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Symptoms of Visual Vertigo (VV; sometimes referred to as vision dependent balance) are provoked or aggravated by specific visual contexts (e.g. supermarkets, driving, crowds, or movement of objects) typically in large size (full field) repetitive or moving visual patterns. VV emerges in vestibular patients if they have increased visual dependence and difficulty in resolving conflict between visual and vestibulo-proprioceptive inputs. For example, when we watch something that is moving our brain (which relies on visual input) may think we are moving. In some cases, just viewing a photograph of movement may stimulates the imagination and make you believe you are moving.

Balance is a complex and highly integrated process that depends on the following:


 * Somatosensory, visual and vestibular inputs for the reception of information from the body (intrinsic) and the environment (extrinsic);
 * The brain for the integration of this information and the formation of a motor plan, and
 * The musculo-skeletal system for the production of adequate movements to execute the plan.

Problems in one or more of these areas can lead to imbalance and reduced functional performance.

It is important to understand that VV is a symptom and not a diagnosis. VV results from a mismatch between the vestibular, visual, and somatosensory systems (e.g., Meniere’s disease, BPPV, migraine). Normal body function includes a functional overlap where the three systems are able to compensate, in part, for each other's deficiencies. It is important to identify the underlying cause of VV. Symptoms of VV commonly indicate that there is a problem in the vestibular system located in the inner ear and the brain. The vestibular system processes sensory information involved with controlling balance and eye movements.

Optokinetic drums (either physical of electronic) are used to diagnose tracking problems by stimulating and evaluating nystagmus (involuntary rapid movement of the eyeball). Normal response includes smooth eye tracking in the direction the drum is turning and back, but in patients with symptoms such as VV, the eyes will skip or dart. The Situational Characteristic Questionnaire (SCQ) was designed to identify vestibular dysfunction.

Repetitive optokinetic stimulation has reportedly led to improvement in patient symptoms but many people report no improvement.