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When Clumsiness Is More Than It
Seems

It may be your eyes:

When Clumsiness Is More Than It Seems

It may be your eyes:

vertical heterophoria

If clumsiness has plagued you throughout your life and you often find yourself tripping over things, walking into doorways and bumping into walls, or having trouble playing sports, you might have a condition known as Vertical Heterophoria (VH).

Clumsiness in Children with BVD

It Could Be Your Eyes

Vertical Heterophoria (VH) is a form of Binocular Vision Dysfunction (BVD) characterized by a subtle vertical misalignment of the eyes. While this misalignment can be very subtle, it can make it incredibly difficult for our eyes to send one clear image to our brain.

Here’s what happens when someone has VH: With two eyes, we are able to see one clear image. This is because our brain is able to transform the images seen by each eye into a single image, which is known as binocular vision.

In patients with VH, there is a slight misalignment between their eyes resulting in their eyes being out of sync with one another, causing the brain to have a very difficult time processing those two separate images to form one clear image.

The result? The brain forces the eye aligning muscles to fix the problem by realigning the eyes. But the realignment is only temporary and misalignment then recurs, which is followed closely by realignment, and the cycle of misalignment and realignment continues. Over time, this places an immense amount of strain on the eye muscles and leads to dizziness, clumsiness and difficulty with coordination and depth perception.

Clumsiness in Children with BVD

Signs of Vertical Heterophoria in Children

Children as well as adults can be affected by VH, though it’s often harder to recognize and diagnose due to the fact that many kids don’t realize they have a vision problem because they don't know what "normal" is. It’s up to parents, teachers and caregivers to be on the lookout for signs that the children in their lives might be experiencing this condition or other possible vision problems. Some signs to watch for include:

Clumsiness:

Clumsiness in childhood as kids grow into their bodies is not at all unusual, but frequent and extreme bouts of clumsiness may indicate shadowed or double vision, as well as blurred vision.

Headaches:

Children who have vision problems often spend a good part of the day squinting and straining in an effort to see the board and other things in the classroom clearly. This can understandably lead to headaches, so if your child frequently complains of their head hurting and seems unusually cranky after a long day at school, it may be time for a NeuroVisual Examination.

Lack of Coordination:

While young children are often uncoordinated, by the time they hit school age, they should be fairly adept at activities that call for good depth perception and good hand-eye or hand-foot coordination (like catching or kicking a ball). If these activities continue to be a struggle, it could be a sign of VH.

Specific Symptoms in Children

If your child has VH, the symptoms will vary depending on their age.

For children ages 4 to 8-years-old, common behaviors and symptoms of VH can include:

  • Poor handwriting (poor spacing, writing letters too big or small)
  • Difficulty reading
  • Avoiding activities
  • Playing with toys very close to their face
  • Sitting close to the TV
  • Difficulty identifying shapes, colors and numbers that are age-appropriate
  • Difficulty seeing the class board
  • Frequently bumping into objects
  • Difficulty catching balls
  • Stomach aches and headaches at school or away from home
  • Light sensitivity
  • Covering one eye to see
  • Anxiety in public places
  • Frequent squinting in order to see

Find out if your 4 to 8-year-old is experiencing clumsiness and other symptoms due to VH

For children ages 9 to 13-years-old, common behaviors and symptoms of VH can include:

  • Repeatedly bumping into things while walking
  • Having difficulty completing homework due to headaches and nausea
  • Repeatedly reading the same things over and over
  • Sensitivity to bright lights
  • Closing one eye to make it easier to see
  • Blurred vision when using the computer
  • Blurred vision or tired eyes when looking at the blackboard in class
  • Verbal skills that are ahead of reading skills
  • Frequent blinking

Find out if your 9 to 13-year-old is experiencing clumsiness and other symptoms due to VH

Symptoms of Vertical Heterophoria in Adults

There are several symptoms associated with VH in adults, which typically include the below. Some individuals experience all of these symptoms, while others experience only a few, such as headaches, nausea, and dizziness.

  • Headaches
  • Migraines
  • Dizziness
  • Nausea
  • Anxiety
  • Sensitivity to light
  • Difficulty with balance / unsteady walking
  • Pain in the neck
  • Frequent head tilt
  • Motion sickness
  • Reading comprehension, difficulty reading and learning
  • Dyslexia
  • Learning disability
  • ADHD/ADD

Find out if your clumsiness and other symptoms are a result of VH.

How Vertical Heterophoria is Diagnosed

To determine if your clumsiness is the result of VH, we suggest you first see your primary care physician or specialist to rule out other causes. If no cause is found for the symptoms, our team at Vision Specialists of Michigan can help determine if VH is the issue.

During your visit:

1. We ask you to fill out a specialized questionnaire designed to screen for those who might have VH.

2. You will be asked to complete a detailed Health History form.

3. An eye exam is performed to determine the need for correction of nearsightedness, farsightedness, and astigmatism (a common imperfection in the eye’s curvature).

4. A specialized exam is performed (NeuroVisual Examination) to determine if visual misalignment is present

5. If diagnosed with VH, you will be fitted with a trial version of your new prescription. Most people notice a significant improvement in their symptoms within just a few minutes of putting on the trial lenses.

You can expect to spend approximately 3 hours in our office during your visit.

Get Treatment for Clumsiness

For anyone suffering from clumsiness, there is treatment. Our compassionate doctors at Vision Specialists of Michigan will complete a thorough NeuroVisual Examination to determine the extent of your vision misalignment (or your child’s) and prescribe you with the specialized aligning lenses. Every person can receive treatment for BVD, as long as they are old enough to wear the specialized aligning glasses (and be able to tell or show the doctor how they feel).

Your Clumsiness Could Be Caused By Your Eyes

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Dr. Sandy DiPonio earned her optometry degree from Illinois College of Optometry in 1996. She is a highly skilled and experienced eye care professional dedicated to giving her patients of all ages excellent and compassionate care. She has a wide variety of experience in binocular vision, pediatric and adult eye care, ocular disease and contact lens fitting. She strives to provide each of her patients the best quality of life they can achieve with their vision through knowledge and education of treatment options.

Dr. DiPonio is a member of the American Optometric Society and Michigan Optometric Society.

Dr. Sally Hoey has been practicing optometry since graduating from Michigan College of Optometry in 2001. During her time in optometry school, she developed an interest in binocular vision, culminating in a senior thesis involving binocular vision.

Prior to joining Vision Specialists of Michigan, Dr. Hoey specialized in the diagnosis and treatment of vision-related learning problems as well as other binocular vision disorders. Her other areas of interest include specialty contact lens fittings and treating dry eye. Dr. Hoey strives to provide her patients with clear, comfortable vision while meeting their individual needs at the same time.

Dr. Hoey had the opportunity to provide eye care on an optometric mission trip to Guyana, South America and vision screenings at a local medical clinic. She is a member of the American Optometric Association, Michigan Optometric Association, Metropolitan Detroit Optometric Society and the College of Optometrists in Vision Development.

Dr. Jennifer Place graduated with honors from Michigan College of Optometry in 2001.

Before joining Vision Specialists of Michigan, she specialized in treating pediatric and adult patients with binocular vision disorders and vision-related learning problems, as well as fitting specialty contact lenses and managing various types of ocular disease. She enjoys working with patients with unique visual needs, and she takes great pride in providing all patients with highly customized care.

Dr. Place has volunteered for Opening Eyes, a program that provides eye exams to the athletes of the Michigan Special Olympics, and she participated in an international mission to St. Lucia to provide eye care to those in need. Dr. Place is a member of the Detroit Optometric Society, the Michigan Optometric Association, the American Optometric Association, the College of Vision Development, and the Optometric Extension Program Foundation.

Dr. Mary Jo Ference has been practicing optometry since 1990 upon graduating from Ferris State University- Michigan College of Optometry, and is certified in Low Vision Rehabilitation. She has worked at Sinai-Grace Hospital systems for over 20 years before joining Vision Specialists of Michigan in 2013 to work with binocular vision disorders. Her clinical areas of expertise include visual rehabilitation of pediatric and adult patients who have suffered from brain trauma, injury or disease. She has taught both optometry and ophthalmology residents at Sinai Grace Hospital. Dr. Ference has sat on numerous boards, including Sinai Grace Hospital, Berry Out-Patient Surgical Center, and Seedlings Braille Books for the Blind. She is actively involved in area school districts to provide education, training and access for students, teachers, OT’s and PT’s to eye care service rehabilitation information. Dr. Ference has lectured extensively nationally and internationally.

Dr. Debby Feinberg began practicing Optometry in Oakland County in 1983, upon graduating from Illinois College of Optometry. She joined her father, Dr. Paul C. Feinberg, at Mall Optical Center, which was located in Summit Place Mall.

Since 1995 Dr. Feinberg has been developing the field of NeuroVisual Medicine which is the optometric subspecialty that identifies and treats neurological / medical symptoms that originate directly or indirectly in the visual system.

Dr. Feinberg has been performing pioneering work with Binocular Vision Dysfunction (BVD), a condition where a vision misalignment (frequently subtle) creates difficulties with the two eyes working together to create a single 3-dimensional image, and difficulties with the two eyes following that image as it moves.

The symptoms caused by BVD are not usually associated with problems with the visual system, and include headache, dizziness, anxiety and panic, persistent post-concussive symptoms, gait instability and balance problems, frequent falls, neck pain, motion sickness, nausea, and reading and learning problems.

In 2004. Dr. Feinberg established Vision Specialists of Birmingham, specifically designing the practice to accommodate the needs of the NeuroVisual Medicine patient.

In 2011, the office moved to its current location in Bloomfield Hills and updated its name to Vision Specialists of Michigan.