| Sumario: | Background: Vertical deviations present in diverse patient populations with a multitude of puzzling symptoms and complaints. Many patients with vertical deviations have visited numerous doctors looking for an explanation for their symptoms of dizziness, headaches, motion sickness, and double vision. Vertical deviations may be apparent in the clinical optometric exam sequence, but at other times, additional testing must be performed to uncover a vertical heterophoria, including fixation disparity, vertical vergences, a period of diagnostic occlusion, or Maddox rod. Case Report: Three case reports are reviewed with diverse presentations of vertical deviations. The first case report outlines Patient A, a 51-year-old female who presented with dizziness along with a latent hyperphoria that was not apparent on the initial clinical examination. The second case report outlines Patient B, a 52-year-old female who presented with a longstanding large-angle vertical strabismus with strabismic amblyopia in the right eye. The third case report outlines Patient C, a 61-year-old female who presented with intermittent vertical diplopia following a cerebrovascular accident. The three cases all underwent vision therapy or vision therapy in combination with prismatic correction, and all three cases experienced symptom reduction following treatment with optometric vision rehabilitation. Conclusion: Vision therapy alone, or vision therapy in combination with prism lenses, was an effective treatment option for reducing symptoms in a diverse series of patients with vertical deviations.
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