Binocular vision is a vital component of our patient's vision, but is it receiving enough attention at your practice? Traditional comprehensive exams fail to detect subtle phorias, and the rise in the use of handheld devices, post-concussion vision issues, and new prism products is changing the phoria landscape. Optometrists must look beyond their current paradigm and explore new approaches to finding and treating subtle vision misalignment.
Today, patients visit their optometrist for an annual check-up, blurry vision, or to use up their insurance benefits before they expire. But most patients don’t realize they should visit their optometrist for the classic symptoms of BVD, including headaches, nausea, and car sickness. With patients unaware, optometrists are missing the opportunity to ask their patients about these exceedingly common symptoms and treat them. Asking the right questions and screening for BVD is no longer for niche practitioners – it is the right thing to do for all patients.
In this article, we will discuss how to inquire about BVD with your patients. We will focus on definitions of BVD, classic symptoms that patients are experiencing but don't know to tell their optometrist about, and a few of our favorite questions to include in your case history to uncover BVD. Then we’ll answer the $64,000 question: What to do with patients who have BVD?
What is BVD?
Binocular Vision Dysfunction (BVD) is a group of eye misalignment disorders that create significant symptoms. When BVD is present, the eyes have difficulty with synchronization and alignment, causing the brain to receive slightly different images from each eye and struggle to establish a fused image. This can lead to symptoms such as migraines, motion sickness, nausea, and much more.
BVD goes by many names, such as Convergence Insufficiency, Accommodative Insufficiency, Vertical Heterophoria, and Computer Vision Syndrome, but they all have the same underlying problem: subtle misalignment of the two eyes. This can cause patients discomfort, frustration, and limitations in their daily lives.
Sadly, patients are often more aware of their BVD symptoms than their optometrist. In fact, most patients are not aware that optometrists with the proper training can treat migraines, dizziness, and anxiety. These symptoms are typically treated by neurologists, ENTs, psychologists, or psychiatrists. As an optometrist, you have the opportunity to uncover and learn to treat these symptoms from your exam chair.
To successfully identify and treat BVD patients, you must commit to adding a few new questions to your case history for every patient. You will want to set aside a few minutes to listen to patients' experiences and let them know that there is help available.
Okay, so what are the questions that you should be asking?