Overview
A stroke can affect more than movement, speech and memory. It can also change the way a person sees, processes and responds to visual information.
Visual impairment following a stroke can include blurred vision, loss of part of the visual field, double vision, difficulties with eye movements and problems recognising or responding to objects on one side.
These difficulties can affect everyday activities such as reading, walking, dressing, eating and recognising people. They can also increase the risk of falls and make it harder to regain independence.
With appropriate assessment and rehabilitation, people affected by visual problems after a stroke can learn strategies to manage their symptoms, improve their confidence and make everyday activities safer.
At The Royal Buckinghamshire Hospital, our specialist inpatient stroke rehabilitation service supports people recovering from the physical, cognitive and functional effects of stroke.
What is visual impairment following stroke?
Visual impairment following stroke describes changes to vision or visual processing caused by damage to the brain or the neurological pathways involved in sight.
The eyes collect visual information, but the brain is responsible for processing and interpreting what we see. When a stroke damages the relevant areas of the brain, a person’s visual abilities may be affected even when their eyes themselves are healthy.
The effects can vary considerably. Some people lose part of their field of vision, while others experience double vision, difficulty controlling eye movements or problems recognising objects and understanding what they are seeing.
Visual difficulties can occur on their own or alongside other stroke-related problems, such as weakness, reduced coordination, memory difficulties or impaired awareness.
What causes visual problems after a stroke?
A stroke occurs when the blood supply to part of the brain is interrupted or when bleeding damages brain tissue.
There are two main types:
Different parts of the brain are responsible for receiving, processing and interpreting visual information. A stroke affecting these areas or the pathways connecting them can cause changes to vision.
The location and extent of the brain injury influence the type and severity of visual impairment.
Types of visual impairment following stroke
There are several types of visual problems that can develop following a stroke.
Visual field loss (hemianopia)
Hemianopia is the loss of vision in one half of the visual field. It can affect the left or right side of what a person can see, and may involve both eyes.
For example, someone with a right-sided visual field loss may struggle to see objects or people on their right-hand side.
This can make everyday activities more difficult, including:
- Reading, particularly when reaching the end of a line.
- Finding objects on a table or shelf.
- Walking around unfamiliar environments.
- Recognising people approaching from the affected side.
- Navigating doorways, corridors and stairs.
Some people may be unaware of the extent of their visual field loss, particularly during the early stages of recovery.
Visual neglect
Visual neglect, also known as spatial neglect or visual inattention, is a difficulty recognising or responding to information on one side of the body or surrounding environment.
It is not simply a problem with eyesight. Instead, the brain has difficulty directing attention towards information on the affected side.
For example, someone with left-sided neglect may:
- Leave food untouched on the left side of their plate.
- Fail to notice people approaching from their left.
- Bump into objects on one side.
- Only dress or groom one side of their body.
- Overlook words or information on one side of a page.
Visual neglect can have a significant impact on safety, mobility and independence. It can occur alongside visual field loss, but the two conditions are different.
Double vision (diplopia)
Double vision, medically known as diplopia, occurs when a person sees two images of a single object.
A stroke can affect the nerves or brain pathways responsible for controlling eye movements. If the eyes do not work together correctly, the images they produce may not align.
Symptoms can include:
- Seeing two images instead of one.
- Difficulty focusing on objects.
- Headaches or eye strain.
- Difficulty judging distances.
- Problems with balance and movement.
- Closing one eye to reduce double vision.
Double vision can make activities such as reading, walking and using stairs more challenging.
Blurred vision and eye movement problems
Some people experience blurred vision or difficulty controlling the movement of their eyes following a stroke.
This may affect their ability to focus on objects, follow movement or shift their gaze between different areas.
Eye movement difficulties can include problems with coordination, involuntary eye movements or reduced control when looking in particular directions.
Visual processing difficulties
A stroke can also affect the way the brain interprets visual information.
Some people may experience difficulty recognising objects, judging distances, understanding spatial relationships or interpreting what they see.
These problems can affect everyday tasks even when basic eyesight appears relatively normal.
Symptoms of visual impairment following stroke
Symptoms depend on the type and severity of the visual impairment.
Common symptoms include:
- Blurred or distorted vision.
- Loss of vision on one side.
- Double vision.
- Difficulty focusing on objects.
- Problems following moving objects.
- Difficulty judging distances and depth.
- Bumping into objects or doorways.
- Missing objects on one side.
- Difficulty reading or following lines of text.
- Problems recognising familiar objects or people.
- Increased difficulty moving around unfamiliar environments.
- Reduced confidence when walking or completing everyday activities.
Not everyone is aware that their vision has changed following a stroke. Family members and carers may notice changes in behaviour, such as repeatedly overlooking objects on one side or struggling with tasks that were previously straightforward.
How can visual impairment affect everyday life?
Visual difficulties can affect many aspects of daily living and may make rehabilitation more challenging.
Depending on the symptoms, a person may find it difficult to:
- Walk safely around their home or outdoors.
- Navigate stairs, corridors and unfamiliar environments.
- Read books, newspapers or digital screens.
- Prepare food and manage mealtimes.
- Dress and manage personal care.
- Recognise people and objects.
- Judge distances when reaching for items.
- Maintain balance and avoid obstacles.
- Return to driving, work or previous activities.
Visual impairment can also affect confidence and independence. People may become anxious about falling or navigating unfamiliar places, leading them to avoid activities they previously enjoyed.
Identifying these difficulties and addressing their impact is an important part of stroke rehabilitation.
How is visual impairment diagnosed after a stroke?
Visual problems following a stroke should be assessed by appropriately trained healthcare professionals.
An assessment may include:
- Reviewing the person’s medical and stroke history.
- Assessing visual acuity, including the ability to see objects clearly.
- Checking for visual field loss.
- Examining eye movements and coordination.
- Assessing symptoms such as double vision or blurred vision.
- Identifying signs of visual neglect or impaired visual processing.
- Considering how visual difficulties affect everyday activities and safety.
Depending on the symptoms, further assessment may be required from an orthoptist, ophthalmologist or other specialist.
An orthoptist assesses eye movements, visual function and conditions such as double vision and visual field problems. An ophthalmologist is a medical eye specialist who can investigate and manage eye-related conditions.
The assessment findings help establish the type of visual impairment and inform an appropriate rehabilitation plan.
Treatment and rehabilitation for visual impairment following stroke
Treatment depends on the nature of the visual problem. Some people may benefit from specialist eye treatment, while others require rehabilitation techniques to help them adapt to changes in vision.
The aim is to improve visual function where possible, develop practical strategies and support safer, more independent daily living.
Visual scanning and visual search training
People with visual field loss or visual neglect may benefit from structured exercises designed to improve awareness of their surroundings.
Visual scanning involves learning to move the eyes and head towards the affected side to locate objects and information.
Exercises may include:
- Practising scanning across a page when reading.
- Searching for objects in different areas of a room.
- Looking towards the affected side before moving.
- Using visual markers to help identify the edge of a page.
- Repeating everyday tasks that encourage awareness of the affected side.
These techniques can help people develop compensatory strategies for everyday activities.
Occupational Therapy
Occupational Therapy can help people understand how visual difficulties affect their ability to complete everyday tasks.
Treatment may include:
- Practising dressing and personal care.
- Developing strategies for reading and finding objects.
- Improving awareness of hazards and obstacles.
- Practising safe movement around the home.
- Adapting everyday tasks to accommodate visual difficulties.
- Recommending suitable equipment or environmental changes.
The focus is on helping people manage daily activities more safely and independently.
Eye movement therapy
Some people with persistent visual field loss or eye movement difficulties may benefit from specialist visual rehabilitation.
Depending on the diagnosis, this may include eye movement exercises, visual scanning strategies or other interventions recommended by an orthoptist or ophthalmologist.
Treatment should be based on an individual assessment, as different visual problems require different approaches.
Visual aids and adaptations
Some people benefit from equipment and environmental changes that make everyday activities easier.
These may include:
- Magnifiers and accessible reading materials.
- Improved lighting and contrast.
- Large-print information.
- Electronic reading and accessibility tools.
- Visual markers to help with navigation.
- Changes to furniture positioning and home layouts.
Recommendations should reflect the person’s specific visual difficulties and rehabilitation goals.
Support with mobility and balance
Visual impairment can affect balance, coordination and confidence when moving around.
Physiotherapy may help address associated mobility and balance difficulties, while Occupational Therapy can support safer movement and everyday activities.
The rehabilitation team can work together to reduce risks and help people develop greater confidence.
Visual rehabilitation at The Royal Buckinghamshire Hospital
At The Royal Buckinghamshire Hospital, our specialist inpatient rehabilitation service supports people recovering from stroke and other neurological conditions.
Visual impairment can affect mobility, communication, personal care and independence. It is therefore important to consider visual difficulties as part of a person’s wider rehabilitation needs.
Depending on the individual’s assessment and clinical requirements, rehabilitation may include:
Occupational Therapy
Support with everyday activities, visual awareness, functional tasks and strategies to manage difficulties caused by impaired vision.
Physiotherapy
Help with mobility, balance, coordination and physical confidence where visual difficulties affect movement and safety.
Multidisciplinary rehabilitation
A coordinated approach to addressing the physical, cognitive and functional effects of stroke.
Individual rehabilitation goals
Rehabilitation is planned around the person’s needs and priorities, with progress reviewed and goals adjusted as appropriate.
Where specialist visual assessment or treatment is required, access to an orthoptist or ophthalmologist may need to be arranged through an appropriate specialist pathway. The availability of these services should be confirmed with the hospital team.
Who may benefit from inpatient stroke rehabilitation?
Inpatient rehabilitation may be appropriate for people who have ongoing difficulties following a stroke and would benefit from structured therapy and support.
This may include people who:
- Have visual field loss following stroke.
- Experience visual neglect or difficulty recognising their surroundings.
- Have visual difficulties affecting mobility and balance.
- Struggle with reading, dressing or other everyday activities.
- Have a combination of visual, physical and cognitive difficulties.
- Need coordinated rehabilitation involving different healthcare professionals.
Suitability depends on the person’s medical stability, rehabilitation needs, ability to participate and individual circumstances. An assessment is required to establish whether inpatient rehabilitation is appropriate.
Why choose The Royal Buckinghamshire Hospital?
The Royal Buckinghamshire Hospital provides specialist inpatient rehabilitation for adults recovering from stroke and other neurological conditions.
Our multidisciplinary approach focuses on the physical, cognitive and functional effects of neurological injury.
Rehabilitation is tailored to the individual, with the aim of helping patients develop practical strategies, improve their abilities and work towards greater independence.
The team works with patients, families and referring professionals to establish rehabilitation goals and support planning for the next stage of recovery.
Discuss stroke rehabilitation with our team
Visual impairment following a stroke can affect confidence, mobility and independence. Appropriate assessment and rehabilitation can help people understand their visual difficulties and develop strategies to manage everyday activities.
If you or someone close to you is experiencing visual problems following a stroke, our team can discuss the inpatient rehabilitation options available at The Royal Buckinghamshire Hospital.
Call 01296 678800 to speak to the team, visit our Stroke Recovery and Rehabilitation page to find out more or enquire online on the button below.
Frequently asked questions
Can eyesight improve after a stroke?
Some people experience improvements in their vision following a stroke, although recovery varies. The outcome depends on the location and extent of the brain injury and the type of visual impairment. Specialist assessment can help identify appropriate treatment and rehabilitation options.
What is hemianopia after a stroke?
Hemianopia is the loss of vision in one half of the visual field. It can affect the left or right side of what a person sees and may make reading, walking and navigating everyday environments more difficult.
What is visual neglect after a stroke?
Visual neglect occurs when the brain has difficulty recognising or responding to information on one side of the body or surrounding environment. A person may overlook objects, people or food on the affected side, even when their eyesight itself is not necessarily impaired.
Can a stroke cause double vision?
Yes. A stroke can affect the nerves and brain pathways responsible for controlling eye movements. This can cause the eyes to become misaligned, resulting in double vision.
Can visual impairment after a stroke be treated?
Treatment depends on the type of visual impairment. Some people may benefit from specialist eye treatment, visual scanning exercises, eye movement therapy, visual aids or rehabilitation strategies designed to improve safety and independence.
Which specialist assesses vision problems after a stroke?
An orthoptist can assess eye movements, visual function and certain visual disorders. An ophthalmologist can investigate and manage medical eye conditions. The appropriate specialist depends on the symptoms and assessment findings.
Can visual problems after a stroke affect walking?
Yes. Visual field loss, double vision and visual neglect can affect awareness of surroundings, depth perception and balance. These difficulties may increase the risk of falls and make walking less safe.
Can someone drive after experiencing visual impairment following a stroke?
Not everyone can safely return to driving after a stroke. Visual field loss, double vision and other visual problems may affect driving ability. People must follow DVLA requirements and should not drive until they have established that they meet the relevant medical standards.
When should someone seek emergency medical help?
Sudden loss of vision, new double vision or other sudden visual changes can indicate a serious medical problem, including a stroke. If symptoms develop suddenly, particularly alongside facial weakness, arm weakness or speech difficulties, call 999 immediately.
Important: This page provides general information and is not a substitute for individual medical assessment.
Review Date: 09/11/28
Published Date: 09/11/26
