1. Sit directly in front of your patient.
2. Start a conversation with them to keep them relaxed.
3. As you do so, observe their head posture.
1. Center your patient in the middle of a hallway.
2. Pick a target at the end of the hallway that is eye level with the patient.
3. Tell the patient to walk down the hallway while looking at the target, then to walk back to you.
1. Observe their overall head position. Is a tilt obvious? Is the line from their nose to their chin 90 degrees with the line shoulder to shoulder?
2. Observe the position of other parts of their head. Is one ear higher than the other? Is the part in their hair on the "higher" side?
1. Observe their stride. Are their arms stiff or strides short? Do they only move one arm or shuffle?
2. Observe their trajectory. Are they drifting to one side or weaving? Does their head point in the same direction? Do they look unsteady at the turn?
3. Observe their confidence. Are they reaching for the wall? Could they stay upright easily if something changed? Are they taking an extra step at the turn?
…the patient most likely has a vertical misalignment, but others who treat for headaches, dizziness, anxiety, neck pain and other symptoms don't tend to connect these dots. If you're concerned about the patient, it may be time to ask about other symptoms they may have in order to truly understand if this is a VH problem.
…it may just be Vertical Heterophoria. These abnormalities do not always come from acute events, but build up over time for numerous reasons. However, an abnormality in a patient's walk can be an easy sign to consider using microprism to help.