Do you ever feel weird like the room is spinning and you just keep blinking because that may help? Our vision and our balance are closely related. It’s difficult to balance in an environment we cannot see. And when we’re unbalanced, our vision of the world spins into oblivion. We often say that the eyes are the windows to the inner ear (where our vestibular system is located). And the reason balance and vision are so connected is because of the Vestibulo-Ocular Reflex (VOR).
What is the Vestibulo-Ocular Reflex?
To maintain balance and navigate through space in our physical world, we must organize and integrate information from the visual (eyes), proprioceptive (information perceived through our muscles and joints to tell us where we are in space) and vestibular (inner ears sensing motion, equilibrium and spatial awareness) systems. A deficiency in any of these three vital systems can have a dramatic impact on one’s ability to navigate and balance. Each of the systems must communicate with another to come to a consensus of balance.
The visual and vestibular systems communicate through the Vestibulo-Ocular Reflex (VOR). VOR is a reflex acting to stabilize gaze during head movement, with eye movement due to activation of the vestibular system. The reflex acts to stabilize images on the retinas of the eye while we move our heads. In other words, it’s the reflex that keeps the world visually centered.
Give a thumbs up, arms-length out in front of you, slowly turn your head to the left, while keeping your eyes on your thumb that’s still in front of you. You don’t lose sight or balance when turning your head thanks to your vestibulo-ocular reflex. Do you know how you can balance more easily when you’re looking at a still object? That’s your VOR at play.
The Vestibulo-Ocular Reflex usually just works without needing any attention. It acts as our visual stabilizer in the background, keeping the world steady at all times. But when the reflex is misfiring or miscommunicating between the systems, you may get the feeling that the world lags or jumps when you move your head. Or worse, when you move your head too quickly you literally fall into a slight vertigo episode.
As long as we’re moving our bodies and heads, your vestibulo-ocular reflex is working. And so when it’s not working properly, no wonder it’s such a major hassle.
When VOR Goes Wrong
While a dysfunctioning VOR can cause you to experience a vertigo episode, it’s not necessarily the underlying cause of chronic vestibular disorders. Rather, we look at a patient’s VOR as a benchmark for how their balance system is operating as a whole.
As we said before, the eyes are the windows to the inner ears. Thus, during the battery of vestibular tests we run on patients, we use Frenzel goggles to track the patient’s eye movements in response to different visual stimuli. We analyze a patient’s VOR to determine if there is a vestibular disorder underlying their balance problems.
In other words, your vestibulo-ocular reflex is a helpful data point for tracking a patient’s progress over time.
Through proper evaluation and skilled vestibular rehabilitation therapy, we can improve one’s VOR. The main vestibular therapies –habituation, gaze stabilization, and balance training – incorporate some sort of VOR engagement within the therapy. Through proprietary virtual reality programs, we immerse our patients in a variety of visual environments that are designed to test, stress, and strengthen their vestibulo-ocular reflex. These therapies are customized specifically to each patient and only move along when the patient is ready.
At times, we’d all like to think we’re Dr. Google and try to treat the cause of our dizziness on our own. But given the large number of causes of dizziness and vertigo, you might be trying to remedy the wrong problem. That’s why it’s best to defer to experts in the field. Find a Vestibular Audiologist. Fixing balance issues is their entire focus!
Our team at the Dizzy & Vertigo Institute specializes in bringing dizzy patients back to dizzy-free life. And we’re eager to help YOU! We offer in-person or telehealth appointments in order to fit your needs.
You can schedule an appointment with us by calling us at (310) 683-4679 or by filling in our contact form here.