Why Do I Feel So Anxious When I Walk Into A Shopping Mall or Airport?

Patients often tell us they experience symptoms of vertigo or anxiety when walking into a big box retailer or a wide-open space like an airport or sports stadium. You may have explained these sensations to countless doctors, only to have them dismiss you with yet another prescription. The physician may not realize that your issue isn’t related to vertigo or anxiety. Instead, you may be dealing with a visual health condition called vertical heterophoria, which mimics symptoms of other medical issues.

What is Vertical Heterophoria?

Vertical heterophoria is a condition where there is a vertical misalignment of one or both of your eyes. Even the slightest deviation can impact visual information passed from your eyes to the brain. The strain causes your eye muscles to make constant adjustments to clear up your vision, leading to symptoms like:

• Dizziness
• Headaches
• Lightheadedness
• Problems concentrating
• Light sensitivity
• Sinus pain
• Pain during eye movement
• Unease when you’re in a space with high ceilings

While most people are born with the condition because of genetics, you can also develop vertical heterophoria because of:

• A traumatic brain injury (TBI)
• Eye injury
• Concussion

Why Does Vertical Heterophoria Cause Dizziness?

Vertical heterophoria affects the way your eyes process images. For example, you can experience dizziness walking around the mall because your brain is trying to deal with stimuli, bright lights, arrays of products everywhere, and other people’s movements. That can produce dizziness as a side effect, making you feel anxious and uncomfortable in a large space.

The symptoms of vertical heterophoria are not constant. You may go through long periods without having issues, only to experience them all at once during daily life.

Problems While Driving

Individuals dealing with vertical heterophoria may feel the same anxiety when driving. The condition can make it seem like stationary objects are actually in motion. Dizziness can cause drivers to feel like the car is going backward, even when parked. The following actions can exacerbate symptoms of vertical heterophoria while driving:

• Moving head rapidly from side-to-side
• Standing up quickly from a sitting or bent position
• Seeing cars fly by in your peripheral vision
• Going around curves or over bridges

Can My Doctor or Optometrist Help Me With Vertical Heterophoria?

One of the difficulties of treating vertical heterophoria is that it’s often misdiagnosed as another health issue like:

• Inner ear disorders
• Migraine issues
• Vertigo
• Poor sleep habits
• Allergies
• Multiple sclerosis

You would need to visit an optometrist with the training necessary to analyze and treat vertical heterophoria. Vision screenings, which typically check for visual accuracy, are not capable of diagnosing this medical condition. You can have perfect 20/20 vision and still have vertical heterophoria symptoms. 

What Are the Treatments for Vertical Heterophoria?

Once you’ve been diagnosed, your optometrist should recommend ways to correct the misalignment in your vision. Common treatments include:

• Therapeutic prism glasses — These special glasses can cut down or eliminate issues associated with vertical heterophoria like eye strain and dizziness and must be worn constantly.
• Vision therapy — Prescribed eye therapy that utilizes a combination of exercises performed in the doctor’s office and at home to strengthen the connection between the brain and the eyes.

If you believe your medical issues are related to vertical heterophoria, contact NeuroVisual Specialists of Florida at (561) 733-9008 to set up a consultation.