Mini Stroke and Visual Field Loss

by Fred E.
(Los Angeles, CA)

Question: My 88 year old mother had a small stroke 40 days ago and has lost the vision on the right side of her visual field. She has also lost most of her short term memory. She has no numbness or weakness on either side. Her speech is very clear. No slurring, complete sentences and thoughts. She lives in Eugene Oregon and currently resides in assisted living. She takes herself to the bathroom and uses a walker. She is also on oxygen 1.5 litres. How should we rehab her for the best stroke recovery in Eugene? Thanks.



Answer: I don't know if it's the case with your mother, but stroke patients that do not present with problems such as limb paralysis or impaired speech often do not receive adequate rehabilitation or therapy. Stroke patients whose main deficit is hemianopsia may receive very little or no therapy for the condition because it is often overlooked.

Hemianopsia is the term for when a stroke victim loses 1/2 of their visual field. It can spontaneously improve in the first three to six months following a stroke, however, many do not resolve. Compensation techniques can be used for hemianopsia as well as visual aids. I recommend contacting an opthamologist experienced with hemianopsia as well as finding an outpatient facility with an occupational therapist that specializes in vision training (you will need a MD order for the occupational therapy treatment). When you call the opthamologist or therapy clinic, specifically ask if the professional has experience with treating hemianopsia and their background with treating visual deficits in stroke.


Some of the techniques and equipment used to deal with hemianopsia include:

Saccade training or scanning therapy - This involves training the patient to search or scan into the area of visual field that is missing. Some various activities include head/eye shifts, Dynavision, computerized trainers, descriptive walking, last letter cancellation, puzzles, and search strategies.

Boundary marking - training the patient to search for a marker at the end of a line of text.

Optical devices - special lens that can be used in eyewear such as Gottlieb Visual Field Awareness System, EP Horizontal Lens, and Chadwick Hemianopsia Lens

Visual Restoration Therapy - computer-based treatment that attempts to stimulate existing visual neurons to rewire and make new connections. It is based on the premise of neuroplasticity. Some controversy has surrounded this technique, but it is approved by the FDA.