Vision After a Stroke

More than 50% of neurologically impaired patients have a visual or visual-cognitive disorder.

Vision After a Stroke in Olympia

American Family Vision Clinic

What is neuro vision rehabilitation?

The objective of neuro vision rehabilitation is a customized treatment plan created by an optometrist specializing in neuro optometric rehabilitation, taking account of the patient's specific needs, which may include visual, cognitive, and motor impairments. These patients, who span all ages, have a visual impairment which could be caused by a variety of neurological factors, including suffering from a stroke. Unfortunately, it is not uncommon for the visual deficits that these patients are experiencing to be misunderstood which can lead to a misdiagnosis, such as a learning disability or an attention deficit disorder. Neuro optometry uses the principle of brain plasticity to retrain the brain how to properly communicate with the eyes in order to strengthen the visual system after a stroke.

Neuro vision rehabilitation treats many visual conditions, including:

  • Traumatic visual acuity loss
  • Traumatic loss of visual field
  • Diplopia
  • Strabismus
  • Convergence disorders
  • Accommodative disorders
  • Binocular dysfunction
  • Oculomotor dysfunction 
  • Paralysis/ paresis
  • Visual perception deficit
  • Visual spatial dysfunction 

A referral for neuro-vision rehabilitation can improve a patient's quality of life.

 

Vision and the Brain

Research shows that vision is involved in approximately up to 85% of our learning, perception, cognition and activities.

There are three main aspects of vision:

  1. Visual Acuity and Visual Field - visual acuity refers to how clearly a patient can see using the Snellen chart measurements of 20/20 and problems with visual acuity include myopia, hyperopia, astigmatism and presbyopia. Visual field refers to the central and peripheral range that a person can see and when a stroke occurs, around 20% of people suffer from permanent visual field loss. The most common deficit caused by a stroke is a homonymous hemianopia and other types include a quadrantanopia or a scotoma.
  2. Visual perception - this includes how vision interacts with the other senses in the body as the brain is interpreting signals from the eyes. Some examples of visual perception include visual memory, visual-motor integration, and visual-auditory integration.
  3. Visual Motor Skills - there are many skills included, such as:
    • Binocularity
    • Stereopsis 
    • Alignment
    • Fixation 
    • Accommodation
    • Convergence
    • Pursuits 
    • Saccades

A patient who suffered from a stroke can experience issues with any of these components of the visual system and may or may not notice the change in his or her visual abilities.

Vision and the Brain
Visual Damage Following a Stroke

Visual Damage Following a Stroke

There are other characteristic types of damage to the visual system that can occur after a stroke:

Dry Eyes

Some people who have suffered a stroke have a hard time blinking or fully closing their eyes which can affect the moistness of their eyes and can lead to dry eyes. This can cause a burning sensation, irritation, and/ or blurry vision.

Eye Movement Disorders

There are various ways that a stroke can affect the nerves and muscles that control your eye movements. Some examples include:

  • Diplopia - double vision
  • Nystagmus - a condition when the eyes move in a constant vibrating type of motion
  • Strabismus - the eye is misaligned with the other eye
  • Oculomotor dysfunction - difficulty controlling eye tracking movements

The third cranial nerve, known as the oculomotor nerve, and the third nerve nuclei are particularly vulnerable following a stroke. Due to the fact that these innervate eight out of twelve of the extraocular muscles, there are certain characteristic signs and symptoms that can be noticed after a stroke. Similarly, the sixth cranial nerve and nuclei are also susceptible to damage due to a stroke. The sixth nerve is known as the abducens nerve and it innervates two of the twelve extraocular muscles.

Oculomotor Nerve Damage Can Cause: Abducens Nerve Damage Can Cause:
  • Ptosis 
  • Fixed and dilated pupil
  • Convergence insufficiency/ infacility
  • Accommodative insufficiency/ infacility
  • Exotropia 
  • Exophoria 
  • Divergence insufficiency/ infacility 
  • Esotropia 
  • Esophoria
  • Restricted abduction of the damaged eye

There are many other ways that the eyes can be affected, but above are some of the most typical eye conditions caused by a stroke.

Referring a Patient to Neuro Optometric Rehabilitation Can Allow Them to Regain Control Over Their Lives

 

Neuro Optometric Rehabilitation

There is a field within optometry which has been proven to greatly improve a stroke survivor’s visual system. Neuro optometric rehabilitation can allow one to reclaim their independence and even regain visual abilities after suffering from visual damage due to a stroke.
Neuro optometric rehabilitation is vision care that goes beyond the simple correction of eyesight via contact lenses and eyeglasses. In particular, it focuses on the neurological side of the larger visual system, which includes not only the eyes, but the brain as well. As such, neuro optometric rehabilitation therapy centers around improving the brain-eye connection to treat a wide range of vision problems.
Our optometrist utilizes a wide variety of exercises and visual learning games, along with devices such as specialized lenses, to help attain, improve, or regain the important visual skills which will help resolve the patients’ visual issues.

Low Vision

Low vision is the result of partial but irreversible visual impairment. A diagnosis does not mean that one is blind. It just means that the patient has problems that cannot be corrected with conventional interventions, and that he or she may require vision devices and training to enhance the remaining eyesight. In most instances, a person retains some degree of vision that usually responds well to specialty glasses or to other vision aids. The field of low vision is dedicated to helping patients reclaim their independence and improve their quality of life, despite any visual impairment.

Vision and the Brain
Dr. Zurcher cartoon

Summary

The objective of neuro vision rehabilitation is a customized treatment plan created by an optometrist specializing in neuro optometric rehabilitation, taking account of the patient's specific needs, which may include visual, cognitive, and motor impairments. Some people who have suffered a stroke have a hard time blinking or fully closing their eyes which can affect the moistness of their eyes and can lead to dry eyes. This can cause a burning sensation, irritation, and/ or blurry vision.

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Friday
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Location
400 Yauger Way SW. Bldg 1, Ste A Olympia, WA 98502
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(360) 459-1097
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