To figure out our position in space, the brain weighs information from the visual system, the organ of balance (the vestibular system in the inner ear) and the somatosensory system (the feedback we get from our muscles, joints and pressure sensors). In a sense, eyes, ears and joint receptors make up the “keyboard” to the “computer,” the brain.
As with a computer, the efficiency and accuracy of the brain’s performance is only as good as the information it receives. While the vestibular system is normally the biggest culprit when it comes to dizziness, visual problems can also contribute to the symptoms that a patient may be experiencing, thereby worsening symptoms associated with motion and balance difficulties.
Dizziness and balance are some of the most commonly reported issues in healthcare. Vestibular function is important for the maintenance of balance and a stable visual environment when in motion. If there are visual problems even when not in motion, this points more to the visual system having a problem. After certain events such as a concussion or brain injury, both the vestibular and the visual systems can be damaged.
The visual problems can make it harder for the vestibular system to work properly and as a result, a patient may experiences dizziness, unsteadiness or disorientation in an environment with excessive visual stimulation such as a grocery store or busy shopping mall. Alternately, even with a perfectly normal visual system, these scenarios can create symptoms for those with vestibular damage because the brain is overusing vision for its sense of position when it can’t rely on the faulty vestibular system.
It can be difficult to sort out which system is at fault, or if it is a bit of both, but fortunately a vestibular assessment can help to differentiate. If a patient has visual issues that are NOT related to head movement, or if during an assessment we find that our scans for visual acuity, eye movements or visual fields suggest impairments, a trip to the optometrist for further testing would be wise.
When we’re treating issues with the vestibular system, some of the training is dependent on clear visual information. Thus, addressing any concurrent visual problems can be key to significant progress in vestibular rehabilitation. The combination of vision correction provided by an optometrist and vestibular therapy provided by a vestibular therapist can help in reducing or resolving symptoms of dizziness and imbalance, leading to a more favourable outcome.
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