Neuro-Optometric Rehabilitation Association

Enhancing Neurological Recovery Through Vision Rehabilitation

Stroke and Vision

A stroke (also referred to as a cerebrovascular accident, or CVA for short) occurs when the blood supply to part of the brain is suddenly interrupted or when a blood vessel in the brain bursts, spilling blood into the spaces surrounding brain cells. Brain cells die when they no longer receive oxygen and nutrients from the blood or there is sudden bleeding into or around the brain. 1

In the United States more than 700,000 people suffer a stroke each year, and approximately two-thirds of these individuals survive and require rehabilitation.2 According to the Centers for Disease Control and Prevention, stroke is the fifth leading cause of death in America and is a major cause of serious disability for adults.3

Although stroke is a disorder of the brain, it can affect the entire body. Depending on the location of the stroke, people may suffer loss of motor, neurological and perceptual function, as well as experience double vision, blurring, headaches, or inability to detect obstacles.2

How a CVA Can Affect Vision

About two-thirds of stroke survivors have visual impairment that typically relates to diminished central or peripheral vision, eye movement abnormalities, or visual perceptual defects. A wide range of visual disorders can occur following a stroke. Frequently, they give rise to visual symptoms such as blurred or altered vision, double or jumbled vision, loss of visual field, reading difficulty, extreme sensitivity to bright light, and inability to recognize familiar objects or people. 4

The impact of visual impairment is clear with issues relating to driving, activities of daily living, and social engagement, among others.5 Given the high rate of visual symptoms and known impact, it is recommended that all stroke survivors receive comprehensive screening for visual disorders in the early days following a stroke as they may warrant referral for a specialist’s assessment and targeted treatment specific to their type of visual impairment.6

Just as with a Traumatic Brain Injury (TBI), when a person has a stroke, often one type of rehabilitation is not enough to address all of his/her needs. Rehabilitation following a CVA most often requires extensive vision neuro rehabilitation therapy along with physical and occupational therapy. An individual’s visual rehabilitative needs should be addressed as early as possible by a Neuro-Optometric Rehabilitation Optometrist, who will work with other rehabilitation team members to help the stroke survivor learn new ways of performing tasks to circumvent or compensate for any residual disabilities.

References:

  1. National Institute of Neurological Disorders and Stroke, “Stroke Information Page,” Accessed July 10, 2018
  2. National Institute of Neurological Disorders and Stroke, “Post-Stroke Rehabilitation Fact Sheet,” Accessed July 10, 2018
  3. Centers for Disease Control and Prevention, Stroke Fact Sheet, Accessed July 10, 2018
  4. Rowe F.J. Stroke survivors’ views and experiences on impact of visual impairment. Brain and Behavior, 2017; e00778 DOI: https://onlinelibrary.wiley.com/doi/epdf/10.1002/brb3.778
  5. Hepworth L., & Rowe F. J. (2016). Visual impairment following stroke – the impact on quality of life: a systematic review. Ophthalmology Research: An International Journal, 5(2), 1–15.
  6. Rowe F.J. and the VIS Writing Group. Vision in Stroke cohort: Profile overview of visual impairment. Brain Behav. 2017 Nov; 7(11): e00771.Published online 2017 Oct 6. doi:  10.1002/brb3.771