More Than Balance: How the Vestibular System Shapes How We See the World
By Kim Barthel
When we think of the vestibular system, we often associate it with balance, coordination, and movement. But this tiny system tucked within the inner ear does far more than prevent us from falling—it plays a profound role in how we see, how we feel where we are in space, and how we make sense of motion in our everyday experience.
At the core of this interaction is a remarkable reflex: the vestibulo-ocular reflex (VOR). This built-in stabilizer allows our eyes to stay locked on a target even when our head is in motion. Without it, every step we take would feel like a shaky handheld video, blurry, disorienting, and exhausting. This function is foundational—not only for maintaining visual clarity but also for helping the brain distinguish what is moving around us versus how we ourselves are moving. This distinction is crucial for safely navigating our world.
Our brains are wired to have networks of sensation to be interconnected, and this is especially true in how our sensory systems work together. The vestibular and visual systems are deeply intertwined. At multiple levels of the central nervous system, they cross-communicate, working together to create a cohesive picture of our movement through space (Lopez et al., 2012).
Sensory integration is an active process within the nervous system, not simply a brain passively receiving sensory input. The brain is constantly predicting, weighing, and blending data from eyes and ears to support posture, orientation, and even emotional regulation.
Beyond the brainstem, there are dedicated cortical areas in the brain like the parieto-insular vestibular cortex and the cingulate sulcus visual area where these sensory systems literally converge (Beylergil et al., 2020). This anatomical overlap reinforces the idea that vestibular and visual function do not operate in silos. They’re part of a larger neurobiological conversation.
Even higher-order visual functions, like tracking the flow of a moving crowd or navigating a busy hallway, rely on this sensory partnership. Putcha et al. (2014) suggest that we build a unified sense of optic flow, how things move past us in relation to our body through the integration of both vestibular and visual inputs.
When the vestibular system is impaired, it doesn’t just throw off our balance, it can disrupt our visual experience, too. In conditions like Autism Spectrum Disorder, altered activity in vestibular-visual pathways can change how motion is perceived, making it harder to feel grounded or oriented. This has real-world implications for feelings of safety, and quality of life.
Why This Matters for Relationships:
Whether we’re looking into a child’s eyes, reaching out to offer a hand, or walking beside a loved one, our ability to orient ourselves in space shapes how we relate. Sensory disruptions can impact visual connection, attention, and even our sense of presence with others.
Understanding the vestibular contribution to visual function deepens our capacity to support individuals, especially those with neurological differences, who may see and feel the world in unique ways.
In therapeutic relationships, this knowledge allows us to approach visual struggles not simply as “attention problems” or “willfulness,” but as invitations to explore what’s happening beyond what we see, in the body, in the brain, and in the beautifully complex dance between sensation and perception.
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For reference: These ideas and a lot more are discussed in our Vestibular-Visual Matters online on-demand series ((put link https://www.kimbarthel.ca/event/2022/vestibular-visual-matters-prerecorded under VVM)), and will be explored in-person in Johor Bahru, Indonesia starting Jan 29, 2026 and in Brisbane, Australia starting March 12, 2026.
References
Alais, D., Keys, R., Verstraten, F., & Paffen, C. (2021). Vestibular and active self-motion signals drive visual perception in binocular rivalry. Iscience, 24(12), 103417. https://doi.org/10.1016/j.isci.2021.103417
Beylergil, S., Petersen, M., Gupta, P., Elkasaby, M., Kilbane, C., & Shaikh, A. (2020). Severity‐dependent effects of parkinson's disease on perception of visual and vestibular heading. Movement Disorders, 36(2), 360-369. https://doi.org/10.1002/mds.28352
Branoner, F. and Straka, H. (2018). Semicircular canal influences on the developmental tuning of the translational vestibulo-ocular reflex. Frontiers in Neurology, 9. https://doi.org/10.3389/fneur.2018.00404
Castillo‐Bustamante, M., Espinoza, I., Briceño, O., Vanegas, J. M., Tamayo, M., & Madrigal, J. (2023). Vestibular findings on the video head impulse test (vhit) in pregnancy: a cross-sectional study. Cureus. https://doi.org/10.7759/cureus.41059
Gallagher, M., Choi, R., & Ferrè, E. (2020). Multisensory interactions in virtual reality: Optic flow reduces vestibular sensitivity, but only for congruent planes of motion. Multisensory Research, 33(6), 625-644. https://doi.org/10.1163/22134808-20201487
Lopez, C., Blanke, O., & Mast, F. (2012). The human vestibular cortex revealed by coordinate-based activation likelihood estimation meta-analysis. Neuroscience, 212, 159-179. https://doi.org/10.1016/j.neuroscience.2012.03.028
Putcha, D., Ross, R., Rosen, M., Norton, D., Cronin–Golomb, A., Somers, D., … & Stern, C. (2014). Functional correlates of optic flow motion processing in parkinson’s disease. Frontiers in Integrative Neuroscience, 8. https://doi.org/10.3389/fnint.2014.00057
Seemungal, B., Guzmán-López, J., Arshad, Q., Schultz, S., Walsh, V., & Yousif, N. (2012). Vestibular activation differentially modulates human early visual cortex and v5/mt excitability and response entropy. Cerebral Cortex, 23(1), 12-19. https://doi.org/10.1093/cercor/bhr366