So, I'm 24/m and otherwise healthy. I'm reaching out though because I feel very lost and hopeless in trying to fix this. I'm not looking for a diagnosis, but advice on whether I'm on the right track or if I need a second opinion.

For over 9 months, I've been experiencing significant vertigo, nausea/motion sickness, balance issues, sore eyes and headache that mostly occur when I enter or see distant/large spaces. I can stay in my small apartment all day and mostly feel fine, and sometimes step out at night and feel ok. But as soon as I enter a big space like a street, a parking lot, a store or a long hallway, I become badly disoriented, including finding myself sliding to one side and my perception getting worse.

A similar experience happens when I'm making eye contact with someone or talking with a group of people for a while, especially when I'm moving my head/eyes to talk to people. Seeing things like seeing cars move and being on the subway also set it off. Even at home, working on my laptop/phone for a while also seems to cause a milder dizzy/eye strain episode.

The dizzy spells go away once I've sat down, closed my eyes/looked at something still for a while. I'm usually fatigued afterwards and the eye strain is gets better once I've slept.

It's had a really debilitating effect on my ability to do everyday things, but I'm determined to fix it.

I've seen doctors about this and they've shrugged it off as post-covid vaccine reactions, allergies, vestibular migraines, or anxiety (my mental health is actually in good shape). But I never feel like these line up with my experiences and their treatments have done nothing. They've tested my balance (in a small office though) and it's fine while scans and tests have also come back perfect.

I took matters back into my hands and came across binocular vision dysfunction, in particular vertical heterophoria. My symptoms pretty much match nearly all of these, much more than any other vestibular condition my docs have mentioned (especially the 'entering big spaces' problem.)

However, I've also read that many optometrists can't spot vertical heterophoria (or alternatively, that the condition is often quackery designed to exploit people). Is any of this true?

I had an eye test today and the optometrist said my eyes look perfectly healthy, my glasses are also still perfect for my nearsightedness. I complained about my dizzy spells and mentioned binocular vision dysfunction. She did a 'mini test' and found there was a slight issue with convergence but hinted she wasn't too confident about binocular vision testing (she was very thorough in my eye health though).

I asked if prisms would work but she didn't think so and said that vision therapy could help. I've been referred to a vision therapy center who will do a 'binocular vision assessment' but I'm cautious given the cost/benefit (my insurance will partially fund this only once in my lifetime).

Am I only the right track? Will vision therapy help, especially over prism lenses?

Thank you so much for your help in advance!

P.S. If anyone knows anybody/where that can help in Toronto, Canada - that would really be unbelievably amazing!

TL;DR: I'm a healthy person who has experienced symptoms that closely align with vertical heterophoria. It seems most optometrists don't focus in this area. My current optometrist has referred me for vision therapy, what do I need to know and will it help?