Binocular Vision Dysfunction (BVD) Testing in Sydney

Could Binocular Vision Dysfunction Be Contributing to Your Symptoms?

If you experience headaches, dizziness, eye strain, reading difficulty or discomfort in visually busy environments, the way your eyes work together may be contributing.

Complete our short Binocular Vision Symptom Screener to receive an immediate overall score and a breakdown across four key symptom areas.

There are several types of binocular vision disorders:

• Horizontal eye misalignments – convergence insufficiency, convergence excess, divergence insufficiency, divergence excess
• Vertical eye misalignment – vertical heterophoria
• Torsional misalignment – a rotational misalignment between the two eyes
• Strabismus – completely “turned” eye
• Amblyopia – “lazy” eye

Why BVD is Often Missed

Problems with binocular vision occur more than you think. Many times, a binocular vision disorder is overlooked in a standard eye examination. Most eye tests focus on:

• visual clarity
• eye health

They do not assess how your eyes work together under real-world conditions.

This is where the expertise of a behavioural optometrist—also known as a developmental or neuro-optometrist—becomes crucial. They are trained to look beyond standard visual acuity tests and can identify subtle binocular vision issues that may be impacting your daily life.

This leads to frustration among adult patients and, in the case of children, parents wondering why they struggle in school.

Common symptoms associated with binocular vision disorders include:

• Eyestrain or headaches
• Dizziness or vertigo
• Balance issues
• Neck ache or upper back pain due to a head tilt
• Anxiety in open spaces or while driving
• Losing place or skipping lines while reading
• Words moving or running together while reading
• Double vision
• Closing one eye 
• Blurry vision after near work or computer work
• Avoiding near work
• Trouble concentrating or feeling tired
• Light sensitivity
• Feeling carsick easily
• Motion sickness, especially without physical movement
• Poor depth perception
• Migraines
• Visual snow
• Brain fog or slow information processing

If left untreated, binocular vision problems can lead to more serious eye conditions such as amblyopia (lazy eye) or even an eye turn (strabismus). The brain may also suppress or actively shut off vision in one eye, leading to a loss of binocular vision and depth perception.

BVD and Related Conditions

It is common for people with BVD to have been previously diagnosed with a number of conditions including:

• ADHD / ADD
• Autism Spectrum Disorder
• Dyslexia or Reading and learning difficulties
• Agoraphobia
• Anxiety disorders
• Vertigo or BPPV
• Perceptual dizziness
• Vestibular migraine
• Sinus problems
• Meniere’s disease
• Concussion/mTBI and whiplash

In some cases, the visual system is contributing to these symptoms.

People who have a history of traumatic brain injury (TBI) or concussion may have been diagnosed with Post Trauma Vision Sydrome (PTVS) or Post Concussion Syndrome (PCS). CT and MRI scans often appear normal in patients with mild traumatic brain injury, which may occur from contact sports or falls. More than half of the brain is dedicated to vision-related processing, so any injury or accident to the brain can result in a degree of visual dysfunction. These visual dysfunctions can manifest psychologically—such as anxiety and panic disorders—or spatially, affecting balance and posture.

BVD After Concussion or Head Injury

Concussion and mild traumatic brain injury can affect eye coordination, focusing, eye movements and visual–vestibular processing, even when CT or MRI scans are normal.

Patients may experience headaches, dizziness, light sensitivity, difficulty reading, motion sensitivity or discomfort in busy environments.

If your symptoms began after a head injury, please visit our concussion vision assessment page.

Our Approach: BVD & Prism Assessment

At Westmead Eyes Optometrists in Sydney, we assess how your eyes work together and how this relates to your symptoms.

Your assessment may include:

• binocular vision testing (eye alignment and coordination)
• eye movement and focusing assessment
• reading and visual function analysis
• visual–vestibular interaction testing

In many cases, we can trial prism lenses during the consultation and assess whether your symptoms improve immediately.

Your response to trial lenses may provide useful clinical information about whether visual alignment or visual processing is contributing to your symptoms.

Treatment for binocular vision dysfunction may include:

• Prism lenses to support visual alignment and reduce strain
• Therapeutic lenses or tints for visual comfort
• Selective or partial/binasal occlusion in appropriate cases
• Vision therapy or neuro-optometric rehabilitation
• Practical strategies for reading, screens, driving and visually busy environments

Who Should Book a BVD Assessment?

You may benefit if you:

• experience dizziness or balance issues
• have headaches with reading or screen use
• feel overwhelmed in busy environments
• struggle with reading or concentration
• have ongoing symptoms despite normal eye tests
• have been diagnosed with BVD or suspect it

Many of our patients have seen multiple providers before finding answers.

Before Your BVD Assessment

If you have already booked a binocular vision assessment, please complete the Brain Injury Vision Symptom Survey before your appointment.

Although the BIVSS was originally developed for adults with mild-to-moderate brain injury, it gives our optometrists a broad profile of symptoms involving visual clarity, eye comfort, headaches, dizziness, motion sensitivity, visually busy environments, depth perception and reading.

The BIVSS does not diagnose BVD, concussion or the cause of your symptoms. For patients without a known brain injury, we use the score and individual answers as a descriptive symptom profile.

Already booked? Complete the BIVSS rather than repeating the public symptom screener, unless your optometrist asks you to complete both.

Booking an Appointment for Binocular Vision Testing

A standard binocular vision assessment costs an additional $195 and includes additional testing and extended consultation time. Some patients may need to be seen over multiple appointments depending on the complexity of their condition.

For an appointment to test for binocular vision dysfunction, please book a one hour consultation with either of our optometrists, Dr Kevin Trac or Dr Sze Ho Ying