EKF2 Height Requirement

The EKF2 has a dependency on height data (EKF2_HGT_MODE). Why this dependency? Is it there for fusing horizontal optical flow data? And if that is optional, why is this required?

Assuming it IS for vision measurements: In my use case, I dont have GPS and want to change it from a horizontal to a vertical facing camera. Thus height would suddenly become ‘range’ to the surface that Im looking at. But how do I fix the issue that the gravity vector is now different?