Vestibular Dysfunction and Binocular Vision Impairment: A New Clinical Perspective

Individuals with vestibular dysfunction frequently experience dizziness, nausea and imbalance in visually complex or dynamic environments, such as during computer use, shopping, walking in crowds or even during simple eye movements.

To determine whether binocular visual function differs between participants with vestibular dysfunction and healthy controls, and to identify clinical factors associated with binocular visual abnormalities.

Forty participants with vestibular dysfunction and forty healthy controls were enroled. Binocular visual function was assessed using tests of suppression, perceptual eye position, vergence range and stereopsis. Between-group differences were analysed. Logistic regression was performed to identify factors associated with binocular visual function abnormalities. Receiver operating characteristic (ROC) analyses were conducted to evaluate the discriminative ability of binocular visual parameters.

Compared with controls, participants with vestibular dysfunction demonstrated significantly diminished convergence, divergence and stereopsis, while no significant differences were observed in suppression or perceptual eye position. Vestibular dysfunction was independently associated with abnormal convergence (odds ratio (OR) = 47.67, 95% confidence interval (CI): 10.04-226.44), divergence (OR = 5.99, 95% CI: 1.47-24.31) and stereopsis (OR = 42.32, 95% CI: 8.71-205.67). ROC analysis between the two groups showed good discriminative performance for convergence (area under the curve (AUC) = 0.86), stereopsis (AUC = 0.86) and moderate performance for divergence (AUC = 0.72). Among participants, a lower visual score in the sensory organisation test (SOT) was independently associated with abnormal convergence (OR = 16.43, 95% CI: 1.35-199.91), while abnormal positional testing was associated with impaired divergence (OR = 8.98, 95% CI: 1.13-71.27).

Participants with vestibular dysfunction exhibited abnormalities in binocular visual function, particularly vergence capacity and stereopsis. Assessment of binocular visual function may provide complementary clinical information for identifying vestibular dysfunction and guiding individualised clinical management.