Vertical heterophoria, commonly called hyperphoria, is a condition in which one eye aims higher than the other eye. The degree to which one eye rests higher than the other can vary greatly. This condition is often classified as a binocular vision dysfunction meaning that the eyes are struggling to work together as a team and maintain appropriate eye alignment or posture. The tests required to diagnose vertical heterophoria are highly sensitive and often not included in many eye exams, so they unfortunately may be unnoticed and underdiagnosed.
Slight vertical heterophorias may or may not trigger symptoms. Moderate to severe vertical heterophorias typically trigger many symptoms that can be confused with other conditions. To compensate for the eye misalignment, individuals turn or tilt their head to compensate for the poor eye posture.
The main symptoms of vertical heterophoria include:
If you or a loved one experience any of the above symptoms, a Neuro-Vision Evaluation conducted by a Neuro Optometrist is the only means of getting a clear and accurate diagnosis. If you’re interested in better understanding the seriousness and severity of the symptoms you or a loved one are experiencing, we encourage you to take our Vision Symptom Quiz.
Vertical heterophorias may be caused by a concussion or traumatic brain injury, congenital condition (present early in life). Vertical heterophorias are associated with neurological conditions, which is why evaluation is so important. Other changes in vision can cause the visual system to “decompensate” and worsen vertical heterophoria symptoms. Some of these changes may include presbyopia (the need for reading glasses), increased hyperopia or myopia (farsightedness or nearsightedness), or surgery to any part of the eye including cataract removal, LASIK, or a retinal surgery.
Treatment for vertical heterophoria can vary depending on the cause, the symptoms and goals of the patient, as well as the type of doctor treating the patient. At NVTI, we treat the root cause of the vertical heterophoria, which is the binocular vision system’s ability to hold the eyes in alignment. aim to assess the underlying cause of binocular dysfunctions and treat accordingly. Prism glasses are often useful to alleviate symptoms initially, however, they don’t treat the underlying cause. Additionally, sometimes people become too reliant on the prism and continue to need more prism to help compensate for the vertical misalignment over time.
A program of neuro-optometric vision therapy is the best way to address the underlying cause and retrain and improve the brain’s ability to maintain single vision, eye alignment, and depth perception with excellent visual comfort.
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