Q. I can feel the pressure behind the eyes in sinus. Could this be vertical heterophoria?

Answered by
Dr. Manjunath Natarajan
and medically reviewed by Dr.Nithila A
This is a premium question & answer published on Oct 03, 2019

Hello doctor,

I went to an eye doctor and did an eye examination because I started feeling dizziness, loss of concentration, neck and shoulder pain, anxiety while driving, in crowds. Dizziness also rises when I am in bed and driving.

Not painful, but I can feel the pressure behind the eyes, in the sinus areas. But sinus doctor said nothing is wrong. So I read about vertical heterophoria, and all the symptoms are the same as I have. So I wanted to ask is there a particular test for that? Is there any other ways to relieve while I eventually get the check up again besides prism glasses.

Dr. Manjunath Natarajan

Ophthalmology (Eye Care)


Welcome to icliniq.com.

I understand your concerns, vertical heterophoria is a disorder of the mechanisms which maintain the balance of the eye muscles, keeping them on target. Although rare, these can lead to significant distress and dizziness as well. The best test to see if you have heterophoria in any direction is the cover or cover-uncover and alternate cover tests.

These should be done with glasses first and then without them. You need the help of another person while doing this at home or can be quickly done at the doctor's clinic.

1. Cover test or uncover test - close one of your eyes with your hand while trying to look at an image around six meters away first and then held at 50 cm apart, with both your eyes, then take away the covering hand. If you see the eye that was covered moving, then you have a phoria in the direction opposite the direction in which the eye moved.

2. Alternate cover test - is the same as the cover or uncover tests, only that the covering hand is rapidly moved from eye to eye. This gives a more accurate picture of the type or magnitude of the heterophoria.

These are two of the best, safest and economical tests that you can use to diagnose heterophoria. In case you need more information about heterophoria or tests or management options, please send me a scanned copy of your doctors reports and test results. I will do my best to help you with this. I hope you get well soon.

Was this answer helpful?


Ask a QueryAsk a Query Consult by PhoneConsult by Phone Video ChatVideo Chat
Also Read Answers From:

Comprehensive Medical Second Opinion.Submit your Case



Ask your health query to a doctor online?

Ask an Eye Care Ophthalmologist Now

* guaranteed answer within 4 hours.
Enter Your Health Query
You can upload files and images in the next step.



Disclaimer: All health Q&As published on this website is not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek the advice from your physician or other qualified health-care providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.