5 Signs of Visual Problems Following Brain Injury or Stroke
Has this ever happened to you?
Your patient who has experienced a stroke or brain injury has been progressing as expected and then suddenly their progress just stops and they seem to have a hard time following directions.
You might not realize that this can occur because your patient is having a visual problem. Two-thirds of stroke survivors experience vision problems. In fact, about 60 percent of the brain is involved in visual processing. Because of the complexity of stroke and brain injury, vision may get left out of the equation.
So how can you tell if visual problems are getting in the way of your patient’s progress?
5 Signs of Visual Problems
To identify potential visual deficits in your patients, ask yourself these five questions:
1) Can my patient read printed materials?
A patient may not be able to read print for a variety of reasons. It could be that they aren’t wearing their most recent prescription glasses. Or they might be having trouble focusing on the words. It could appear to them that the words are moving on the page. Does it seem like your patient is missing words at either the beginning or end of the text? They may be experiencing a cut in their visual field.
2) Does my patient squint or close one eye when reading?
Your patient’s eyes might not be working together properly, or they could be experiencing double vision.
3) Does my patient look down while ambulating?
This can happen if your patient is unable to see the whole visual field. They are being extra cautious and ensuring they can see where they are going so they won’t trip.
4) Does your patient run into walls or trail the wall while ambulating?
This behavior is a clear indication that your patient is missing part of their visual field. By trailing the wall, they are using a landmark to help guide them.
5) Is your patient anxious in crowds?
Too much visual input and challenges with processing it can often lead to anxiety.
My MedBridge course, Brain Injury and Low Vision Occupational Therapy, (also approved for Physical Therapists!), goes further in depth into the visual issues associated with stroke and brain injury. The course also offers treatment ideas to help your patients become as independent as possible, improving outcomes for your patients and decreasing your frustration. You might be surprised at how often the smallest changes can make the biggest difference.
- Barstow, B., Warren, M., Thaker, S., Hallman, A., & Batts, P. (2015). Client and therapist perspectives on the influence of low vision and chronic conditions on performance and occupational therapy intervention. American Journal of Occupational Therapy, 69(3).
- Berger, S. Kaldenberg, J., Selmane, R., & Carlo, S. (2016). Effectiveness of interventions to address visual and visual-perceptual impairments to improve occupational performance in adults with traumatic brain injury: a systematic review. American Journal of Occupational Therapy, 70(3).
- McDonald, S. A., Spitsyna, G., Shillcock, R. C., Wise, R. J., & Leff, A. P. (2006). Patients with hemianopic alexia adopt an inefficient eye movement strategy when reading text [abstract]. Brain, 129: 158-167.
- Pambakian, A., Currie, J., & Dennard, C. (2005). Rehabilitation strategies for patients with homonymous visual field defects. Journal of Neuro-Ophthalmology, 25(2).
- Spitzyna, G. A., Wise, R. J. S., McDonald, S. A., Plant, G. A, Kidd, D., Crewes, H., & Leff, A. P. (2007). Optokinetic therapy improves text reading in patients with hemianopic alexia: a controlled trial. Neurology, 68(22): 1922-1930.
