasks in environments with excessive visual stimulation, such as a grocery store or shopping mall, may be difficult.”
“A regular eye exam may not reveal the extent that the visual process is affected,” says Shirley Ha, OD, FCOVD, Advisory Board member, Neuro Optometric Rehabilitation Association (NORA). “Since both the vestibular and visual systems are affected in spatial orientation visual deficits related to a vestibular disorder should be evaluated by a Neuro-Optometric Rehabilitation Optometrist, an eye care professional who specializes in the diagnosis and treatment/rehabilitation of neurological conditions adversely affecting the visual system.” Other health care professionals such as Neurologists, Otolaryngologists, and Neurotologists may also become involved in the diagnosis, treatment, and management of dizziness and balance disorders.
Because of difficulties posed by accurately diagnosing and reporting vestibular disorders, statistics estimating how common they are, how often they occur, and what social impacts they have range widely. One recent large epidemiological study estimates that as many as 35 percent of adults aged 40 years or older in the United States—approximately 69 million Americans—have experienced some form of vestibular dysfunction.1
To assist individuals who may be experiencing visual dysfunctions contributing to dizziness and balance problems, NORA and VeDA have developed “The Vestibular-Vision Connection.” This patient-education resource can be viewed and downloaded on NORA’s Patient Caregivers Resource page and VeDa’s Vision & Hearing page.
Both organizations offer additional resources to help patients and caregivers find the help they need, including search features to find providers who can help with diagnosis and treatment. For more information, visit noravisionrehab.org. and Vestibular.org.
- Agrawal Y, Carey JP, Della Santina CC, Schubert MC, Minor LB. Disorders of balance and vestibular function in US adults. Arch Intern Med. 2009;169(10): 938-944.