Binocular vision dysfunction (BVD) happens when the two eyes struggle to work together to form one clear, comfortable image. Even a very small misalignment forces the brain and eye muscles to work overtime to keep vision single, and that constant effort is what produces symptoms such as headaches, dizziness, eye strain and difficulty reading.
It is estimated that 10 to 20 percent of people have some degree of BVD, yet many live with it for years without a diagnosis. A standard eye test can show that each eye sees clearly while missing how poorly the two work as a team.
BVD has two broad causes. For some people it follows a concussion or traumatic brain injury (TBI). For others there is no injury at all, just a subtle misalignment their eyes have been compensating for over many years. We assess and treat both.
Many people first hear about BVD in the context of concussion, and that link is real. But BVD also occurs with no injury at all, from a small misalignment the eyes have quietly been compensating for over a long period.
This is the more commonly missed form, because there is no obvious event to link the symptoms back to. People often assume they simply get headaches, or that they are prone to motion sickness, without realising their eyes are the cause.
Common symptoms include:
If several of these sound familiar and regular glasses have not helped, it is worth having your eye teaming checked.
If you experience a concussion or traumatic brain injury (TBI), there is a significant chance it will affect your vision, potentially leading to binocular vision dysfunction.
Below we cover how concussions can disrupt your visual system, the symptoms to watch for, and why a specialised neuro-optometric evaluation is important. If you experience these symptoms, we recommend visiting both a doctor and an optometrist for a thorough assessment.
A concussion or traumatic brain injury (TBI) disrupts normal brain function due to a blow to the head, stroke, or neurological dysfunction. Studies show that at least 50% of TBI patients experience visual dysfunctions, with some studies reporting up to 90% incidence of post-trauma visual complications.
Children often suffer concussions due to sports injuries, while in adults, the most common causes include motor vehicle accidents and falls.
Many post-concussion symptoms, including dizziness, blurred vision, and difficulty focusing, stem from BVD but are often overlooked in standard medical evaluations.
Binocular vision dysfunction can manifest in various ways after a head injury, including:
Feeling dizzy or uncomfortable when scrolling on screens or in busy environments.
Difficulty tracking moving objects, reading, or maintaining focus for extended periods.
Persistent eye strain and headaches, especially during tasks that require focus.
Trouble with depth perception, leading to difficulties in walking or standing.
Increased discomfort from sunlight, fluorescent lights, and digital screens.
Difficulty maintaining a single, clear image, often affecting reading and driving.
Struggles with estimating distances, such as catching a ball or navigating stairs.
Decreased awareness of objects appearing from the side.
Reduced blink rate, leading to dry, irritated eyes and blurred vision.
A regular eye exam may indicate that your eyes are healthy and that your vision is clear. However, BVD affects how the two eyes coordinate and how the brain processes their input, rather than the sharpness of vision in each eye alone. This means a standard eye test may not detect the full extent of the issue, which is why many people are told everything looks fine while their symptoms continue.
At Adelaide City Optometrist, we specialise in identifying and treating BVD, including with advanced diagnostic tools such as Eye-Sync, which measures eye movement abnormalities following a concussion.
A neuro-optometric assessment evaluates complex visual processes beyond a standard eye test. This may include:
Every injury is unique, so treatment plans are customised to the individual’s needs. Paul Fotkou, alongside Christina Karapetis, provides specialised evaluations and follow up care to restore visual function post-concussion.
Binocular Vision Dysfunction (BVD) happens when the eyes struggle to work together. Tick any symptoms below that you've noticed with no clear reason. This is an awareness tool, not a diagnosis.
This self-check is for general information only and is not a medical diagnosis. Your answers are not stored or sent anywhere. Only a comprehensive assessment can determine whether BVD is present. If you're experiencing sudden or severe symptoms, please see a doctor.
Testing for BVD looks at how well the two eyes align, team and move together, and how much effort the brain is making to keep vision single.
A BVD assessment at Adelaide City Optometrist may include:
The aim of treatment is to reduce the effort your eyes make to stay aligned, so the symptoms settle. Depending on what we find, management may include:
Prism built into your lenses where appropriate, to ease the misalignment
Anti-fatigue or digital lenses, or single vision lenses, tailored to how your eyes are working.
A medical tint (Neuro Tint) where light sensitivity or screen glare is part of the picture
Advice on lighting, screens and reading habits to reduce daily strain
Neuro-optometric rehabilitation where symptoms follow a concussion
Our BVD consultation is $260 and includes two appointments. The first appointment is a comprehensive binocular vision and vision assessment, looking at how your eyes work together and identifying any areas that may be contributing to your symptoms. The second appointment is a functional vision assessment, looking at areas such as vestibular function, saccades, pursuits and eye movements, and reviewing your visual function.
As this is a specialised assessment, it is not claimable through Medicare or private health funds. The full fee is payable at your first appointment.
This depends on what is causing your symptoms and which treatment is right for you.
Where lenses are the main treatment, many people notice a difference soon after starting. This is why we review you at a second appointment, to check how you are responding and make any adjustments.
Where symptoms follow a concussion, recovery tends to be more gradual and depends on factors such as:
Severity of the concussion
How long symptoms have been present
Consistency with the treatment plan
Most patients see improvements quickly, but full rehabilitation is a gradual process. The brain needs time to retrain and rewire itself after an injury.
Whether your symptoms began after a head knock or seemingly out of nowhere, they are worth investigating. Early assessment gives the best chance of settling symptoms and getting you back to comfortable, everyday vision.
Book a BVD assessment at Adelaide City Optometrist.
BVD occurs when the eyes don’t work together properly, leading to symptoms like double vision, dizziness, headaches, and difficulty concentrating.
Common symptoms include double vision, dizziness, headaches, poor concentration, eye strain, and fatigue.
BVD is diagnosed through a thorough eye exam, including tests for eye alignment and coordination. At Adelaide City Optomtrist, testing involves two appointments, each lasting one hour.
Treatment options may include prism lenses, vision therapy, and tinted lenses to improve eye alignment and reduce symptoms.
People with a history of concussions, strokes, or neurological conditions are more likely to develop BVD.
Yes, BVD is often associated with head injuries, strokes, traumatic brain injuries, and other neurological issues.
Currently, Medicare does not cover the cost of BVD testing or treatments such as prism lenses, but we offer payment options at Adelaide City Optometrist.
