Understanding the Vestibulo-Ocular Reflex (VOR) and How It’s Affected by Concussions

Understanding the Vestibulo-Ocular Reflex (VOR) and How It’s Affected by Concussions

One of the most common — and often misunderstood — problems after a concussion is difficulty seeing clearly while in motion. You may feel dizzy when walking, riding in a car, or trying to focus on objects while turning your head. These symptoms are often caused by a breakdown in a reflex you’ve likely never heard of. Dr. Lance Stevenson, DC specializes in identifying and treating VOR dysfunction in patients recovering from car accidents, sports injuries, and falls. Addressing this reflex is key to reducing dizziness, improving balance, and helping you get back to normal life.

What Is the VOR?

The vestibulo-ocular reflex (VOR) is a built-in system that keeps your vision stable while your head is moving. It connects the inner ear (vestibular system) with your eye muscles, allowing you to maintain clear vision during everyday actions like:

• Walking or jogging

• Turning your head while reading signs

• Driving over bumpy roads

• Scanning a crowd

• Looking from your phone to a distant object and back

For example, when you turn your head to the right, your eyes automatically move to the left — just enough to keep your visual field steady. This automatic eye movement is controlled by the VOR, and it operates in milliseconds, without you even noticing.

How the VOR Gets Disrupted After a Concussion

After a concussion, especially from a car accident, the delicate communication between your inner ear, brainstem, and eye muscles can become disrupted. This can happen due to:

• Damage to the vestibular nerve or inner ear structures

• Microinflammation in brainstem areas that process motion signals

• Neck trauma affecting head position awareness

• Discoordination between eye movements and head motion

Even if imaging scans look normal, your brain's ability to stabilize your vision during motion may be impaired — making you feel unsteady, anxious, or visually overwhelmed.

Common Symptoms of VOR Dysfunction After Concussion

If your VOR isn’t working correctly, you may experience:

• Blurry or bouncing vision (oscillopsia) when walking or moving your head

• Dizziness or nausea triggered by movement or scrolling on screens

• Poor balance, especially in busy or visually stimulating environments

• Difficulty reading signs or text while in motion

• Fatigue or brain fog during visual tasks

• Motion sensitivity in cars, elevators, or crowded spaces

These symptoms are especially common in patients from Overland Park, Shawnee, North Kansas City, and Raytown who are trying to return to work, school, or sports after a concussion.

How We Test the VOR at Our Kansas City Clinic

We use several non-invasive tests to assess how your eyes respond during head movement:

1. Dynamic Visual Acuity Test

You read a letter chart first with your head still, then while it's gently moved side-to-side. A drop in visual clarity indicates impaired VOR.

2. Head Impulse Test

We have you focus on a target while we make small, quick head turns. If your eyes can’t stay locked on the target, your VOR may be underperforming.

3. Vestibular-Ocular Motor Screening (VOMS)

This standard post-concussion screen evaluates how your eyes and vestibular system function together. Symptoms like dizziness, headache, or nausea during head-eye movements often reveal VOR issues.

VOR Rehab: How We Fix the Problem

If your VOR is dysfunctional, the good news is it can be retrained through vestibular rehabilitation therapy (VRT). These targeted exercises gradually restore proper reflex function by improving:

• Eye-head coordination

• Motion tolerance

• Visual stability during movement

• Integration with balance and postural systems

You may start with simple gaze stabilization drills (like focusing on a letter while turning your head) and progress to more complex tasks involving movement, background motion, or visual distractions.

At our Kansas City office, we create custom rehab plans that fit your lifestyle — whether you’re a student in Leawood, a commuter in Independence, or a parent in Lee’s Summit trying to get back on your feet after a car accident.

Don’t Let VOR Dysfunction Hold Back Your Concussion Recovery

The vestibulo-ocular reflex plays a critical role in how you see, move, and feel after a head injury. If it’s not working right, your recovery will be slower and more frustrating — even if your brain scans look “normal.”

Dr. Lance Stevenson, DC provides expert-level concussion care that includes VOR testing and rehab, along with cervical spine and oculomotor assessments. Our Kansas City clinic helps patients recover fully — not just from the brain injury, but from the lasting imbalances it creates.

Call 816-226-7476 today to schedule your evaluation and find out if VOR dysfunction is affecting your recovery from a concussion.

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