An eye that goes up/down
Vertical strabismus can be completely debilitating, leading to nausea, dizziness, and an inability to function normally in everyday life.
Many times, this can be linked to a nerve palsy or prior surgeries and is worse looking specific directions.
While it is a difficult diagnosis, there are still solutions. Many times, using glasses with prism is a great starting point. Vision therapy can improve control tremendously and surgery can be used as a last resort.
Exercises must start here and as peripheral fusion improves, the patient slowly works towards central. Sorting out the peripheral is going to give the brain cues needed to see single and line the eyes up.
Various forms of technology allow for each eye to be presented different options making conditions ideal for using the eyes together. This skill can then be transferred into real life. Virtual reality can be used through Equal Eyes (at home), Vivid Vision, or Optics Trainer (in-office). Each has something unique to offer, all will be a great brain workout.
Vision therapy is the overarching, comprehensive approach for treating vertical strabismus. It should always precede surgery. The brain is not able to use the eyes together and needs an integrated approach to learn or relearn this skill. VT can help avoid prism adaption as well. It is the most effective option.
Surgery is definitely an option when you have a vertical eye turn. The first step is to try using glasses with prism. If you are able to get single vision with prism, then surgery may be a great option if you aren't getting results from vision therapy, especially for vertical eye turns.
When there is no prism that allows you to see single, your brain probably doesn't have the ability to fuse the images from both eyes so the surgery results probably won't help much..
Make sure the brain can fuse those double images first through vision therapy and prism. Only after that point should surgery be considered.
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