4.2 - Homonymous Hemianopia: Half the Vision, Whole Life Impact

You bump into people on one side, ignore food on half your plate, or skip the start of every sentence. But your eyes seem fine. What’s going on?

Imagine trying to drive with one side of your windshield permanently blacked out. That’s the daily experience for someone with homonymous hemianopia—a type of visual field loss that cuts off half the visual world.

This post explores what causes homonymous hemianopia, how it affects everyday life, and what can be done to adapt and improve function through vision rehabilitation.

What Is Homonymous Hemianopia?

Homonymous hemianopia means loss of the same side (left or right) of the visual field in both eyes. It results from damage to the brain's optic radiations or occipital lobe, typically on one side, due to:

• Stroke

• Traumatic brain injury

• Brain tumors or surgery

• Multiple sclerosis

Despite the eyes themselves being healthy, the brain cannot interpret input from one half of the visual world.

Symptoms & Daily Challenges

• Misses text or words on the left/right side while reading

• Collides with obstacles on the affected side

• Ignores half of a room or object (e.g. doesn’t see the handle on a mug)

• Difficulty navigating unfamiliar environments

• Unsafe driving or trouble crossing streets

• Increased anxiety, fatigue, and frustration in busy settings

📊 Around 30% of stroke survivors experience hemianopia—and many are unaware of the extent of their field loss.

Vision Rehabilitation Strategies

• Saccadic training to improve eye movements and scanning into the blind side

• Prism lenses to shift peripheral images into view

• Contrast and lighting modifications to enhance awareness of obstacles

• Visual scanning games and tools for cognitive engagement

• Orientation and mobility therapy to increase safety in public and home settings

Quote to Remember

Final Thoughts

Homonymous hemianopia can feel isolating, but it’s not the end of full, confident living. With vision rehab and awareness training, many patients regain mobility, improve reading, and feel safe in their environment again.