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Vision & visual processing
Dizziness with varifocals: getting used to them or a reason to look more closely?
You can read with your new glasses. Yet the room feels unfamiliar when you walk. When you look sideways, things seem to swim; on stairs, you become more cautious. You wonder whether you simply need to get used to them or whether the glasses are unsuitable. Both possibilities deserve a closer look.
Can varifocals cause dizziness?New varifocals can initially make vision feel unfamiliar, or cause headaches or dizziness. Different lens areas are designed for different distances, changing the demands on how you direct your gaze. Pronounced, persistent or increasing symptoms should be checked. Dizziness experienced while wearing glasses is not always caused by the glasses.
Why sharp vision and confident orientation are different things
When reading a single word, you can find the appropriate lens area and hold your head still. When walking, the situation changes constantly. You look ahead, sideways and towards the ground. At the same time, your head and body move through space.
Varifocals combine areas for distance, intermediate and near vision, with gradual transitions. Where you look through the lens therefore affects the image. The Institute for Quality and Efficiency in Health Care explains that adapting to varifocal lenses can initially be difficult and may involve headaches or dizziness.
If you previously mainly moved your eyes sideways, the same eye movement through the new lens may feel different. Appropriate use of the lens zones should therefore be explained and tried in practice during fitting. Adaptation does not mean accepting marked unsteadiness indefinitely.
A sensible order: glasses, vision, then other functions
1. Have the fitting and use checkedTell your optician exactly when difficulties arise. The frame fit, lens centration, prescription and suitability of the lenses for your daily life are all part of this check. Bring your previous glasses too, if possible.
2. Assess unexplained visual symptomsIf problems persist or double vision, eye pain or marked changes in vision develop, an ophthalmologist's assessment is important. Where there are questions about how both eyes work together, an orthoptic examination may be included.
3. Consider how functions interact during movementOnce the optical correction has been checked and no acute medical cause prevents it, gaze direction, head movement, standing and walking can be considered functionally. The question is which particular task remains difficult.
Observations that help at your appointment
“The glasses make me dizzy” is a useful starting point. A specific description helps even more: does it happen when sitting or only when walking? When looking sideways or downwards? Only with the new glasses, or without them too? Was unsteadiness already present beforehand?
You do not need to provoke these situations repeatedly. Note what you happen to notice. It is particularly helpful to distinguish a blurred image, spatial distortion, an actual spinning sensation and unsteadiness when placing your feet. These experiences can feel similarly unpleasant, but raise different follow-up questions.
How you use them also matters: glasses mainly used for reading face different demands from glasses worn outdoors or while constantly switching between several screens. The same solution is not optimal for every task.
How a functional assessment can follow
For spatial orientation, the nervous system combines visual information with balance and body awareness. In a functional assessment, we consider these demands step by step. Looking at a stationary target is a different task from keeping it clear during a head movement or changing your gaze direction while walking.
Example: clear when sitting, uncomfortable with head movementWe begin with the professionally checked visual correction in a safe starting position. First, you look steadily at a clearly visible target, then add a small head movement. The target, lighting and distance stay the same. Depending on the response, we simplify one demand and then compare the original task again. An appropriate walking task is added only when it can be done safely. This example illustrates the assessment approach; it is not an instruction to provoke symptoms yourself.
This allows us to describe more precisely whether steady viewing is already difficult or whether the combination with movement is what stands out. A change in the comparison can guide further exercise selection. It does not determine whether your prescription is correct: that remains a matter for optical or ophthalmological assessment.
You can find more about the functional background in the articles on gaze stabilisation during head movement and spatial orientation when going downstairs.
Take particular care on stairs and unfamiliar routes
If you feel unsteady, use a handrail, good lighting and allow enough time. Avoid forcing adaptation on difficult stairs or while driving. Discuss with the professional which visual correction is suitable for these situations. Simply leaving your glasses off can also be unhelpful because the correction is then missing.
The VISIBLE study examined additional single-vision distance glasses in older multifocal wearers at increased risk of falling. The results differed according to activity and everyday circumstances. They do not justify a blanket recommendation for everyone to remove varifocals when walking.
When should you stop waiting?
If you feel markedly unsteady or symptoms increase, have your optical correction checked promptly. Sudden loss of vision or new double vision requires urgent medical assessment. If speech difficulties, paralysis or a pronounced inability to walk occur at the same time, call 112 immediately. A temporal link with new glasses does not automatically explain these warning signs.
Common questions about varifocals
How long does adaptation take?This varies from person to person. With pronounced symptoms, a fixed waiting period is not particularly helpful. During fitting, discuss what course to expect and when to return for a check.
Should I wear the new glasses all the time despite dizziness?Not at the expense of your safety. Agree on a suitable introduction with the professional fitting them. Unsteady walking or pronounced symptoms are reasons to report back.
Can training compensate for incorrectly fitted glasses?Unsuitable optical correction should be corrected. Functional training can follow where appropriate questions remain, but does not replace that check.
Why are stairs harder than reading?Stairs combine looking downwards, changing distances and movement. This is a different visual and orientation task from reading while still, and should be discussed specifically if you feel unsteady.
Your glasses have been checked, but unsteadiness remains?It may then be useful to look more closely at how vision and movement interact. My page on vision and visual processing in Vilshofen provides further information. In a free initial consultation we discuss whether this additional perspective suits your situation.
Sources and further reading
IQWiG: How can presbyopia be corrected?
Haran et al. (2010): VISIBLE randomised controlled trial. Study of additional distance correction and falls in older multifocal wearers; the findings cannot be applied to all glasses wearers.
Haran et al. (2010): VISIBLE randomised controlled trial. Study of additional distance correction and falls in older multifocal wearers; the findings cannot be applied to all glasses wearers.