After a stroke, you may have vision changes or vision loss. Your vision may be affected because the stroke has injured part of your brain or affected the nerves and muscles around your eye itself. Consider having your vision checked after a stroke, even if you don’t have symptoms.
Issues with vision are common after a stroke. In fact, around
Here’s what you need to know about vision change after stroke, how it’s diagnosed, and how it’s treated.
Exactly how a stroke affects someone’s vision and eyes depends on the person and the areas of their brain that are affected.
The most common types of vision loss include:
- Homonymous hemianopia: Vision loss that occurs in either the right or left half of the visual field — the total area where you can see — in each eye.
- Homonymous quadrantanopia: Vision loss that occurs in either the upper or lower quarters of your visual field.
- Scotoma: An obstruction (blind spot) anywhere in your visual field.
Other vision issues may include:
- Spatial inattention: Also referred to as “
neglect ,” spatial inattention happens when your brain doesn’t process visual information on the side affected by the stroke. If the stroke impacted the right side of your brain, this means the neglect would be on the left side of your vision (and vice versa). - Eye movement disorders: Nerves and muscles around your eyes may be impacted after a stroke as well. This may lead to impaired function of your eyes.
- nystagmus (rapid movement from side to side, up and down, etc.)
- strabismus (eye turning inward, outward, etc.)
- diplopia (double vision)
- oculomotor dysfunction (tracking issues, convergence insufficiency, cranial nerve palsy, etc.)
- issues with balance, coordination, or depth perception
- Dry eyes and light sensitivity: When people develop issues with blinking or closing their eyes, their eyes may become dry. Dry eyes can become irritated, burn, or create blurry vision. Others may become sensitive to bright light or disoriented in low light.
Stroke affects the brain in different ways for different people. If the stroke affects the occipital lobe or the brainstem, a person is
Occipital lobe
The occipital lobe is the area of your brain where visual processing takes place. This means that the occipital lobe takes in the information from your eyes and makes sense of it. While all lobes of your brain can receive visual information, the occipital lobe is considered the “
Brainstem
The
A doctor or healthcare professional may refer you to different specialists to help with poststroke vision issues. You may have vision issues from your eyes, brain, or both.
The type of doctor (or doctors) you see will depend on the root cause of your problem.
- Ophthalmologists and optometrists: Ophthalmologists and optometrists are doctors who treat disorders of your eyes.
- Neurologists: Neurologists focus on your brain and its impact on vision.
- Neuro-ophthalmologists and neuro-optometrists: These doctors and eyecare professionals look at the relationship between your eyes and brain.
To give you a diagnosis, a doctor will likely ask for a full health history and perform a physical exam. Each type of doctor may have specific tests they perform as well, including tests to assess your:
- overall vision clarity
- visual field
- eye alignment
- visual tracking
- any other area of vision concern
You probably have questions for a doctor. Try writing them down before your appointment so you don’t forget any. The doctor is there to help you understand what’s going on and direct you to the appropriate care to get you feeling better.
It’s a lot to take in, so you may also consider taking a trusted person with you to your appointment to help jot down answers.
Questions might include:
- What are the specific issues I am having with my vision?
- What’s causing my vision change/loss? Is it my brain, eyes, or both?
- What treatments do you recommend for my issues?
- Will my vision trouble/loss go away with time?
- What other specialists do you recommend I see about my vision?
- Can I drive with the changes in my vision?
- I am feeling anxious/experiencing depression — is this normal?
- Is there anything I can do to lower my risk of having another stroke?
- What resources are available to me for help with transportation, in-home care, therapies, and otherwise?
After giving you a diagnosis, the doctor will come up with a treatment plan that addresses your specific concerns. Treatment may include vision therapy, glasses, and other tools to help with your eyes and your overall health.
Vision therapy
There are various exercises to help with different vision issues that may help you regain some of what you’ve lost or retrain to help you see better. Exercises are individualized to address each person’s unique needs and provide ways people can compensate for changes or otherwise work around vision issues.
Scanning, for example, is a particularly effective treatment for stroke survivors who have lost a portion of their visual field. Scanning involves doing eye exercises to gain better visual awareness toward and away from blind spots.
Prisms and other devices
In the case of nerve palsy or other conditions that create double vision, a doctor may suggest using a prism in your glasses. Prisms bend the light so your eyes will see the same image and not double. They can be added onto existing glasses (almost like a sticker) or cut into a new prescription.
Eye patches may also be used in certain situations for people with double vision. They may be particularly helpful when you’re reading, watching television, or doing another visually heavy task.
Physical, occupational, and other therapies
Other therapists, such as physical and occupational therapists — may work to improve your balance, coordination, or spatial awareness. Other activities may help you adapt to vision changes and their impact on your everyday life.
Other support
A doctor may also suggest learning relaxation techniques, such as deep breathing, to help you cope with stress, depression, or anxiety that vision changes may cause.
Experts explain that some vision problems may improve in the first 6 months after your stroke. That said, let a doctor know if you’re experiencing any changes in your vision or if you have vision loss.
The earlier you can identify an issue, the sooner you can get help.
Otherwise, the outlook for people with vision loss after a stroke is individual and depends on numerous factors, such as where the damage to their brain occurred, how soon the issue is discovered, preexisting vision issues, and access to appropriate therapies.
Can I drive with vision changes after a stroke?
Driving after having a stroke is permitted on a case-by-case basis. A doctor may not recommend that you drive until your vision issues are resolved. If you need assistance with transportation to/from appointments, visit the ElderCare Locator website or call 1-800-677-1116 to ask for the Office on Aging in your area.
What if I experience sudden vision loss?
See a doctor ASAP if you experience a sudden loss of vision. There’s a condition called retinal vessel occlusion (eye stroke), where your retinal artery can be blocked. Your vision may be blurry or dim before you lose it. The risk factors for this condition are
Where can I find a neuro-optometrist or neuro-ophthalmologist?
These specialized eye doctors deal with the connection between your brain and eyes. A primary doctor may be able to refer you to one near you. Otherwise, try searching in the Neuro-Optometric Rehabilitation Association’s directory.
I don’t have visual symptoms. Do I need to have my eyes tested?
Yes. Experts say that symptoms alone may not be enough to identify all vision issues after a stroke. Some people may not even be able to explain that they’re having vision difficulties. Around two in three people will experience some vision change, and a doctor can help.
If you’re experiencing vision problems after a stroke, you aren’t alone. While some vision issues may get better in the months immediately following your stroke, others may last much longer.
Even if you experience