Visual field deficits after stroke or brain injury can be overlooked early on as more severe, and life threatening, injuries sustained from the stroke or brain injury are treated. Patients should undergo a vision evaluation as soon as possible after their injury. Even if a patient does not perceive any problems with his or her vision, defects may be present, and they can have an extensive impact on the patient’s life and rehabilitation efforts.

Spontaneous Improvement and Recovery

Within three months of a stroke or brain injury, it is common for patients to experience spontaneous improvement and occasionally full resolution of their visual field deficits. In other words, some vision difficulties will clear up by themselves. In many cases, spontaneous recovery is partial and does not eliminate the need for formal vision rehab after stroke or brain injury.

Strokes and brain injuries are associated with several types of visual field deficits. These visual field deficits can include blind spots within vision, and other effects that can lead to difficulties in everyday activities. Vision rehab after stroke or brain injury can help address these deficits.

Hemianopia and Quadrantanopia

Hemianopia, also known as hemianopsia or visual field loss, is common among survivors of stroke and brain injury. It is defined as decreased vision or blindness in half of the visual field in one or both eyes. There are various types of hemianopia, including quadrantanopia (quadrantanopsia/quadrantic hemianopia), which is characterized by low vision or blindness in one quarter of the visual field.

Hemianopia’s Impact on Daily Life

Hemianopia and quadrantanopia are associated with the following problems:

• Difficulty reading, watching TV, and performing other daily life activities
• Increased risk of tripping, falling, bumping into objects, being struck by unseen objects, knocking over objects, and similar accidents
• Difficulty keeping one’s place when reading
• Being startled by people or objects that seem to pop out of no where

Scotoma

Scotoma, also known as a blind spot, is an area of diminished vision or blindness surrounded by normal or nearly normal vision. A scotoma generally appears as an island of darkness, lightness, or blurring; it can be any shape or size and can affect any region of the visual field.
Scotoma’s Impact on Daily Life

Scotomas are associated with the following issues:

• Limited mobility, especially if scotomas are large and/or numerous
• Difficulty reading
• Needing reading materials to be magnified, as well as greater illumination and contrast
• Difficulty perceiving colors

Diffuse Field Defects and Low Vision

Diffuse visual field loss has a range of symptoms. Patients suffering from low vision may experience one or more of the following:

• Overall blurring
• Loss of central vision
• Loss of peripheral vision / tunnel vision
• Multiple field loss (seeing dark objects scattered around objects)

Low Vision’s Impact on Daily Life

Diffuse visual field deficits, or low vision are associated with the following problems:

• Frustration, depression, and unemployment
• Loss of independence
• Inability to drive safely
• Difficulty reading, watching TV, and using a computer

Other Visual Field Deficits Common Post Stroke or Brain Injury

In addition to low vision, survivors of a stroke or a brain injury may experience one or more of the following:

• Double vision (diplopia)
• Visual balance disorders (characterized by vertigo/dizziness, falling or the sensation of falling, lightheadedness, blurry vision, and/or disorientation)
• Sensitivity to light
• Dry eyes / low blink rate
• Visual hallucinations
• Impaired visual memory (inability to recognize faces, letters, numbers, colors, etc.)

New research into neuroplasticity in the vision center of the brain, as well as the subsequent development of advanced vision rehab technology, has given new hope to survivors of stroke and brain injury. It is important for patients and caregivers to keep the following points in mind:

• Even if patients don’t perceive any problems with their vision, or their visual field deficits seem to spontaneously resolve in the months after their injury, it is important for them to be evaluated by a doctor in order to measure any vision loss, or eye damage that could have taken place. An evaluation can reveal visual field deficits, or other problems that patients didn’t know they had. In addition, an undiagnosed visual defect can undermine other rehabilitation efforts, have a devastating impact on daily life, and increase the risk of injuries resulting from poor vision.
• Vision rehab techniques such as Vision Restoration Therapy may help a patient improve his or her vision, regardless of when the stroke or brain injury occurred. In addition, VRT can address visual field deficits that were previously considered untreatable.
• Vision rehab can be an effective complement to traditional rehabilitation efforts, such as occupational and physical therapy. In addition, vision rehab can give patients a sense of independence and well-being, helping them successfully undergo rehabilitation, resume hobbies, and more.

Traditionally, those patients whose vision loss was detected were treated simply with devices and techniques that only helped them adapt to their vision loss. Although treatments like special prisms affixed to glasses, purposeful head turning, and more efficient visual scanning techniques have reduced the patients’ visual handicap, nothing has been done to reduce the size of, or depth of the blind area. Vision Restoration Therapy (VRT) is the only FDA-cleared medical device that can help to restore vision loss. While other techniques previously taught the patient to adapt to their vision loss, VRT works to trigger neuroplasticity in the brain. Through this triggering of neuroplasticity vision can be restored.

To learn more about the various types of visual field deficits, vision rehab post stroke or brain injury, or how to begin vision therapy, please contact NovaVision by email or call us at 1.888.205.0800.