Did you know that dizziness, headaches, and pain in the sinus region can be due to a binocular vision dysfunction (BVD)? There are several tests we can use to assess for this, but let’s review one of the simplest being the 5 Minute Cover Test. Before we do this though, let’s do a quick review of what a BVD is.

What is a binocular vision dysfunction (BVD)?

Binocular vision dysfunction is a condition where the eyes are not looking in the same direction. When looking straight ahead, to the side, up, down, as well as near and far the eyes should be aligned and move together as a pair. Causes of BVD are usually due to poor functioning of a nerve or nerves that control eye movement, or of the muscles that control the eye movement itself. People can be born with BVD, it can be due to a concussion, or it can develop later in life as the muscles of the eyes get weaker. 

Symptoms of binocular vision dysfunction

Dizziness, headaches, facial pain, blurred vision, and possible double vision that can be triggered by any of the following:

  • moving your head,
  • reading,
  • looking back and forth between objects at different distances,
  • being in moving vehicles,
  • large spaces with tall ceilings.

Using the 5 minute cover test as a screen 

A simple test to help rule in a BVD is the 5 minute cover test. This is a real simple test. It can be done anywhere and requires no special equipment. 

How to perform the 5 minute cover test:
  1. Rate symptoms from 0-10 where 10 refers to the worst level of symptoms imaginable and 0 refers to no symptoms. 
  2. Cover one eye with your hand, then with your other eye find and object to focus on in the distance.
  3. After 5 minutes of looking at that target, while still covering your eye, rate your symptoms again from 0-10. 
  4. If the symptoms have lessened, a BVD may be contributing to your symptoms. 

Other tests for BVD include the: Cover Test, Cover Uncover, the Alternate Cover Test, Hirshberg Test, and the Maddox Rod Test.

What should I do if the 5 minute cover test is positive?

If the 5 minute cover test or any of these other tests are positive, further medical consultation is recommended to determine which or what combination of the following should be considered:

  • Vision therapy with a trained optometrist and/or physiotherapist.
  • Eye patching or the use of eye drops for the strong eye. 
  • Corrective eye glasses. 
  • Surgery. 

If you have dizziness, headaches or facial pain that seem to have visual triggers, feel free to book a vestibular assessment with one of our therapists at North 49 who can assess your condition and work with your other care providers (i.e. optometrist, family physician) to address your problem.

North 49