Vision changes after a stroke

Hi, I am Dr. Katelyn Jordan. I am the low vision optometrist at the Brooks Rehabilitation Center for Low Vision Therapy. We see many patients post-stroke who report that their vision is different or reduced since their stroke. However, frequently, it can be hard to explain or understand what exactly what has changed with your vision after a stroke. A stroke can cause a variety of problems with your sight. These include double or blurred vision, loss of central vision in one or both of your eyes, and visual field loss. In fact, up to a quarter of stroke survivors may have vision loss. Symptoms of vision loss due to stroke may manifest in different ways:

1. Frequently bumping into objects like door-frames or people.

2. Difficulty and uneasiness in moving about in crowded areas.

3. Unsure of footing while walking and may trip or stumble.

4. Often startled by moving objects or people appearing suddenly.

5. May have bruises on shoulder or arm from colliding with door-frames.

6. Frequently losing place in reading and becoming frustrated when reading.

7. Struggling to find or misjudging the start or end of a line of print in reading.

8. Withdrawing from most reading.

9. Frequently spilling drinks when eating.

10. Unsteady balance in walking and may report dizziness.

11. Problems in finding things on desks, counter tops, cabinets or closets.

12. Fear or anxiety in walking through unfamiliar areas.

13. Uneasiness or even panic attacks in crowded areas.

14. Withdrawal from going to stores or other crowded areas.

15. Getting around well at home, but avoiding outside activities.

Hemianopsia (also known as hemianopia) is present in about 15 percent of stroke patients. This condition blanks one side or one quadrant of your vision field in each eye. This creates difficulty completing even simple tasks, such as walking straight ahead, reading all the way across a page, or seeing all the food on a plate.

Normal scene

Normal perception of a scene

hemianopsia scene

Perception of a scene by someone with a hemianopsia

Diplopia, or double vision, affects about six percent of all stroke patients. In this condition, the two eyes fail to work together properly. In addition to losing depth perception, patients with diplopia face a reduced field of vision and everyday visual confusion. The condition can be temporarily relieved by closing or covering one eye.

diplopia scene

The left side shows normal perception of a scene while the right side shows the perception of the same scene by someone experiencing diplopia

Other ocular diseases can cause visual symptoms similar to those that develop from a stroke. It is important to have a dilated eye exam performed by an ophthalmologist or an optometrist after the stroke to rule out vision loss from any other condition. Frequent causes of vision loss not related to stroke include macular degeneration, glaucoma and diabetic retinopathy. Identifying these disease processes and initiating the proper treatment is vital in preventing further vision loss.

Once the cause of vision loss has been determined and any medical treatment deemed necessary has been initiated, a low vision examination can be performed to identify rehabilitation potential and to develop a rehabilitation plan. Regardless of the cause of vision loss, the goal of low vision rehabilitation is to maximize the remaining vision to help address the functional needs of the patient and help each patient to achieve their goals.

While most stroke patients with vision loss do not fully recover their vision, partial recovery or natural vision improvement is possible, usually in the first months after a stroke. Proper diagnosis and a vision rehabilitation plan can help improve participation in most daily activities, self-esteem and feelings of independence.

For more information on vision rehabilitation services following stroke, please contact us at:

Brooks Rehabilitation Center for Low Vision Therapy

2519 Riverside Avenue

Jacksonville, FL 32204

904.389.9989

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