3.2 - Stroke & Vision: Navigating The Visual Aftershocks

For many stroke survivors, the world doesn’t look the same—not because their eyes are damaged, but because their brain’s visual system has been thrown off course.

Imagine watching TV with half the screen blacked out—or trying to read a sentence while the words on the left side have vanished. That’s what it can feel like when a stroke affects the visual system.

This post explores how stroke and vision are deeply connected, what types of visual disruptions can occur, and how vision rehabilitation helps survivors regain clarity, confidence, and control in daily life.

How Stroke Affects Vision

Vision isn’t just about the eyes—it’s mostly about the brain. A stroke can damage key areas of the brain involved in:

• Visual fields (what you can see on either side)

• Eye movements (scanning, tracking, focus)

• Spatial awareness (judging depth or distance)

• Visual attention and perception (processing what’s seen)

Even if the eyes are perfectly healthy, the brain’s ability to process vision can be seriously impaired.

Up to 60% of stroke survivors experience vision problems—many of which go undiagnosed in the early stages of recovery.

Common Post-Stroke Visual Issues

• Hemianopia: Loss of one half of the visual field (left or right)

• Quadrantanopia: Loss of one quarter of the visual field

• Blurred or double vision (diplopia)

• Eye movement disorders (e.g. slow scanning, poor tracking)

• Visual neglect: The brain ignores one side of the visual field (often mistaken for attention issues)

• Sensitivity to light or motion

• Poor reading fluency and comprehension

• Balance and orientation issues due to faulty visual input

Why These Symptoms Matter

Post-stroke visual challenges affect much more than reading or seeing—they impact mobility, independence, confidence, and even mental health.

Without visual awareness on one side, patients may bump into walls, ignore food on one side of a plate, or struggle with daily tasks like dressing and navigation. These frustrations can fuel isolation, anxiety, and depression.

According to the Stroke Association, people with untreated visual field loss are at significantly higher risk of falls and reduced functional independence.

How Vision Rehabilitation Supports Stroke Recovery

1. Visual Field Training - Exercises that retrain scanning habits and build awareness of the blind side. Often includes saccadic eye movement practice and adaptive strategies.

2. Prism Lenses - Used to shift or expand the visual field and help compensate for hemianopia or diplopia.

3. Eye Movement Therapy - Targeted vision therapy helps rebuild smooth pursuits and saccades, improving tracking and reading.

4. Visual Attention Retraining - Especially critical in visual neglect cases. Combines visual scanning with cognitive and motor cues to stimulate awareness.

5. Multisensory & Multidisciplinary Rehab - Combining vision therapy with physical and occupational therapy for balance, coordination, and spatial awareness gains.

Common Misdiagnoses or Missed Diagnoses

• Stroke survivors may complain of visual confusion but receive no follow-up exam beyond acuity

• Vision loss may be misattributed to aging or cognitive decline

• Patients with spatial neglect are often treated for attention disorders rather than vision processing issues

📌 This is why functional vision testing is critical after any neurological event.

Quote to Remember

Final Thoughts

Vision rehabilitation for stroke survivors isn’t a luxury—it’s a necessity. Relearning how to see the world fully, safely, and clearly is often the final step toward reclaiming independence. With the right interventions, patients can move from disorientation to orientation—from frustration to function.