BVD can be caused as a result of several different factors. Some people experience BVD due to facial asymmetry, where one eye is physically higher than the other. It can also be caused by a nerve or eye muscle abnormality, which is something many people are born with. As people with these abnormalities get older, the eye muscles become even more strained from trying to constantly realign the image they are sending to the brain, which results in the uncomfortable symptoms of BVD.

BVD can also develop as a result of a stroke, brain injury, or similar neurological disorder. It can manifest at any time, with symptoms usually developing around 40-years of age.​​​​​​​

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