Changes to vision after a stroke

One of the first signs of a Transient Ischaemic Attack (TIA) or stroke can be visual disturbance – loss of vision in one area of the visual field which can be experienced as not being able to see on one side. Another problem can be seeing double. When this was first experienced, people sometimes put it down to a migraine (see ‘The event: A stroke or TIA‘).

Some people found that the visual disturbance recovered a few days after the stroke, however, others found that it persisted for longer with variable severity. The ability to read close up or to see distances were sometimes changed although this was usually temporary.

Visual field

There are many types of visual field loss after a stroke, but the most common one is called hormonymous hemianopia. This is when people can only see the right half or the left half of what they are looking at out of each eye. People sometimes said that they had lost vision in one of their eyes after their stroke, however it is more likely that the stroke has affected the visual pathways which travel from one side of both eyes to the brain, rather than damage in the one eye itself.

Visual loss on the right is due to damage to the pathways carrying information from both eyes to the left side of the brain and visual loss on the left is due to damage to the pathways carrying information from both eyes to the right hand of the brain.

Most people we spoke to had experienced this as a partial loss of their peripheral vision. This could cause problems with things like bumping into door frames, knocking things over or not seeing the first or last part of a sentence when reading.

She has loss of her peripheral vision on the left and finds she knocks into things and sometimes…

Age at interview 64

Gender Female

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Her mother has loss of peripheral vision (hemianopia) and sometimes she does not brush one side…

Age at interview 59

Gender Female

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Some people found that the loss of peripheral vision could largely be compensated for by turning the head or scanning wider although this tends not to work if the left side of vision is lost.

She lost peripheral vision on the right and sometimes has to turn her head to see things on the…

Age at interview 83

Gender Female

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Loss of visual field often meant that people had to give up driving. Vision is usually assessed using a special test and if the loss is only partial then the person may be allowed to drive.

A woman who had experienced a more severe hemianopia explained that it had been quite difficult to explain to her colleagues, because her eyes looked normal and they assumed that she had lost the vision in just one eye. She worked in a doctor’s surgery and one of the doctors put some elastoplasts over one side of a pair of glasses so other people could experience what it was like.

She describes how heminopia (loss of visual field) was difficult for colleagues to understand but…

Age at interview 41

Gender Female

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A man who had severe hemianopia also had some perception problems which caused him to neglect or ignore things on his left hand side.

He describes the tests he had for a severe hemianopia. He also suffers from visual neglect and…

Age at interview 58

Gender Male

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Double vision

A less common visual problem after stroke is double vision. This is due to damage in a part of the brain at the back of the head that coordinates the movement of both eyes. A man explained that although the vision in both his eyes was perfect he would see two of everything. He had been provided with special glasses with a frosted lens. He would alternate which eye he used by changing the lens every month.

Has double vision and wears special glasses with a frosted lens. He also lacks coordinated…

Age at interview 62

Gender Male

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Sometimes prismatic lenses can be used to correct double vision, however as this man explains the movement of the eyes needs to be coordinated.

Other visual changes

We spoke to a few people who had experienced less common visual changes following a stroke.

One woman had a range of visual problems including visual field loss and loss of depth perception which made it difficult for her to cross the road and go downstairs.

She has some loss of peripheral vision and poor depth perception which makes crossing the road…

Age at interview 31

Gender Female

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Her visual perception and visual memory had also been affected. She struggled to recognise unfamiliar surroundings, found it difficult to follow directions. She also experienced some problems with recognising unfamiliar faces and had some changes in her perception of colour.

She has a relatively rare visual problem which makes it difficult to recognise unfamiliar…

Age at interview 31

Gender Female

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The Stroke Association has a leaflet on ‘Visual problems after stroke’ and so do Chest, Heart and Stroke Scotland.

 

Changes in sensations after a stroke

Numbness and heaviness Changes in sensation were one of the first things that people noticed when they were having a stroke particularly numbness in the...