By Millie Brecheisen, physiotherapist in Basel. Updated: 1 October 2026.
At home, in a quiet room, you feel almost normal. In a supermarket, the floor seems to move. Scrolling on your phone can produce the same sensation. Dizziness in supermarkets or while using screens may reflect sensitivity to visual motion, often called visually induced dizziness (VID).
Why busy places can make you dizzy
Some people feel comfortable in a quiet room, then become dizzy in a supermarket, a station or in front of a scrolling screen. The problem does not necessarily involve the prescription of their glasses. It may be visual motion hypersensitivity, also called visually induced dizziness. A 2023 systematic review identified this phenomenon in several groups, including people with vestibular disorders, migraine and concussion [1].
Why visually rich surroundings become difficult
Balance depends on ongoing agreement between vision, vestibular signals and body position information. Following some conditions, the brain may give vision too much weight or tolerate sensory conflicts less well. Moving shelves, people passing in different directions and driving in heavy traffic can then become demanding.
A person may describe nausea, floating, tired eyes or brain fog rather than spinning. These descriptions help guide assessment.
VID is not one single diagnosis
Visual sensitivity may occur within PPPD, vestibular migraine, vestibular hypofunction or symptoms after concussion. It can also become a daily problem in its own right. Before proposing visual desensitisation, we need to understand the context in which it occurs.
Assessment can explore head movement tolerance, gaze stability, balance, eye movements and visual stimuli. Depending on the presentation, neurological or ENT assessment may be useful.
Why complete avoidance can sometimes maintain the problem
Wearing dark glasses constantly, stopping all screen use and avoiding shops may provide short term relief while gradually reducing tolerance. Once the diagnosis is clear and contraindications are excluded, gradual exposure is usually a more coherent approach.
Optokinetic stimulation has been studied as an addition to vestibular rehabilitation. A 2024 systematic review reported improvement in treated groups, but did not establish a universal dose or show superiority in every situation [2].
What physiotherapy aims to restore
Treatment aims to regain everyday activities: shopping, computer work, taking the tram, driving or walking through a crowd. Exercises are linked to these goals. Some people begin with simple visual scenes. Others combine vision, walking, head movements and dual tasks.
In Basel, the programme follows the identified mechanism and the response after exposure, rather than a generic internet protocol.
Clinical points that help make sense of the assessment
Record specific triggers, how quickly symptoms appear, recovery time and associated movements. Comparing a visual task while sitting, standing and walking can help distinguish a mainly visual difficulty from a broader sensory problem. Consider vestibular migraine, PPPD, hypofunction and a history of concussion.
Three situations to describe at the first assessment
The word screen can hide very different difficulties. Reading still text, scrolling a page and watching a fast video do not place the same demands on the system.
- In a shop: are shelves, crowds, head turns or the length of the visit difficult?
- On a screen: is the problem scrolling, switching windows, light or reading?
- During transport: do vehicle movements and passing scenery trigger the same symptoms?
These details help choose the assessment. This article explains the pattern. Rehabilitation steps are covered in the article on VID treatment.
A physiotherapy assessment in Basel
A vestibular assessment in Basel can clarify whether visual discomfort occurs with migraine, PPPD, hypofunction or concussion. Describe the screens and places involved without deliberately provoking a severe episode before the appointment. These examples help select relevant assessments.
Frequently asked questions
Why is the supermarket so difficult?
Movement in the visual field, repetitive patterns and head movements create a substantial sensory load.
Does this mean my eyes are diseased?
Not necessarily. The difficulty may involve integration between vision, vestibular signals and body position information.
Should I push until I feel very dizzy?
No. Exposure is gradual. Strong provocation can make the programme difficult to sustain and is not necessary for progress.
Related articles
- Dizziness and vestibular rehabilitation in Basel
- VID treatment: rehabilitating dizziness triggered by visual motion
- PPPD: understanding persistent dizziness and its treatment
- Vestibular migraine: dizziness with or without a headache
Scientific references
[1] Clinical characteristics of visual motion hypersensitivity: a systematic review. 2023. Read the reference on PubMed.
[2] Law JH, Koh HY, Kua A. Optokinetic stimulation in the rehabilitation of visually induced dizziness in people with vestibular disorders: A systematic review. Clinical Rehabilitation, 2024. Read the reference on PubMed.
[3] Staab JP. PPPD: Review and Update on Key Mechanisms. Neurol Clin. 2023. Read the reference on PubMed.
This information explains possible mechanisms and rehabilitation options. Diagnosis and treatment depend on an individual assessment.
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