You Know the Patients that don’t Respond to Treatment?

Vision Specialists of Michigan, Symptoms Map

They Could be Suffering from Binocular Vision Dysfunction (BVD):

Binocular vision is the process where the two eyes (which are controlled by the brain and four cranial nerves) team together to create a single, 3-dimensional, fused image, and then team together to follow that image as it moves. BVD occurs when there is a problem with any part of the binocular vision system that leads to difficulty maintaining fusion or image following. The symptoms of BVD stem from a misalignment but also from the body's struggle to maintain a single, 3-dimensional fused image. They include not only the traditional symptoms of diplopia, but many other symptoms not usually associated with BVD.

Symptoms of a Patient that may have BVD:

The number & severity of symptoms are different for each person.

Pain: headaches, face ache, eye pain or pain with eye movement, neck ache, upper back & shoulder pain, head tilt

Vestibular: dizziness, lightheadedness, nausea, unsteadiness/drifting to one side while walking, lack of coordination, motion sickness

Psychological: anxiety, feeling overwhelmed or anxious in crowds or large spaces (e.g., malls, big box stores, etc.)

Reading: difficulty/fatigue with concentration, difficulty with reading and comprehension, skipping lines while reading, losing one’s place while reading

Vision: double vision, blurred vision, overlapping or shadowed vision, light sensitivity, difficulty with glare or reflection, closing/covering one eye to make it easier to see

Many people with Traumatic Brain Injury (TBI) develop a small amount of eye misalignment from their injury that cause these symptoms.

Vision Specialists of Michigan, What is the solution?

What is the solution?

Vision Specialists of Michigan (VSM) patients undergo a detailed and thorough examination of their vision, including assessment for small amounts of eye misalignment (the NeuroVisual evaluation). Problems with near vision, far vision and alignment will be corrected using prismatic glasses, resulting in a reduction (or sometimes elimination) of their symptoms.

Practical Application

Over the past 20 years, Vision Specialists of Michigan has helped over 8,000 patients, including 3,000 TBI patients. The average patient experiences a 30-50% reduction of symptoms on the same day of treatment with an average reduction of 80% by the end of treatment.

What Doctors are Saying:

I have referred over a hundred TBI patients to VSM. This is one of the best medical improvements we have had to treat brain injury patients in decades.

Jennifer Doble, M.D.,
PM&R Physician, TBI Specialist

Hear additional medical colleagues share their experience with BVD on video here.

Telltale Signs a Patient may have BVD


Head Tilt

Society of NeuroVisual Medicine demonstration of head tilt to overcom BVD

Elevated Eyebrow

Society of NeuroVisual Medicine demonstration of elevated eyebrow to overcom BVD

Orbital / Eye Elevation

Society of NeuroVisual Medicine demonstration of orbital eye elevation to overcom BVD


  • Trapezius muscle tenderness / tightness (neck pain)
  • Reproduction of symptoms with extraocular muscle (EOM) exam, particularly with upward gaze
  • Reproduction of symptoms (particularly dizziness, nausea and anxiety) with near point of convergence (NPC) testing
  • Drifting to one side with ambulation



  • 5 Minute Cover Test: Covering one eye for 5 minutes and observing a noticeable reduction of BVD symptoms
  • Scoring 15+ on Binocular Vision Dysfunction
    Questionnaire (BVDQ): online at

All the testing, seeing doctor after doctor over all these years, I’ve finally found my answer at VSM and it totally changed my life.

-TBI Patient

See Patients share their BVD story
on video here.

BVD is Commonly Confused with:

  • Migraines
  • Anxiety disorders
  • Dyslexia
  • Sequela of a stroke
  • Inner ear disorder
  • Reading/Learning disabilities
  • TMJ
  • Panic disorders
  • Spinal misalignment issues
  • Sinusitis
  • Meniere’s Disease
  • Convergence Insufficiency
  • Persistent Post-concussive symptoms
  • Agoraphobia
  • Gastroparesis/cyclic vomiting
  • Vertigo
  • Malingering/Faking it/”You’re Crazy”

Research: Online

  • Mechanisms of TBI & Visual Consequences in Military &Veteran Populations. (Goodrich GL, et al, Optometry & Vision Science, 2013)
  • Identification of Binocular Vision Dysfunction (Vertical Heterophoria) in TBI Patients and Effects of Individualized Prismatic Spectacle Lenses in the Treatment of Postconcussive Symptoms (Doble, et al, PM&R Journal, 2012)
  • Dizziness Ameliorated With Prism Treatment of Vertical Heterophoria (Rosner, et al, Poster, American Academy of Otolaryngology – Head and Neck Surgeons Annual Meeting, Washington DC, 2012)
  • Chronic Headache Amelioration with Prismatic Lens Treatment of Vertical Heterophoria (Feinberg, et al, Poster, American Headache Society 54th Annual Scientific Meeting, Los Angeles, 2012)
  • Prism vs. Prozac: A Novel Approach to the Amelioration of Anxiety With Prismatic Lens Treatment of Vertical Heterophoria (Feinberg, et al, Poster, Anxiety Disorders Association of America Annual Meeting , 2012)
  • A Retrospective Analysis of Vertical Heterophoria Treatment and Amelioration of Post-Concussive Disorder Symptoms Utilizing a Multifaceted Assessment Battery (Rosner, et al, Poster, 9th World Congress on Brain Injury, Scotland), 2012)


Society of NeuroVisual Medicine Logo

In 1995 our doctors developed the NeuroVisual Evaluation (a specialized eye exam that finds the hidden misalignment of BVD). Our groundbreaking prismatic glasses eliminate the need for the body to make any corrections, resulting in a reduc-tion or even elimination of the symptoms of Binocular Vision Dysfunction.

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Suite #100
Bloomfield Hills, MI 48302

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