4.1 - What Is Visual Field Loss? Understanding the Edges of Sight

You can see what’s in front of you—but somehow, you keep bumping into things, missing road signs, or skipping words on the left side of a page. It’s not forgetfulness. It might be visual field loss.

Imagine watching a movie on a widescreen—then slowly losing the edges until you're left with a narrow slit in the middle. That’s what visual field loss can feel like.

In this first post of the Vision & the Visual Field Series, we’ll break down what visual field loss is, why it happens, how it affects everyday life, and how vision rehabilitation can help people reclaim their full perspective.

What Is Visual Field Loss?

The visual field is everything you can see when your eyes are fixed in one direction—including your peripheral (side) vision. Visual field loss occurs when part of this field becomes blurry, dim, or completely blank due to damage in the visual pathways of the brain, optic nerve, or retina.

Unlike blurry vision (a clarity issue), field loss is a space issue—whole sections of the visual environment are missing.

Types of Visual Field Loss

Each pattern offers clues about the underlying cause:

• Hemianopia – loss of one entire side (left or right) of both eyes

• Quadrantanopia – loss of a quarter of the field (upper/lower, left/right)

• Bitemporal Loss – missing outer (temporal) halves of vision

• Binasal Loss – missing inner (nasal) portions of the field

• Scotomas – patchy blind spots in central or peripheral vision

• Tunnel Vision – severely restricted peripheral vision, often linked to glaucoma or retinitis pigmentosa

Real-Life Impact of Field Loss

Field loss doesn’t just affect what someone sees—it affects how they live:

• Skipping words or lines while reading

• Colliding with doorframes, desks, or pedestrians

• Struggling to find items on cluttered shelves

• Anxiety or disorientation in crowded or unfamiliar spaces

• Unsafe driving or inability to meet visual licensing standards

• Social withdrawal due to visual overwhelm

📊 A 2019 study published in Brain Injury found that over 50% of patients with acquired brain injury had significant visual field impairments—but most were undiagnosed at discharge.

Causes of Visual Field Loss

Visual field deficits can result from:

• Stroke (especially occipital lobe involvement)

• Traumatic brain injury or concussion

• Brain tumors

• Multiple sclerosis

• Glaucoma or optic nerve damage

• Retinal diseases

• Pituitary tumors (pressing on the optic chiasm)

Why Field Loss Is Often Missed

Because people aren’t always aware of what they’re not seeing, especially with gradual onset. They adapt their behavior—turning their heads, tilting their eyes—without realizing the field itself is compromised.

How Vision Rehabilitation Helps

• Visual field testing to map and track deficits

• Prism lenses to expand awareness of blind zones

• Saccadic eye movement training to improve scanning across the field

• Mobility training to rebuild spatial confidence

• Task adaptations for reading, navigation, and daily living

Quote to Remember

Final Thoughts

Visual field loss can be frightening, especially when it’s invisible to others—but with the right tools, support, and training, patients can adapt, retrain, and regain confidence.