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Visual Influences on Vestibular Adaptation

Recruiting

Effects of Impaired Visual Acuity and Binocular Control Abnormalities (VABC) on Vestibulo-ocular Reflex (VOR) Adaptation in Adults With and Without Vestibular Hypofunction

Who can join

Ages 18 to 60 · All sexes

Full eligibility criteria
Inclusion Criteria:

For All Participants (All Groups)

* Age 18 to 60 years
* Able to provide informed consent

Group-Specific Inclusion Criteria:

* Group 1: Abnormal Uncorrected Static Visual Acuity (No Vestibular Hypofunction) Normal peripheral vestibular function
* Group 2: Abnormal Uncorrected Static Visual Acuity + peripheral Vestibular Hypofunction
* Group 3: Binocular Vision Abnormalities (No Vestibular Hypofunction) Normal peripheral vestibular function
* Group 4: Binocular Vision Abnormalities + peripheral Vestibular Hypofunction

Individuals who have abnormal static visual acuity, a binocular vision abnormality (ocular misalignment, convergence insufficiency), and vestibular loss will be assigned to Group 4.

The following definitions will be used when determining group placement:

* Abnormal Static Visual Acuity: Uncorrected visual acuity (head is still) ≥0.30 logMAR in both eyes.
* Unilateral Vestibular Hypofunction: 60 ms VOR gain \<0.80 unilaterally for the lateral semicircular canal.
* Bilateral Vestibular Hypofunction: 60 ms VOR gain \<0.80 bilaterally for the lateral semicircular canals.
* Normal Vestibular Function: 60 ms VOR gain of 0.80 to 1.20 bilaterally for the lateral semicircular canals.
* Convergence Insufficiency: ≥6 cm near point of convergence.
* Ocular Misalignment: ≥4 prism diopters of manifest deviation of the eyes (tropia) on cover/uncover testing.

Exclusion Criteria:

* Diagnosis of fluctuating vestibular disorders (e.g., benign paroxysmal positional vertigo)
* Neurologic conditions (e.g., multiple sclerosis), dementia,
* Alcohol or drug abuse,
* A major psychiatric disorder (e.g., schizophrenia),
* Pain that limits cervical spine range of motion by \>50% or that results in an -altered gait pattern.

About the study

The goal of this study is to learn whether a balance-training exercise called incremental vestibulo-ocular reflex adaptation (IVA) is safe and effective for adults with vision impairments, with or without additional vestibular (inner-ear balance) problems.

The main questions it aims to answer are:

* Does IVA cause only mild, temporary symptoms and no serious adverse events? * Does IVA improve eye-movement reflexes, balance, and walking, and do these improvements differ between people with vision problems alone and those with both vision and vestibular impairments?

Researchers will compare adults with vision impairment only to adults who have both vision and vestibular impairments to see whether the groups respond differently to IVA.

Participants will:

* Complete symptom ratings before and after IVA * Undergo tests of vestibular reflexes (e.g., VOR gain) * Complete balance and walking assessments

What is being tested

Sponsor: Emory University · Participants: 100 · Started: Feb 4, 2026

Contact the study team

Official record on ClinicalTrials.gov — NCT07380256

Locations in the U.S.

GeorgiaDizziness and Balance Center, Atlanta
Emory Ophthalmology Clinics, Atlanta (Not yet recruiting)

Conditions

From ClinicalTrials.gov, data retrieved Sep 30, 2026. Each study sets its own eligibility; the study team decides who can join.