Vision Changes After a Stroke

If you’ve had a stroke, you may feel like no one understands what you’re going through. But you’re not alone. One in 4 people have a stroke during their lifetime.

People who have had strokes often experience side effects like paralysis, memory loss, and behavior changes. But almost two-thirds of stroke survivors have vision problems, too. This is particularly likely to occur if a stroke happens toward the back of the brain, where it processes vision.

If you have vision loss after a stroke, you may not be able to get it all back. But being diagnosed and treated soon after symptoms start can help with recovery.

How you see after a stroke

When you have a stroke, blood supply to part of your brain is cut off, making brain cells die. A stroke that affects either side of the brain can cause vision problems. How bad vision loss is—and what’s affected—depends on where the stroke happened, how bad it was, and how quickly you got treated. Here are some of the most common vision problems.

Vision loss. You may notice that:

• You can’t see in the right or left half of 1 eye.

• You can’t see on the very top or bottom of your eye.

• You have a blind spot in 1 or both eyes.

Blurred or double vision. Sometimes, a stroke affects your brain stem. This is the part of your brain that helps control eye movement. As a result, you may have trouble moving your eyes together in 1 direction. It makes it harder for you to do daily activities, like walk or read. Your eye muscles or nerves may also be damaged. This can cause your eyes to jiggle (nystagmus) or turn in (strabismus). These conditions can affect your depth perception, balance, and coordination.

Dry eyes. If you can’t blink or close your eyelids fully, your eyes won’t be able to stay moist. This can lead to dry eye, a condition that can cause more serious eye complications like eye ulcers.

Vision inattention or neglect. Damage to certain parts of your brain may leave you unaware of objects or people on your stroke-affected side. You may ignore them or bump into things by accident.

How to manage vision changes

If you’ve had a stroke, see an eye doctor (ophthalmologist) as soon as possible. Your healthcare team may even recommend you see a neuro-ophthalmologist, an eye doctor who specializes in vision problems due to stroke. They’ll be able to diagnose your specific vision issues and come up with a treatment plan. This may include:

• Vision rehabilitation therapy. This is like physical therapy for your eyes. One common method in this therapy is scanning. It helps train your eyes to scan toward and away from areas of vision loss. As a result, you’re better able to use the vision you still have. You can have this therapy with a neuro-ophthalmologist or an optometrist. You also may see an occupational therapist. You can find a neuro-optometric rehab professional in your area here.

• Prisms. These are special lenses that are added to your glasses to correct double vision. They bend light before it travels to your eye. This moves images to the right spot on each eye and makes 1 clear picture.

• An eye patch. This can temporarily remove double vision.

• Balance training. Damage to your brain makes it harder for it to send messages to your eyes. Because of this, you may think the floor and walls are tilted. Your body will tilt to compensate. Balance training activities, like putting more weight on the foot of your unaffected side, can help.

In addition, you can try the following things at home to help you cope with vision changes:

• Use rulers and markers to keep your place while you read. Look into large print books at your local library. If you like e-books, enlarge the text.

• Put lamps to the side of you to prevent shadows.

• Declutter surfaces like your kitchen counter. This way, it’s easier to see the things you want.

When it comes to vision changes after a stroke, timing is everything. The sooner you act, the better your chances of recovery. And remember, you’re not alone. Your loved ones and healthcare team are there to help you.