Wednesday, November 24, 2010

Dizziness & Vertigo

     I have been seeing more patients with dizziness and vertigo.

     A patient recently wrote In your opinion, is it still possible that something ELSE could be wrong with my eyes that is causing my dizziness or making my dizziness worse?” 
     I replied: "The quick answer: YES.  From your description it appears as if you might have a visual processing problem but not necessarily a sight problem.  By this I mean your brain may not be integrating what you are seeing – things that a standard eye exam would not pick up.  Most patients of this type have at least two things in common: 1)motion sickness (e.g., nausea, headache, dizziness, fatigue, malaise, drowsiness, depression, bodily warmth, pallor, and/or cold sweats) with repeated eye movement or when observing rapid motion, and 2)unusual sensitivity to light."

     Almost all patients have histories of carsickness, which occurs almost exclusively in the daytime.  The reason for this is that less peripheral motion is observed at night. Reduced awareness of objects in the periphery (functional tunnel vision) also occurs but is seldom recognized by patients.  However, they often report a history of "klutziness."  Unfortunately the standard computer-based peripheral vision tests will not pick this up.

     With a diagnosis, I would proceed with vision therapy.  Classically vestibular therapy is used for dizziness and vertigo.  However it is often not successful with type of problem because the deficit is essentially being "allergic to visual motion".  Vision therapy desensitizes and reprograms the brain to not react adversely when moving the eyes and/or seeing or feeling motion.  The therapy could be considered physical therapy for the eyes and brain.  With careful guidance, you learn to adjust your own level of training to get the best effect and minimize discomfort.

     Vision therapy is similar to riding a bike in that it involves mostly "the learning and knowing how", not brute strength.  Once reprogrammed, most patients remain symptom free for many years, if not forever.  A few do regress to a degree after time.  When this happens, they find it quite easy to retrain themselves on their own with much less effort and second time around.

     Several success stories can be found at: CLICK HERE

     --Dr. James B. Mayer


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