A Stranger Diagnosed Me With Misaligned Eyes

“Do you get headaches?” a middle-aged rando asked me after a hot yoga class. Weird pick up line, I thought, but okay, I’ll go with it.

“Yeah,” I said.

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“What about neck pain?”

“Uh huh.” Where was this going?

“Have you had a concussion?” “Um. Yes.” His questions weren’t getting me hot, but they were getting me curious.

“You’re eyes are misaligned. You’re going to continue to have problems.”

This guy was socially clueless, for sure, but he was also a neurologist. He referred me to a website to get more information and yea—my eyes are probably misaligned. Until that day, I didn’t even know what that meant. And before I go pay someone to confirm this, I figured I’d get a little free medical advice while informing and entertaining you.

Apparently, “normal” vision is called binocular vision, and it means that your eyes work productively together as a team to make a coherent field of vision for the brain to process. When this isn’t happening, it could be a case of eye misalignment—or when the eyes are not working together as a team. It is also sometimes referred to as strabismus or binocular vision dysfunction. You’ve definitely known or seen someone with some kind of eye misalignment. What we usually call “lazy eyes” or “wandering eyes” are kinds of misalignment, as are crossed eyes.

There can be multiple degrees of misalignment and my case is likely pretty subtle. The doctor in my yoga class is the only person who’s ever noticed. “There are many varieties of it [eye misalignment],” says Howard R. Krauss, surgical neuro-ophthalmologist at Providence Saint John’s Health Center in Santa Monica, California. You can have eye misalignment issues from birth or they can develop as a result of concussion or traumatic brain injury. “When people have normally aligned eyes and they become misaligned in adulthood, they generally have symptoms from it, which could be headache, a tendency to close one eye, and double vision. But if people have an eye misalignment that’s present in early childhood, sometimes the young brain adapts to it such that at times when the eyes may be misaligned, there is no perception of double vision.”

Basically, if your eyes are slightly misaligned at birth, your body can compensate and correct for it in other ways. “The brain has a strong desire to maintain binocular vision when it can,” he tells me. “And sometimes in the young child, that leads to a head turn or an unusual head position or a head tilt.” These kind of compensations can be tracked over a long period of time using photographs. Krauss works with a lot of celebrity clients and he says that sometimes he uses google images across decades to get a sense of a client’s condition. “In many cases,” he says, “I can see a tendency for the head to tip or for the head to be turned over many years that is sometimes a tip off for me of an eye misalignment.”

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In other words, you could have an asymptomatic eye misalignment that eventually becomes symptomatic—either because of injury or gradual deterioration of the eye muscles. I was in an accident in 2011 that caused a concussion. I have no idea yet if the concussion created the problem or just exacerbated an already existing condition.

Some people who have an eye misalignment have learned how to compensate for it subconsciously over many years, Krause tells me. “But you have a concussion and you could lose your ability, hopefully temporarily, to compensate as well as you were doing automatically before.”

I’m not sure yet what the details of my own situation are. I’ve had symptoms of fogging in my right eye, headaches, and jaw pain for years but it never occurred to me that those minor problems had anything to do with my eyes or that they were even connected. Most people are pretty ignorant about eye misalignment because it might not affect their daily function, but if it does, it’s worth exploring. So let’s break down how you can figure out if you have an issue.

First, “take a look in the mirror. If one of your eyes is wandering or they are both going in different directions, you may have eye misalignment,” says Arian Fartash, a San Francisco-based optometrist. This could be really subtle, so you might want to have a photo taken where you are looking right at the camera. Better yet, you can take your photos to an optometrist or opthamologist, as Krauss suggests. Other symptoms are seeing double and blurriness that comes and goes, Fartash tells me.

“You also won’t be able to watch a 3-D movie if you have eye misalignment because your eyes are not working together as a team, which is needed for your brain to process what you are seeing on the screen,” Fartash says. I can see 3-D movies (thank goodness), but I leave the theater feeling weird and headachy and I never understood why. I always thought I was just kind of allergic to advanced technology.

So, what should you expect in terms of treatment if you have an eye misalignment issue that’s severe enough to bother you? There are a lot of options. “Sometimes you just need glasses with a certain prescription to correct the issue,” Fartash says. “This usually works best for people born with eye misalignment. Another option is glasses with prism lenses.” If prism glasses seem nerdy, you should know that even the legitimate President wears them. “You may remember seeing Hillary Clinton wearing these when she testified before the Senate Foreign Relations Committee in 2013. The lines in the prism bend light seen by one of your eyes and align it with the image seen by your other eye.” Perhaps they can even help you see through international conspiracies.

“The last option is surgery,” Fartash says. The problem for adults, though, Fartash says, is that, in most cases it works better for kids than adults.” Vision therapy can include several kinds of treatment. Krauss explained to me that it can be anything from using computerized devices to simple eye movement exercises. He cautioned that people who are concerned that they might have an eye misalignment issue shouldn’t self-prescribe treatments, even if they’re just movement. “There isn’t necessarily one exercise that works best for everyone,” he says, “And there are some exercises that can be counter to the particular misalignment that you have.” Krauss was careful to note that, while some exercises “may not be helpful, they probably won’t be harmful.”

The doctors that I spoke to agreed that the best thing you can do take care of yourself, eye misalignment or no, is to get your eyes checked regularly. “Most people take most of their bodily functions for granted until there’s a problem,” Krauss says. He’s right, I think. I have taken the easy function of my body for granted. And now it’s time to get a check-up so I can pump the breaks on my imagination (is it somehow a brain tumor?) and find out how to deal with my eye dysfunction.

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