From the Research
Vertigo that improves when closing your eyes is likely related to visual dependency or visual vertigo, and the most effective treatment is vestibular rehabilitation therapy, as it helps retrain the brain to properly integrate visual, vestibular, and proprioceptive information. This condition suggests that the brain is experiencing a mismatch between visual input and other balance systems. When you close your eyes, you eliminate the conflicting visual information, which can temporarily reduce vertigo symptoms. This pattern is common in conditions like persistent postural-perceptual dizziness (PPPD), visual vertigo syndrome, or during the recovery phase after vestibular neuritis or labyrinthitis.
Some key points to consider in managing this type of vertigo include:
- Avoiding visual triggers like busy patterns, scrolling on screens, or complex visual environments can provide immediate relief.
- Gradual exposure to these triggers through vestibular rehabilitation can help desensitize the brain over time.
- In some cases, medications like low-dose SSRIs (such as sertraline 25-50mg daily or fluoxetine 10-20mg daily) may help reduce symptoms, particularly if anxiety is a contributing factor 1.
- The improvement with eye closure occurs because the brain relies heavily on visual cues for balance, and when this system is overly sensitive or poorly calibrated, removing visual input can temporarily restore balance.
- Studies have shown that the Epley manoeuvre is a safe and effective treatment for posterior canal BPPV, with a high success rate in resolving vertigo symptoms 1.
- However, the Epley manoeuvre may not be directly applicable to visual vertigo, and vestibular rehabilitation therapy remains the primary treatment for this condition.
- It's also important to note that residual dizziness after successful treatment of BPPV is a common self-limited disorder, more frequent in the elderly, and the Dizziness Handicap Inventory (DHI) score at the time of diagnosis can be a useful tool to quantify the impact of this vestibular disorder on the quality of life and to estimate the risk of residual dizziness 2.