What visual problems can you develop after having a stroke?
25 November 2021
What is a stroke?
Strokes occur when the blood supply to part of your brain is cut off. A stroke is a medical emergency and the sooner you receive treatment, the less affected you are likely to be. You can identify a stroke by remembering the acronym FAST. This translates to:
- Face – look out for facial changes, such as one side of the face dropping
- Arms – weakness, numbness or inability to lift one or both arms
- Speech – slurred speech or inability to talk or understand questions and conversations
- Time – dial 999 as soon as possible in order to receive treatment quickly
Strokes can affect your speech, movement, taste, continence, balance and more, but one of the main things impacted by a stroke is your vision. As a result of this you can’t, by law, drive for one month following a stroke. We’re going to discuss the effects of a stroke on your vision so you know what to look out for during a stroke recovery period. Visual changes aren’t always picked up following a stroke as sight changes aren’t life-threatening or as immediately obvious as the other effects of a stroke, yet two thirds of stroke survivors actually experience vision problems. Of these two thirds, 20% of stroke survivors experience permanent visual damage.
How can a stroke affect your vision?
First of all, it’s important to note that vision problems that occur following a stroke happen because of brain damage, and not because anything has happened to your eyes. A stroke can damage the part of your brain that controls and receives visual information, preventing you from processing and seeing images as you should. Further to this, loss of vision in one eye can actually be an early sign of a stroke before it even occurs. This is something to bear in mind, should you experience any visual changes.
There are a number of visual symptoms you might experience after a stroke, including:
- Blurry vision
- Double vision
- Loss of some parts of your visual field
- Light sensitivity
- Dry eyes
- Poor depth perception
- Inability to recognise faces or objects
However, there are four main types of vision problems that occur in the aftermath of a stroke. The Stroke Association have identified them as the below issues:
- Loss of visual field (aka hemianopia)
Visual field loss can affect any section of your visual field, which is the term used to describe the view that you see when your eyes are open. Following a stroke, some people find that they lose one side of their visual field or even some of their central vision. If the right side of your brain was affected by the stroke, it’s possible that the left side of your visual field in each eye could be affected. Loss of vision in this manner can be particularly distressing and can cause issues when attempting to navigate busy environments, read, or even recognise familiar faces.
- Problems with eye control and movement
As a stroke damages the nerves that control your eyes, eye movement can be affected. Sometimes this presents as your eyes not working as a pair and moving in different directions. This can result in strabismus or double vision, affecting your distance and depth perception. In some cases, nerve damage from a stroke can also cause nystagmus, a condition whereby your eyes shake from side to side. Although this doesn’t always affect your vision, it can be very distracting and upsetting when it does.
- Issues with processing visual information
Some people find that after a stroke, they suffer with visual agnosia. This is a condition with which they can see objects but have issues recognising them. Crucially, this can affect reading as, although they can see the text, they are unable to process the information that they are seeing. Visual agnosia can also mean that some stroke sufferers are unable to identify or name objects or colours, despite being able to see them perfectly. Further to this, your brain may also not receive information about what you are seeing on a particular side of your visual field, leading you to bump into things because you don’t realise that there is something there.
- Dry eyes and light sensitivity
A stroke can affect the nerves of your eyelid, slowing down the rate at which you blink and preventing you from closing your eyelids fully. This stops your eyes from being as hydrated as they should be, causing dryness. You can try to combat this with eye drops or by reminding yourself to blink fully more regularly. Although consciously remembering to blink properly isn’t an ideal long-term solution, it should help with the symptoms and encourage your eyes to lubricate themselves more effectively.
What treatments are there?
Once somebody has had a stroke, a normal part of their assessment and follow-up care is to test their vision. If these examinations reveal that their vision has been affected, there are a number of optical aids that can be offered. The Stroke Association identifies these as “magnifiers, which increase the size of what you are looking at, and minifiers, which help you to concentrate on the areas you can see”.
Your vision can gradually improve following the initial changes you may experience following a stroke, so you might find that the effects become less severe over time. If you’re worried about your vision and have had a stroke recently, visit your optician or doctor who will be able to advise you on further treatment and ways to cope and manage with your new vision.
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