Dizziness Improved by Vertical Heterophoria Treatment

Abstract

Objective: Vertical heterophoria (VH) is a binocular vision disorder with symptoms of headache, dizziness, anxiety, neck pain, and reading difficulties, treatable with prismatic lenses. The study’s objective was to quantify dizziness and associated symptom reduction after prismatic lens treatment in patients with a chief complaint of dizziness concomitantly diagnosed with VH. Method: Retrospective analysis of 46 patients presenting to an optometric binocular vision subspecialist between August 2009 and May 2011. Pre- and posttreatment data included Dizziness Handicap Inventory (DHI), Headache Disability Index (HDI), Zung Self-rating Anxiety Scale (Zung), and Vertical Heterophoria Symptom Questionnaire (VHSQ). A visual analog scale measured overall symptom reduction. Results: Treatment effects were analyzed using paired t tests. Following prismatic lens treatment, there was a 51.4% decrease in DHI score ( P < .0001), 45.9% reduction in HDI score ( P < .0001), 22.4% reduction Zung score ( P < .0001), 50.2% reduction in VHSQ score (VHSQ, a VH symptom burden instrument developed by the authors; P < .0001), and a 71.4% reduction in overall symptoms as measured by the 10-cm visual analog scale ( P < .0001). Conclusion: Treatment of dizziness with prismatic lenses resulted in a marked score reduction of the validated metrics for dizziness, headache, and anxiety, which correlated with a marked reduction of overall VH symptom level. Prospective studies are needed to further validate this intervention and determine prevalence of VH in dizziness patients.