Hemianopsia - Vision Loss After A Stroke Or Brain Injury
Errol Rummel OD, FAAO, FNORA
This protocol is only to be used when Rx’d by an optometrist or when under the in-person supervision of an optometric physician, a physical therapist, or an occupational therapist.
The Care Of Hemianopsia And/Or Neglect
Patients who have had a stroke or traumatic brain injury may lose one half of their side vision to the right or left. This is called “hemianopsia”. Patients who have a hemianopsia are usually very aware of the side vision loss.
“Neglect” (also known as hemi-spatial inattention) is the inattention to, or lack of awareness of visual space to the right or left and is usually associated with a hemianopsia. The symptoms and signs of hemi-spatial inattention are:
- The patient cannot or does not, readily or spontaneously scan into the area of the hemianopsia.
- The patient doesn’t have a conscious awareness of the existence of their field loss.
- The patient consistently bumps into things on the side of the hemianopsia.
- When reading, the patient misses parts of words on the side of field defect and/or during a visual acuity test, misses letters on the eye chart on that side.
- The patient postures with a head or body orientation away from the side vision loss.
"Side Vision Awareness Eyeglasses" (SVAG)
Ordering Rummel Reading Guides And Rummel Buttons
Note: Please be in touch with your local low vision doctor as to how to obtain this device.
- For Right Hemianopsia Buttons, Order # AFR225R
- For Left Hemianopsia Buttons, Order # A=R225L
- For Reading Guide Set (for Right and Leit Hemianopsia), Order #ER049
Hemianopsia is one of the most common side effects of a stroke or traumatic brain injury. It can leave the patient disoriented, and struggling just to make it through their day. Patients can find themselves afraid to go out, concerned about their safety. If you're suffering from side vision loss, or someone who cares for such a person, let your doctor know about SVAG.
Once a patient has learned compensatory visual scanning in the direction of the hemianopsia, advanced optical technology prescription Side Vision Awareness Glasses (SVAG) developed by Dr. Rummel should be considered for safer ambulation, and to enhance activities of daily living in the direction of the field loss.
What To Include In A Possible Stroke Workup
History Of Stroke-Related Signs And Symptoms Best-Corrected Visual Acuity Pupil Reflexes
Cover test, phorias, ocular range of motion Threshold visual field testing Dilated fundus examination Stethoscope auscultation of the carotid arteries for bruits to resolve—an alternating eye patch may be the only treatment available.