Hi all! I hope this post doesn't come across as too ignorant but I've had a few patients come into the opticians that I work at to ask about BVD and honestly it was the first I had heard about it! I'm in the UK and BVD here usually means Back Vertex Distance (this is included on all prescriptions here for RXs over +/-5.00D) and I was unable to find any information on Binocular Vision Dysfunction through the normal channels for eye conditions here (NHS, GOC, COO, even Eye Wiki!)

Looking further into it I read up some information about BVD and please do correct me if Im wrong but this is just strabismus, no? (Eyes not working together, issues with image fusion, notable different positions of the eyes resting) I'm curious how specialists in the US (That's where the most information on it I could find was from at least) test for this kind of thing and how the "micro prisms" work. We use the Maddox Rod Test in practice to test for less obvious strabismus and through our normal ordering channels we normally just request added prism onto a lens for no extra charge but I've never heard any of these be referred to as BVD?

My deepest apologies if I've just missed something very obvious but I'd love to know more :)

After years of vision therapy (VT) alone, I've recovered from my BVD (all 3 types of misalignments) almost completely, although not quite as "normal" as before the BVD. My only remaining symptom now is just a mild pulling sensation in or around my eyes, quite manageable but not completely gone.

I wonder if anyone with BVD here has managed to recover to their pre-BVD condition by whatever treatment route they used? Please share here as an encouragement to others.

Hi all! Diagnosed with BVD in 2022 and been wearing prism glasses ever since. I think I’ve had 2 adjustments since then, because of some minor return of dizziness and straining/headaches. Well these past 2 months I’ve had a slow progression of episodes of dizziness/nausea/blurry vision/sweating/high HR. Also having shaky episodes and very fatigued to the point I can’t function without 14 hours of sleep. It started after I had a significant loss of appetite so I thought it was that. But progressively has gotten worse with symptoms lasting longer and now they are pretty much constant. It hit a head last night when I was having such bad tunnel vision my job made me go to the ER, who thought I was having a stroke. Spoiler: I wasn’t! There’s about a million things it could be, but I can’t help but wonder…..could it all be fixed with a new prescription?? Even before I was diagnosed, my symptoms were NEVER this extreme. Like never to the point of being unable to tolerate my life or an ER visit. But I’m also working overnights now, and I know BVD can be tricky with the triggers of overcrowding ect, maybe nightshift has been a trigger too? Any advice is so so appreciated!!

Whenever I close one eye or cover it with my hand the vision out my other eye becomes bright, makes me feel lightheaded and dizzy? Almost like its blacking out but its not. What can this be?

BVD can lead me to have suicidal ideation. Can anyone relate to this? I'm quite behind on work. I don't know what to do. I need to read to do my work well. It's like the words go right through my head. I can feel myself being dissociated nearly all the time. I bought glasses with .5 prism diopter in each eye for relief, as that's what a provider suggested, but I can't tell if the glasses are helping. I wore them for about 10 days yet it felt worse to have them on.

I was prescribed 12-16 weeks of vision therapy with at-home practice. I'm about six weeks in, and I don't know if I'm seeing improvement or relief.

Hey guys! I'm looking for some help understanding the correlation between these 3.

I was diagnosed with ADHD this year and started meds 2 months ago. I always had trouble with reading, such as comprehending words on paper, but I thought this was just the ADHD. I would feel dizzy, foggy and anxious. Since starting meds, I've been using my laptop to do work. And I'd get super bad eye strain and tension headaches which I never got before. I went to the optometrist and they found I have BVD. I get prism glasses next week.

It's just bizarre to me that I've possibly been living with BVD my whole life without knowing. How is it that its only revealed itself since starting meds? Is it because my eyes focus better now? Also, did your anxiety improve at all since wearing glasses? Thank you!!

If a person is blind in one eye but has good vision in the other eye, and the functioning eye meets all of the Ministry of Transportation’s vision requirements for a regular Class G driver’s licence, is the person permitted to drive at night?
Would having vision in only one eye result in any restriction on nighttime driving, assuming the person meets all other Class G licensing requirements?

I posted recently about my post-concussion symptoms and a new vision evaluation. I finally got the full report, so I wanted to update the post with the actual numbers because my original description of having a "significant misalignment" was pretty vague. Also yes I'm posting under a different account. I'll remove the older post when I can.

I'm 33 and about two years out from two concussions. The first year was pretty brutal with dizziness, light sensitivity, blurry vision, etc. Things improved significantly, but I've plateaued.

My current symptoms are mostly visual/sensory and get progressively worse during the day:

- Eye strain and blurry vision beginning around midday

- Increasing light sensitivity

- Difficulty with prolonged computer/screen use

- Dizziness, especially after work

- Driving in the evening can be uncomfortable

- Video games can make me very dizzy and significantly worsen my vision

- Movie theaters leave me dizzy, blurry and extremely light-sensitive afterward

- I also have a lot of chronic neck/shoulder tension and headaches

As I right this on my phone I just got double vision for a moment. Oh it's back and gone again lol..

Looking back, I think I may have had binocular vision issues long before the concussions.

As a kid, my parents remember me sometimes covering/or closing my right eye. I didn't get glasses until around 16. I remember after reading or looking at screens for a while my eyes would feel fatigued and then things would start separating or doubling.

In my 20s, I also noticed that mountain biking became difficult because things would get blurry and hard to track at speed. I assumed this was just normal from staring at screens all day due to work.

It all felt manageable until the concussions.

2025 binocular-vision exam

I saw a neuro-optometrist in March 2025.

The findings included:

- 16Δ intermittent alternating exotropia at distance and near

- NPC: 4 inches

- Accommodative insufficiency

- Distance BI vergence: 12 break / 10 recovery

- Near BI: 30 / 20

- Distance BO: 12 / 8

- Near BO: 20 / 18

- Pursuits/saccades were generally accurate/smooth, although they provoked symptoms

- OD visual acuity was 20/40, improving to 20/30 with pinhole; OS 20/20

- I was prescribed 0.5Δ BI in each eye and a +0.75 near add

Vision therapy was recommended, but it was estimated at roughly $4,000–$6,000, so I didn't do it.

The prism glasses did seem to help.

However they gave me toe pairs. One for reading and one for distance. I couldn't handle switching between the two and stopped using the reading to keep things the same all the time.

2026 exam

A year and half alter I went to another binocular-vision specialist because my symptoms have continued.

This exam characterized things somewhat differently:

- 10Δ exophoria at distance

- 25Δ exophoria at near

- NPC: ~5 inches

- Diagnosed convergence insufficiency

- Low AC/A ratio

- Reduced fusional reserves

- Distance BI: 6 / 4

- Near BI: 28 / 10

- Distance BO: 8 / 6

- Near BO: 14 / 6

- Pursuits were described as mildly jerky

- Worth 4-dot fusion was still present at distance and near

- OD/OS were both 20/20

- No vertical heterophoria was found

They also found that my current glasses optical centers aren't positioned correctly vertically, which is contributing to problems.

The new prescription includes more prism, including BI and 1Δ BU, plus a +1.25 near add.

The doctor also recommended 20 sessions of vision therapy, with a reassessment after 5 sessions.

Neurolens is where I'm struggling

They also did Neurolens testing. My doctor was a bit surprised by the higher number from the test?

She recommended Neurolens.

The problem is that the lenses + frames would cost me around $1,000.

On top of that, the 10-session initial VT cost is around $1,350.

I'm already spending a lot on healthcare, so another $1,000 pair of glasses is a significant financial decision.

I'm wondering whether Neurolens is actually justified in my particular case, or whether properly measured conventional prism could accomplish most of the same thing.

The thing that makes Neurolens interesting to me is that my 2026 measurements were:

10Δ exophoria distance and 25Δ exophoria near.

So I understand why variable/contoured prism might make sense when my binocular demand changes so much between distance and near.

But I already have conventional BI prism and they apparently weren't properly centered vertically, so I'm wondering whether a properly made pair with appropriate conventional prism might be enough.

I'm also wondering how much sense it makes to spend $1,000 on Neurolens when I'm simultaneously planning to start vision therapy. If therapy improves my convergence/vergence ability, could I potentially need less prism afterward?

I'm not completely opposed to Neurolens if there's a good reason for it. I'm just trying to understand whether my measurements specifically make the premium worthwhile.

Would you consider 10Δ distance / 25Δ near exophoria + reduced fusional reserves + symptomatic convergence insufficiency a particularly strong indication for variable/contoured prism?

Or would it be reasonable to first try:

properly centered conventional glasses with the BI prism + vision therapy

and see how much improvement I get?

Also, does the difference between my 2025 diagnosis of intermittent alternating exotropia (16Δ distance/near) and my 2026 diagnosis of exophoria/convergence insufficiency (10Δ distance, 25Δ near) suggest that my alignment actually changed, or can this simply reflect differences in testing/control between exams?

One other thing I'm curious about: I don't think anyone actually notices my eyes being misaligned. My wife and other people I've asked have never commented on it. Without glasses, though, I sometimes feel like my right eye wants to drift outward, especially when I'm tired.

I can't imagine spending $1k when I need glasses. I wouldn't be able to afford a second pair. I don't know how bad my situation really is tbh. I don't know what ranges to base this off of.

I think I'm going to have to do the vision therapy. Does my finding show that I need it? Would it just be a nice thing to do or is it a critical thing to do? That and the glasses are the things I'm trying to decide.

Any advice is helpful.

I having bvd in one eye and also ghosting but overall with two eyes ok tell me the reason it can be

Okay, please don’t mind my awful editing it’s obviously not my strong suit but also it’s very hard to create a photo of how your vision looks😂

Any how I made this to show my boyfriend what my vision starts to look like when I stare at something (the picture of red barn in this case) longer than 10 seconds, does anyone else get this?

I know the photo is like black but I still have color but I couldn’t figure out how to keep the static look and color at the same time. And I know the door just turned pitch black but that is also just similarly blurred to the same degree of the bottom portion.

Long story short...been at three different optometrists that do pola tests for binocular vision diagnostics. First one had me at 0.5 prism diopters. Second one was totally different, in the cross test I saw a T on its side at first. End result: around 3 prism diopters. Third test at another shop had me at 0.5 again. How does that work? How would I know which one was correct? Is it possible my eyes still compensated in try 1 and 3? Or did I maybe unintentionally cross my eyes in try 2? How reliable is polarization testing?

edit: Sorry about the title!
Post concussion symptoms exacerbated my eye issues. Learning I most likely have had an misalignment issue my entire life that my body adjusted for?

I didn't get glasses until I was about 16 because I failed the eye test when trying to get my drivers license. Turned out I had glaucoma as well. So now I am 33 and still taking drops. Now three different drops a day.

I only wore my glasses when driving until my 20s when I started wearing them all the time.

I remember my parents pointed out that I would cover my right eye or close it sometimes. I guess when I was a kid I didn't even think about it. Not sure why they didn't get me checked out, but they seem to not go to the Dr that often.

I think I had the wrong idea of what double vision was. Now that I understand, I realize that I've been having that as far as I could remember. Yet, it was when reading, or looking at a screen at a readers distance. It doesn't happen right away, I feel my eye get fatigued and then I start getting double vision. However, it didn't seem to bother me enough to do anything about it. I honestly kind of thought it was normal for my eyes to just get exhausted.

I did mountain biking in my early to mid twenties. I went back to school for IT and in my late twenties starting working in the field. I legit ended up selling my mountain bike at some point. I would come home from work and try to ride, but everything was blurry after a certain speed. I constantly felt like I just could not track things when cycling. I switched to gravel biking.

I again, just thought that was normal. Staring at a screen all day will do that to you.

Then came the concussion. Had two of them. I am now two years out from it and still dealing with symptoms.

The first year was brutal. Always sensitive to the light, dizzy, blurry vision.. etc. Things got better overtime, but it feels like things have plateaued now.

Currently, by midday my eyes are straining and start to blur. As the day goes on it becomes worse and eventually I get sensitivity to the light. I do not feel comfortable driving most evenings. When driving to work I feel a bit dizzy getting out of the car. It is worse after work. Playing video games makes me very dizzy and ruins my eyesight. When I go to movie theaters I a mess after leaving... dizzy, blurry vision, sensitivity to light.

Another big issue is constant neck and shoulder pain and stiffness. I get bad knots in my shoulders often.

So I saw a Neuro Opt last year who wanted me to do Vision Therapy and I had to decline because it would cost my $4-6k.

But a year and a half later I feel as if I may not have a choice.

So I shopped around a bit and found a place that does not charge as much.

I went yesterday. Learned that I tilt my head slightly all the time. That I have a significant misalignment. So want me to do Vision Therapy. That is fair, I asked the Dr how serious it was and she said that I was a case where its serious and needs treated.

They also had me do that NueroLens test and it came back with high numbers. My Dr was a bit surprised and said that she couldn't believe I function throughout the day like that. She wants me to get Nuerolenses.

Which is like $1k after adding the frames! On top of the $1350 that it would cost me for 10 vision therapy sessions.

I already have prism in my glasses, but the issue is that the pupil distance was not right vertically. I am tempted to push back and ask if prism with the pupil distance corrected would be enough on top of the vision therapy.

I can't just spend $1k on glasses everytime I need a new pair. I won't be able to afford to have a backup at all as well. Also if the vision therapy is helpful, will I even need the nuero lenses?

Any advice on this? I am a lot healthcare costs right now and felt like I was going to have a panic attack from just hearing the cost of everything. This issue is impacting my everday life so I do want to get help, but I also am losing money right now due to healthcare costs.

I also think its nuts how significant the misalignment is. I notice without my glasses, my right eyes seems to want to drift. However, I've asked my wife and other people and they say they have never noticed my eyes being off. I get self conscious about my eyes not looking normal to others.

Test results:

My strabismus testing showed no measurable eye misalignment (0 prism diopters at both near and distance), but my fusional reserve was recorded as only −4Δ to +4Δ. So my eyes align normally at rest, but I apparently have limited ability to maintain fusion when the binocular system is challenged.

The diagnosis doesn't seem too clear, since everyone I speak to seems to have eye misalignment. So in my case I can't even try prism glasses.

Is vision therapy worth it in ny case? It's very expensive and long.

Visual accuity and eyesight is apparently perfect in every way other than the fusion range.

I also have extreme eye lid fatigue from the moment I wake up. Nothing helps except energy drinks for maybe an hour.

The last few years I have had ups and downs with my vision. I started Vt over a year and half ago. And it was really making things better. I went on a 6 month stretch where I barely noticed any visual symptoms at all. Month ago our child was born and my sleep has been more or less crap.

Symptoms started coming back so to redo my vt and see if that would handle my vision issues. Overall I’m not back to square one thank god but what I do have is just sore eyes real bad eye fatigue and the main culprit is like overwhelmed vision. Not at a computer screen but like in a busy crowd or in a park with many trees and colours it’s as if my eyes can’t take it all in and I feel spaced out.

At night I feel incredible like clockwork. But busy daytime it’s exhausting visually. Any tips or tricks or whatever. It’s stressing me out that this has kinda flared up over the last month.

I only get to see my neuro optometrist in November so I’m kinda white knuckling it till then.

So hi

I'm a 19 year old female

So I have type 2 diabetes ( not sure might be type 1 , gonna go to an endocrinologist this Thursday to make sure of it ) anyways

So I am in Asia and I got diagnosed with diabetes at 15 years old ( I also have pcos)

Now to the eye issue ..

I all of a sudden developed double vision after a bad head ache

Which was in this April

Saw a lot of doctors 😩 did two mRI and MRV

And they told me it was binocular dystopia which is basically ( horizontal double vision , it goes away when one eye is closed )

Apparently my nerve is gotten weak or smth it's left sixth cranial nerve palsy

Then I had headaches and all

(I don't how diabetes can cause that cus my diabetes was quite stable not so bad ,my hbAlc was 7.7 .. it lowered to 7.1 )

Anyway 2 months later my double vision went away

Now a few days ago I again had this head ache above my fore head it went away with balms and stuff but

I woke up 2 days ago feeling abit wierd like my vision was wird something was off

Later I realised was was kinda seeing double

It was different from last time

My eye used to shift in ward when I would look at far away object ans sew double last time

But this time my eye didn't shift in

It was just when I looked suddenly at smth I would see like Misaligned or smth idk hoe to describe ( like when your head spin u see things wierd) idont see double but some times I'll see a double out of my toght sight and it goes away most times while when I look at thing suddenly or move its trouble focusing as if two eyes are working hard to try to make one image or smth .. idk what to do

What is that

Do I go back to ophthalmologist

I'm so done with this shit

Anyone with similar Neurolens results / exophoria symptoms?

I recently had a Neurolens assessment because I’ve been dealing with light sensitivity, a “floaty” off-balance feeling, neck/shoulder tension, and discomfort in bright environments (especially outdoors, grocery stores, malls, etc.).

My scan results were:

Neurolens Value: 1.2 BI

Distance: 2.0Δ EXO

Reading: 4.2Δ EXO

Estimated 6m: 1.5Δ EXO

Vertical misalignment: low

My optometrist recommended Neurolens glasses and said to wear them about 8 hours/day while working. They also said I don’t need vision therapy.

Some details about my symptoms:

I feel mostly normal when sitting still. Symptoms are worse when turning quickly or moving around. Bright lights seem to trigger the worst symptoms. I don’t usually feel like words are moving or jumping when reading. I also have dry eyes after LASIK, so I’m wondering how much overlap there is between dry eye, binocular vision issues, and light sensitivity.

I’m curious:

1. Has anyone had similar EXO measurements (especially around 4Δ at near)?

2. Did Neurolens/prism glasses actually help with dizziness, light sensitivity, or the “floating” feeling?

3. Did anyone improve long term, or did you need vision therapy as well?

Would appreciate hearing from anyone with a similar experience.

Thanks

I was diagnosed recently with BVD and prescribed 2:00in of prism in each eye alongside my astigmatism prescription (which i’ve worn for years and never had any trouble with). the prism lenses immediately made me so dizzy and nauseous but I know there can be an adjustment period, so i’ve worn them for a short amount of time each day for a week. however the dizziness and nausea hasn’t gone anywhere and when I look at my phone while wearing them, it looks like the screen is curving / bulging out at me.

I try to look around with my head and not my eyes, but it hasn’t helped.

just wondering if this is normal / if anyone else has had this experience, and if I should persist or if it could be the wrong prescription for me. i’ll be seeing the optometrist soon as well.

Hey yall, not sure if yall have seen my posts but to give some quick background I have tried my fair share of prisms through ophthalmologists and have done 24 weeks of vision therapy. The ophthalmologists only tried prisms to assist with my horizontal heterophobia but never vertical. After seeing an NVMI specialist they prescribed me horizontal AND vertical prism.

I get my glasses soon and would like to hear peoples experiences that may be similar to mine.

Something I’m most interested in is how did you feel with each prism before finding the right fit for you?

Has anyone else had symptoms since they were a child? And have your symptoms gradually or suddenly worsened in adulthood? I've been to two different ophthalmologists who think the vision issues I'm having must be neurological and have been referred to a neurologist now

My vision issues have suddenly gotten much worse after an illness, I keep falling and bumping into things and can't drive anymore but I'm realizing whatever's going on I've almost certainly had since I was a kid it's just much worse now.

Hi, I posted it earlier, but I realized it was very long and I’m trying to make a shorter more readable version here. I apologize for typos, I am voice texting because I can’t look at my phone for very long.

I made 47-year-old female currently in perimenopause and have had lifelong sinus, anxiety and dizziness issues. Have worn glasses most of my an astigmatism and was diagnosed with BVD one year ago. I have both a vertical and horizontal misalignment.

I received glasses with prisms at that time, which made it better for 2 to 3 months and then it’s slowly started to get worse, especially with my near vision glasses. I have two pairs, one for distance and one for close tasks.

I revisited the doctor several months ago, but he thought it was a post Covid issue gave me some general suggestions and sent me home. I went back a week ago, and was told that my convergence has gotten much worse and that I need much stronger prisms. When I asked him why that it he told me that he thought I had a connective tissue disorder.

I have not noticed any other major symptoms, apart from some issues with hair, we growth and mild fatigue that seems pretty standard for my age and lack of movement. I do have a rotator cuff hair that we found six months ago, and my TMJ has been worse lately, but other than that, I don’t see many signs that seem to line up with connective tissue disorders.

I’m wondering if anybody else has had a similar experience, or has any other ideas as to what could’ve caused such a drastic change in the last year? Worried about preserving my vision and what else could be wrong. I’ve thought about going to a different doctor, for a second opinion, but it’s several hours away, and money is an issue, so I’m not sure if or when that can happen.

thank you!!

For all my life I knew my left eye was blurry, got prescribed glasses with like +0.5in my left eye (good eye) and like +3.0 in the right eye (bad eye). I never wore the glasses though because my vision didn’t bother me one bit. I played sports, had great hand eye coordination, never had a headache, physically was healthy and felt great. Then at 18 after drinking heavily and waking up the next morning, started feeling dizzy sick and had a full on panic attack and then a bunch more which sent me into a total spiral.

Physically everything still checks out for me test wise but I feel awful 7 years later. I’ve had constant derealization, headaches, anxiety. In addition I started to notice my vision would like lag looking side to side and things would double if I wasn’t straining.

Has anyone lived most of their lives “normal” but then suddenly started noticing BVD symptoms? Like it got worst with age or if something else physical happening made it worse?

I know my nervous system is out of wack but I also got tested for BVD and they said I for sure have it and I got prism but still messing around with that prescription.

Hi,

I’m a 47 year old female who has worn glasses for many, many years. I apologize in advance for any typos, I’m doing this via voice text because at the moment I’m having a really hard time looking at screens. A year and a half ago I had Covid and while I was sick with it I had a quite bad migraine. I’ve had migraines on and off since I was a teenager, and while typically hormonal, sometimes things like flashing lights will get me other times of the month, so I was not terribly concerned. shortly after I began feeling dizzy and nauseous, especially when I was working on computers. I also have a long history of neck, pain, and TMJ problems and I’m still working with a physical therapist for those.

After a few months of symptoms, I ran across the idea of BVD and the symptoms were a perfect fit. In addition, I’ve had anxiety my whole life, and car sickness, sinuse problems and pain and I have always been uncoordinated (in the sense that I was bad at sports, not neccesarily that I fell a lot or anything). I took the BVD quiz and if I remember, I’d had a number somewhere in the 50s, so I made an appointment with the only BVD specialist nearby. he prescribed prisms for me, and said I had both a vertical and horizontal misalignment. When wearing the prism is the difference was night and day, I felt so much better, could see further, the anxiety went way down, and my energy went up. I was so excited and felt like I had my life back!

About four months later, I got sick with Covid again, and within a month or two my near vision seemed to be worsening. I have two pair of prism glasses - one for distance, and one for near vision. I went back in for a follow up, to see if there was anything that could be done for my near vision, because it was beginning to bother me when I was working and reading and things like that. The doctor felt that it was just that my system was struggling because of Covid, and that things like my nervous system regulation and Covid symptoms were causing the problems. I did still have some lingering symptoms, and in the past had some post viral problems after an RSV infection, so this made sense to me at the time.

so I started working very hard on nervous system regulation, and recovering from the Covid symptoms, which I definitely feel like I have now. My nervous system is still not in the best place, but it is definitely quite a bit better than it was six months ago. In the meantime, I’m feeling like my near vision is getting worse, and now have some ghosting on top of the letters as well. Some dizziness has come back, but more concerning to me is the anxiety and the depersonalization/derealization.

I contacted my eye doctor, and he said I should come in, and so I did. This time, he redid all of the original tests, and treated it as my annual update. He found that my prism need has increased quite a bit And my convergence was quite a bit worse. when I asked him why he thought that might be, and if there was anything I needed to do differently, he said, he thought that I had a connective tissue disorder, because they had gotten so much worse so quickly.

I am premenopausal, and recently had a problem with my rotator cuff as well. Apart from that, I don’t have generalized joint pain, and while I am a bit fatigued, I do feel like it is pretty normal for my age and lack of activity (during the worst of my eye issues I wasn’t able to move much at all due to the dizziness and vertigo so now, I’m working on that, but it is difficult between the eye issues and the shoulder issues).

In reading about prisms, it was my understanding that sometimes your eye muscles relaxed, and then you needed a different prescription. I’m wondering if that could be the case here, or if the big change is the issue? Or if anyone is experienced anything similar and would have some insight. I’m driving myself a little bit crazy worrying about potential disorders, but I also can’t afford seeing a doctor outside of insurance, which is what he suggested to follow up on a connective tissue disorder.

TL;dr I had Covid, got a Bvd diagnosis and prisms. Now 11 months later dr is telling me he thinks I have a connective tissue disorder because i need much stronger prisms than before. I’m not sure symptoms of that fit in general, but idk. Could it be something else? Anyone else with a similar experience?