Who doesn’t dread going to a crowded supermarket, airport, or shopping mall? They’re noisy, cluttered, and an overall hassle. But for those with visual vertigo, it’s more than just an inconvenience. It’s an over-stimulating nightmare. Visual Vertigo or Visually-Induced Dizziness (VID) is exactly as it sounds: dizzy symptoms spurred on by visual stimulus. Busy environments, flashing lights and crowds of people are the places that VID patients are quick to avoid.
What is Visual Vertigo?
To make this perfectly clear, VID is not a condition. Rather, it’s a group of symptoms triggered by busy environments and excessive visual stimulus. Therefore, vestibular disorders – such as vestibular migraine, vestibular neuritis, persistent postural-perceptual dizziness (PPPD), Meniere’s Disease, and benign paroxysmal positional vertigo (BPPV) – commonly cause visual vertigo. It can also result from a head injury and whiplash if the vestibular system is impacted in these incidents. VID also goes by the name visual vertigo, space and motion discomfort, supermarket syndrome, or visual vestibular mismatch.
Nausea & vomiting
Salivation (mouth watering)
Driving or riding in a car
Public transit – Airplanes, trains, buses, boats
Scrolling on a phone or laptop
“Busy” fabric patterns or abstract images
Seeing movement over large areas – movies, clouds, crowds, etc.
Many different theories exist on why visual vertigo vertigo occurs. Most scientists believe a mismatch happens in the parts of the brain that contribute to balance – similar to what happens during motion sickness. Others think it happens when a vestibular weakness leads to the brain becoming over-reliant on the visual input for balance causing the visual dependency. Numerous systems make up our balance – vision is just one of them. So, when the brain relies too heavily on visual cues, those environments with busy visuals (supermarkets, movies, etc.) lead the vestibular system haywire, thinking there is more movement taking place than there is. Thus, dizziness ensues.
One of the major problems with VID is that patients very easily realize that the culprit of their symptoms is these visually busy environments, which leads them to avoid them at all costs. In the short term, this helps patients avoid their condition. But in the long-term, it weakens their brain and body’s ability to adapt and strengthen against these triggers. It’s like having a weaker left arm and never working it out at the gym because it’s weak. Avoidance is a dangerous cycle that perpetuates the problem. This brings us to visual vertigo treatment.
Treating Visual Vertigo
Ultimately, treating Visual Vertigo comes down to diagnosing the root cause, which oftentimes is a vestibular disorder. Diagnosis always starts with understanding the patient’s situation through an in-depth conversation. From there, we run patients through specific tests that pin down exactly what’s wrong with the vestibular system causing this discomfort. Treatment then starts with that underlying cause. For instance, treating a patient’s vestibular migraine might resolve the VID symptoms as well. If not, treating VID is then largely focused on vestibular rehabilitation, optokinetic exercises, and slowly reintroducing patients into those environments through virtual reality (VR) that cause their VID to flare up. Vestibular Rehabilitation Therapy includes visual and optokinetic desensitization, sensory reweighting, gaze stabilization, and habituation therapy. Learn more about VRT here. Optokinetic exercises consist of videos designed to make patients feel dizzy, but with the goal of building the brain’s ability to make sense of these visual signals. Always, ALWAYS, patients should work with their vestibular specialist to work through optokinetic exercises as there is a method to gradually progressing through this stimulation. Lastly, is to focus on reversing those avoidance behaviors. To do this, we use virtual reality goggles to reintroduce VID patients into those environments they fear most. Like the optokinetic exercises, the goal here is to gradually build a person’s internal processes for dealing with these environments. Until one day, they are no longer affected. Putting patients into uncomfortable visual situations is a major part of treating VID. Thus, the treatment process often comes with heightened anxiety and discomfort. That’s why there’s often a need for Cognitive Behavioral Therapy to help patients mentally and emotionally deal with this treatment process.
Because recognizing that busy visuals trigger dizziness, Visually-Induced Dizziness is one of the more common self-diagnosed dizzy symptoms. But we cannot emphasize enough the importance of seeking a trained Vestibular Audiologist. If you or someone you know experiences dizziness or disorientation in visually busy environments, please call us at (310) 954-2207 or schedule an appointment with one of our balance specialists. The Dizzy & Vertigo Institute specializes in bringing dizzy patients back to an asymptomatic life. We’re located in Los Angeles, California and have options for you if you live in another state. We look forward to hearing from you!