Visual field loss and its management

The visual field is a space in which multiple objects can be seen simultaneously by our eye that is steadily fixed. Daily activities such as reading, driving and shopping can all require a healthy visual field. When our visual system is functioning correctly, the brain tells us quickly where an object is in space and what it is. Being aware of our physical surroundings is essential.

Visual field loss is caused by traumatic brain injuries, autism, stroke and neurological diseases. Stress or fatigue also cause a person's functional visual field to constrict.

Visual field loss and its management in Olympia

How can visual field loss affect your life?

  • You might frequently bump into objects like door-frames
  • You might find it difficult to move into crowded areas
  • You may have unsteady balance in walking
  • You may have problems finding objects on desks
  • You may skip lines, repeat words and have trouble navigating a page while reading.
  • Daily activities such as driving, grocery shopping become difficult.
  • You may have a hard time judging distance and speed of objects.

If you experience any of these symptoms, after a thorough visual field evaluation, our eye doctor can prescribe a proper treatment and management plan to improve your visual function. To schedule a visual field and functional eye exam in Olympia, please call (360) 491-2121.

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What are the different types of visual field defects?

Altitudinal visual field defect refers to loss of visual field in the horizontal half. 

Bitemporal visual field defect is the loss of visual field in half of both right and left visual field.

Homonymous hemianopsia is the absence of vision in the same half of each eye's visual field. It is most commonly caused by stroke. It is present in 30% of stroke patients.

Central scotoma is a black spot in your central vision. It is caused by glaucoma and other retinal diseases

What is visual spatial inattention?

A visual spatial inattention is a deficit of awareness and attention to one side of space. Even though the patient has good vision, half of their visual world no longer matters to them. In most cases, the neglected side is the left. There is a tendency for the patient to bump into things on one side and not pay attention to things on that side. Their mental images are half as well, not due to a problem with vision, but due to a problem with consciousness.

What is visual spatial inattention?
What is visual spatial inattention?

What is visual spatial inattention?

  • Electroretinography
  • Amsler grid: A basic visual field test for central vision
  • Confrontation visual field test
  • Automated static perimetry test
  • Kinetic or functional visual field test
  • Frequency doubling perimetry
What is visual spatial inattention?

How can magnocellular deficits affect your life?

A magnocellular deficit is a disorder that impairs the ability to learn and read. It leads to difficulties such as reading comprehension and poor reading fluency. When trying to read small letters, patients complain that they move around and blur. Magnocellular deficits cause patients to be uncoordinated and clumsy, and they have trouble balancing.

How are constricted visual fields or visual field defects treated?

Neuro vision rehabilitation

Neuro vision rehabilitation addresses the peripheral system with the help of lenses, prisms and binasal occlusion. Lenses help to stabilize the vestibular ocular systems. Base in or yoked prisms may also be prescribed by our eye doctor. Binasal occlusion covers the nasal visual field to reduce the stress on your visual system. It helps with your gait and balance.


Filters may be incorporated into your eyeglasses to reduce glare and enhance contrast. Green filter combined with blue help with photosensitivity. Blue filter reduces ocular pain with eye movements. Yellow filter reduces blue light from passing through the lens and helps with computer and fluorescent lighting.

How can prisms help with visual field loss?

Prisms can change the spatial orientation of the patient. It can expand space or constrict space. They are used in vision therapy and/or a full time prescription in glasses. They are prescribed by an eye doctor after a thorough eye exam.


Peli prisms

They are primarily used to locate objects outside the visual field of patients with homonymous hemianopsia. They are placed on the lens of the temporal field defect. You do not actually view through the prisms but if an object is seen peripherally on the field loss side, they are used to detect the object. It is advised to practice walking and use of stairs while wearing the peli prism. They may be fit on the upper visual field first if you are having a hard time adapting to it.

Yoked Prisms

Yoked prisms can cause improvement in posture and gait when it is prescribed correctly. They also enhance the functional visual field. The key to effective treatment with prism lenses is how it's being prescribed. 

Peripheral visualization therapy program

In this exercise, you will be asked to scan into the side of the field loss and to remember as many objects there as possible. Then you will be asked to look straight ahead to visualize those objects. After that you will point to the area where you saw the objects. While you are still pointing, you will be asked to turn your head so that you could view the missing field.

Side vision awareness eyeglasses (SVAG)

These glasses have the widest viewing area, which enhances the visual field. If you're out shopping, these glasses can be very helpful. When crossing the street, these glasses can also be helpful because they allow you to see the cars more clearly. Depending on state law, patients with hemianopsia who wear side vision awareness glasses may be able to drive again.

What is visual spatial inattention?

Common Questions

There are steps that can be taken to help reduce the risk of visual field loss in people with a history of traumatic brain injury (TBI). These may include wearing protective headgear to prevent injury, seeking medical attention promptly if an injury does occur, and managing any underlying health conditions that may increase the risk of TBI.
There are many resources available to support people with visual field loss and their families. Low vision clinics and rehabilitation programs can provide specialized evaluations and treatment for visual field loss as well as providing local resources, a deeper understanding of how visual field loss impacts the patient, and referrals to other parts of the care team. Assistive technology such as software, lenses, or devices can aid people with visual field loss in accessing information and communicating more effectively. Furthermore neuro optometric rehabilitation including lenses and therapy can help the patient improve their visual function and peripheral vision. Specialized buses and paratransit services are available to assist people with visual field loss in getting around. Moreover, there are financial assistance programs available to help pay for low vision aids and other expenses related to visual field loss. If you or your loved one is experiencing visual field loss, call us to schedule an evaluation today at (360) 491-2121. We are proud to be a leading provider of advanced eye care for patients from Olympia, Lakewood, Tacoma, and Lacey.
Visual field loss and its management
Dr. Zurcher cartoon

Schedule a neuro optometric eye exam today

Visual field loss severely impairs your vision and ability to perform daily tasks. It can be caused by traumatic brain injuries, autism, stroke and neurological diseases. With a functional visual field test, our eye doctors will be able to provide you with the most appropriate treatment and tools to improve your visual function and manage or treat your condition.

Call us today at (360) 491-2121 to schedule a visual field and functional eye exam. Patients with visual field loss and vision deficits visit our clinic from all over Washington, and we are proud to be a leading provider of neuro optometric rehabilitation services for patients from Olympia, Lakewood, Tacoma, and Lacey.


Such a nice optician. My grandson is only 4 and needs glasses. We were so sad, but he explained the issues, and we will follow up as he suggested.

Anna P.

I had such a good experience with the clinic. Very friendly staff and doctor, did not have to wait for long to be called, and was treated respectfully. Thanks, American Family.

June S.

Dr. Zurcher has gone above and beyond what any other eye doctor has ever done to figure out what is going on with my eyes. Very happy with American Family Vision.

Christine R.

Family Vision Clinic changed our lives! My daughter was frequently car sick, and she was getting headaches every day, often painful enough that they brought her to tears. We saw a string of doctors and therapists, but we made no progress. Finally, we found Dr. Levi Zurcher and his eye therapist Rain. After ten weeks of eye therapy my daughter no longer gets headaches, and she no longer gets car sick. Daily tears are a thing of the past. I really can’t say enough about this clinic. It was fascinating to watch Dr. Zurcher work. For the first time, someone who knew what they were doing was intently studying my daughter, really trying to figure out all of her eye issues, and his therapist Rain is one of the most patient and lovely people that I’ve ever had the good fortune to meet. We’re finished with eye therapy—yay!—and I have switched to American Family Vision Clinic for all of my family’s other eye health needs.

Lars Wulff

Very professional, yet kind and helpful. They do what they can to make the appointment comfortable. I was running a bit late, I made sure ti call. They were able to switch me with a patient who was already there, they treated me with respect, and helped my son have confidence by getting him the eye care he needed that day. Thank you so much! Would recommend to anyone. It's a blessing that they care enough to work with people who have all different types of insurance from work to state coverage.

Justin E.

The staff is friendly. The Doc is very knowledgeable. The office is family friendly and everyone is so patient with the little ones.

Amy Fagerness
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