What is Visually Induced Dizziness?

Visually induced dizziness is vertigo or dizziness that is triggered by a complex, large field, or moving visual stimulus (Bisdorff et al., 2015; Staab, 2023). Vertigo describes the sensation that you or yourself are moving, despite no actual movements, while dizziness describes a range of sensations related to impaired spatial orientation, without the distorted sense of motion (Bisdorff et al., 2015). Whilst the symptoms of visually induced dizziness are characterised by their visual triggers, what causes them varies from person-to-person, and as such a situation one finds intolerable another can find tolerable (Staab, 2023; Staab et al., 2017). Visually induced dizziness has many different names: optokinetic motion sickness, visual vertigo, and visually induced vertigo may all be referred to as visually induced dizziness.

Visually induced dizziness often develops as an acute or chronic symptom of another vestibular condition. Common associated conditions include: persistent postural perceptual dizziness (PPPD), a functional form of chronic dizziness; vestibular migraine, a migraine which can cause vestibular or balance symptoms and sometimes may present without an actual headache; vestibular neuritis, which is an inner ear disorder that can cause vertigo, dizziness, balance issues, nausea, and vomiting; and Ménière’s disease, an inner ear condition that affects balance and hearing (Arshad et al., 2023; Best et al., 2009; Bruderer et al., 2017; Dieterich et al., 2016; Dieterich & Staab, 2017; Kim et al., 2023; Popkirov, Staab, et al., 2018; Staab et al., 2017; Thomson, 2017). Visually induced dizziness is more common in females (2:1 ratio) (Formeister et al., 2018; Ruckenstein & Staab, 2009) and in middle age (Dieterich et al., 2016; Neuhauser, 2016; Strupp, 2003). There also seems to be a complex relationship with anxiety, where anxiety can be a predisposing, maintaining, and consequential factor (Staab, 2023; Staab et al., 2017) and, for best patient outcomes, must also be treated along with visually induced dizziness symptoms (Popkirov, Stone, et al., 2018; Trinidade, Cabreira, Kaski, et al., 2023).

Explanation of Images

The first image is an example of repeating patterns, particularly those with high contrast and high spatial frequencies. Real world environments with patterned carpets or wallpapers are particularly problematic for people with visually induced dizziness because the optic flow created when moving past these patterns creates an intense visual motion cue. The second image contains moving stimuli (people moving in crowds). These moving stimuli can create situations of visual-vestibular conflict where the visual system is relaying global motion signals, while the vestibular system might be indicating the individual is not moving. The third image will typically involve bright lights and flicker. People with visually induced dizziness can have high visual sensitivity and visual stress (Pavlou et al., 2007; Powell, Derry-Sumner, Shelton, et al., 2020), and many also have migraine (Eggers et al., 2014). Fluorescent lighting and flickering lights (e.g. sunlight flashing through trees) can also simulate visual motion. The final image is a supermarket – an intense visual environment that combines all these factors and is often a feared location for people with visually induced dizziness. So much so that the condition was once known as Supermarket Syndrome (McCabe, 1975).

Additional Resources

Dizziness – NHS

Visually Induced Dizziness – “Supermarket Syndrome” – Vestibular Disorders Association

References

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