The Role of Neuro-Optometrists in Stroke Rehabilitation and Vision Restoration

In the United States, a person has a stroke every 40 seconds, and survivors of this neurological  condition are often left with health issues due to the damage in the brain. One of the more common side effects of a stroke is vision impairment, which occurs in about 65% of stroke survivors.

As stroke survivors navigate recovery, neuro-optometrists, including the team of neuro-optometrists here at DeyeNAMICS, are often important pieces of the recovery puzzle. The role that neuro-optometry can play in recovering from stroke is important, as it focuses on vision restoration.

Here, we explain why vision issues are common after a stroke and how we can help recover this vision.

Stroke and Vision Loss

A majority of strokes — about 87% — are what we call ischemic strokes, which occur when the blood supply to your brain is obstructed.

This obstruction leads to oxygen deprivation in the brain that can cause brain cells to quickly die off and communication between brain cells disrupted. This type of brain damage often affects areas of your brain that are part of your vision system, such as your:

• Occipital lobe
• Brain stem
• Parietal lobe
• Frontal lobe
• Temporal lobe

In fact, most areas of the brain play some role in your vision, so a stroke affecting any of these areas has the potential to result in visual dysfunction and specific visual symptoms.

Depending upon the areas of the brain that are affected by stroke, survivors can develop different vision issues, including:

Field Cuts

Under normal circumstances, your eyes enjoy a wide field of vision (almost 180 degrees from right to left). After a stroke, you may experience field cuts, such as homonymous hemianopia, which is the loss of half of the visual field in each eye. There’s also quadrantanopia, which is the loss of a quarter of your field of vision, and scotoma, which are blind spots in your vision.

Field cuts from a stroke can affect both eyes equally, or one eye more than the other, but can be seriously detrimental and affect quality of life. 

Visual Neglect

Strokes tend to affect one side of your body, and this is true of your vision, as well. After a stroke, many people experience visual neglect on the affected side, which we also call spatial inattention. This is an adaptation to their new visual experience which often appears as reduced awareness of one side of the body which often relates to the side of the visual field cut.

Eye Movement Disorders

Another common side effect of stroke is an eye movement disorder, which occurs when the stroke damages nerves and/or muscles that control the movement of your eyes. Eye movement disorders often create issues with balance, depth perception, and double vision. 

These eye movement disorders can also occur because how you perceive your space has changed. If you have a cut in your left visual field and need to move your eyes to look at something in that area, the accuracy of your eye movements reduces which changes your ability to move your eyes effectively. 

Rehabilitating Your Vision After a Stroke Through Neuro-Optometry

If you’re experiencing vision issues after a stroke, it's important to get a neuro-optometrist on your recovery team. Our vision experts can work quickly to identify how the areas of your brain that were affected resulted in specific vision issues.

Armed with that information, our neuro-optometrists get to work right away to rehabilitate your visual system using targeted tools and therapies.

For example, our neuro-optometrists often turn to prism lenses that shift the images one sees to try and expand the visual field, effectively changing the visual field cut. We also use scanning techniques to help with field cuts — we train your eyes to scan in and out of these areas.

We’ve also had great success with visual restoration after stroke with neuro-visual postural therapy to help with spatial processing. This therapy utilizes various activities to change how you interact with your space and supports visual rehabilitation after a stroke.

Ultimately, our goal is to help restore critical neural connections in your brain to help power your vision.

So, if you or a loved one is dealing with the aftermath of a stroke in the form of vision problems, we’re here to help. To sit down with one of our neuro-optometrists, please contact us at one of our offices in Sacramento, Bellflower, or Valencia, California; Guildford, Connecticut; Cedar Rapids, Iowa; or Plano, Texas, to set up an appointment.