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A sensorimotor anomaly of the binocular visual system characterized by an abnormal tendency for the eyes to rotate around the anterior-posterior axis.


The signs and symptoms associated with cyclophoria may include, but are not limited to, the following:

  1. asthenopia (ICD:H53.149)
  2. pain in or around the eye (ICD: H57.13)
  3. headaches (ICD: R51)
  4. reduced efficiency and productivity/diminished accuracy/inconsistent work product
  5. diminished performance with time on task
  6. tendency to close or cover one eye
  7. difficulty sustaining near visual function
  8. avoidance of visually demanding tasks
  9. compensatory head tilt (ICD: R29.3)
  10. abnormal postural adaptation/abnormal working distance (ICD: R29.3)
  11. inconsistent visual attention/concentration and/or awareness
  12. distractibility while performing visually demanding tasks
  13. general fatigue (ICD: R53.83)
  14. dizziness/vertigo (ICD: R42); especially during/after sustained visually demanding tasks
  15. motion sickness (ICD: T75.3XXA)
  16. incoordination/clumsiness (ICD: R27.8)
  17. difficulty visually tracking and/or following objects
  18. loss of place, repetition and/or omission of words or lines of print while reading


Cyclophoria is characterized by one or more of the following diagnostic findings:

  1. cyclodeviation measured at distance and/or near
  2. cyclodeviation reported under tests of dissociation



The doctor of optometry determines appropriate diagnostic and therapeutic modalities, and frequency of evaluation and follow-up, based on the urgency and nature of the patient’s conditions and unique needs. Vision disorders that are not totally cured through vision therapy may still be ameliorated with significant improvement in visual function and quality of life. The management of the case and duration of treatment would be affected by:

  1. the severity of symptoms and diagnostic factors, including onset and duration of the problem
  2. the complications of associated visual conditions
  3. implications of patient’s general health, cognitive development, physical development, and effects of medications taken
  4. etiological factors
  5. extent of visual demands placed upon the individual
  6. patient compliance and involvement in the prescribed therapy regimen
  7. type, scope, and results of prior interventions


Some cases are successfully managed by the prescription of therapeutic lenses and/or prisms. Most cyclophoria require optometric vision therapy, which incorporates the prescription of specific treatments in order to:

  1. enhance fusional vergence ranges, stability, and flexibility in all positions of gaze
  2. reduce cyclophoria
  3. enhance depth judgments and/or stereopsis
  4. integrate binocular function with information processing
  5. integrate binocular skills with accurate motor responses
  6. integrate binocular skills with other sensory skills (vestibular, kinesthetic, tactile, and auditory)
  7. increase visual stamina/integrate newly established skills with information processing


The following treatment ranges are provided as a guide. Treatment duration will depend upon the particular patient’s condition and associated factors. When duration of treatment beyond these ranges is required, documentation of the medical necessity for additional treatment services may be warranted for third-party claims processing and review purposes.

  1. The most commonly encountered cyclophoria usually requires 30 hours of office therapy.
  2. Cyclophoria may require substantially more office therapy, if complicated by associated factors such as prior eye muscle surgery, non-comitant deviations, cerebral vascular accident, head trauma, and/or systemic conditions.


At the conclusion of the active treatment regimen, periodic follow-up evaluation is required. Should signs, symptoms, or other diagnostic factors recur, further therapy may be medically necessary. Therapeutic lenses may be prescribed during or at the conclusion of active vision therapy to assist in the maintenance of long-term stability.