How Strokes Affect Vision And Eye Alignment

A stroke can have a profound effect on speech and facial muscles, but it can also affect the vision. Our ability to see involves the brain as well as the eyes, and the damage a stroke causes in the brain can have a direct impact on the eyes' visual pathways. A stroke can damage the nerves that move and align the eyes, which affects the eyes' ability to work as a pair and results in blurred vision and/or double vision that can make it hard to focus on objects. This can cause the eyes to become crooked.

An eye stroke, or retinal artery occlusion, occurs when blood flow to the retina is blocked

In the case of an eye stroke, the blockage affects the retina. When the retinal veins are blocked, fluids leak into the retina, causing swelling and preventing oxygen from circulating, which impacts your ability to see. When blood flow to the retina is completely interrupted, severe damage to the eye can occur. An obstruction in your main retinal vein is called a central retinal vein occlusion (CRVO). When it happens in one of your smaller branch veins, it’s called a branch retinal vein occlusion (BRVO). If it affects the central retinal artery, it’s known as central retinal artery occlusion (CRAO). CRAO can be the most severe of the three.

The symptoms of an eye stroke can develop slowly over hours or days, or they can come on suddenly. They also depend on which blood vessel is obstructed and whether you have CRVO, BRVO, or CRAO. The biggest sign it may be a retinal stroke is if you experience symptoms in one eye only. The severity of vision loss and the area of the vision field affected may depend on the region of the retina involved in the blood flow blockage. A blockage in the central artery often leads to more severe symptoms and central vision loss.

The most common CRAO symptom is partial or complete central vision loss. It may mimic a black curtain coming down in front of your eye. The retina may appear pale and have a cherry red spot. CRAO is the eye equivalent of an ischemic cerebrovascular accident. The extent of the damage depends on how long the blood flow blockage lasts. The longer the interruption of blood flow, the greater the damage and the more severe the symptoms will be.

Symptoms of an eye stroke include blurred vision, floaters, pain or pressure, and bleeding

An eye stroke, or retinal artery occlusion, occurs when there is a blockage in the blood vessels supplying blood to the retina. The retina is the thin film at the back of the eye that sends light signals to the brain, enabling us to see. When the retinal veins are blocked, fluids leak into the retina, causing swelling and interrupting the circulation of oxygen, which can severely impact your vision.

• Blurred vision: This can steadily worsen and affect one side or the entire field of vision.
• Floaters: Small gray spots floating in your field of vision.
• Vision loss: This can occur gradually or suddenly and can range from subtle to severe.
• Pain or pressure: Eye strokes are often painless, but severe cases may cause localized pressure or discomfort in the affected eye.
• Bleeding: The retina may appear red or have blood spots throughout.

These symptoms are a medical emergency, and immediate care is necessary to prevent permanent vision loss or blindness. The faster you receive treatment for an eye stroke, the more likely you are to experience positive outcomes.

Eye strokes are medical emergencies and require immediate treatment to prevent permanent vision loss

An eye stroke, or retinal artery occlusion, occurs when there is a blockage in the artery supplying blood to the retina. The retina is the part of the eye that communicates with the brain to process light and images. When blood flow to the retina is interrupted, fluid can leak into it, causing swelling and preventing the circulation of oxygen. This can lead to severe damage to the eye, including permanent vision loss or blindness.

Eye strokes are medical emergencies that require immediate treatment to prevent permanent vision loss. If you experience any of the following symptoms, seek immediate medical attention:

• Sudden loss of vision or changes in vision in one eye, including blurriness, floaters, dark spots, or decreased visual contrast
• Pain or pressure in the eye, which may indicate severe retinal vein occlusion
• Partial or complete central vision loss, which may manifest as a black curtain coming down in front of your eye

The sooner you receive treatment for an eye stroke, the better your chances of preserving your vision and preventing permanent damage. Treatment options may include:

• Medications to reduce eye pressure or dissolve blood clots
• Laser treatment to seal leaking blood vessels
• Eye massages to improve blood flow to the retina
• Paracentesis, a procedure that involves using a needle to remove fluid from the eye and relieve pressure
• Hyperbaric oxygen therapy, which delivers high levels of oxygen to the bloodstream through large, pressurized chambers

It is important to note that eye strokes can also be early signs of other vascular events, such as ischemic strokes and heart attacks. Therefore, it is crucial to seek medical help as soon as you notice any vision changes or other stroke-related symptoms.

Vision problems are common after a stroke, including blurred vision, double vision, and field loss

Vision problems are common after a stroke, with about two-thirds of people experiencing some form of visual impairment. These issues can affect your daily life in various ways, such as reading, shopping, and even getting around. While the impact on your vision may not always be immediately apparent, different challenges can emerge over time. Here are some of the most common vision problems that can occur following a stroke:

Blurred Vision

Blurred vision is a symptom of an eye stroke, specifically when there is a blockage in the central retinal artery. This can be caused by a blood clot or the narrowing of blood vessels due to fatty plaque buildup. Blurred vision can also result from eye movement problems caused by nerve damage after a stroke. This can lead to difficulties in maintaining stable focus and result in double vision.

Double Vision

Double vision, or diplopia, is often associated with eye movement problems after a stroke. It occurs when the nerves that control eye movement are damaged, resulting in both eyes being unable to work together effectively. Treatment options for double vision include prisms, patching one eye, or using a patch.

Visual Field Loss

Visual field loss is a common issue after a stroke, where you lose part or whole sections of your visual field. This can affect your ability to locate objects, navigate in crowded environments, or perform tasks like reading. Hemianopia, the loss of one-half of your visual field, is the most common type of visual field loss following a stroke.

Eye Movement Problems

Damage to the nerves controlling eye movement can lead to eye movement problems, causing difficulties in maintaining focus and resulting in blurred or double vision. You may also experience weakness in your eye muscles, making it challenging to follow moving objects or shift your gaze quickly.

Visual Processing Problems

Visual processing problems can manifest as difficulties in recognizing objects or people, judging depth and movement, or experiencing visual hallucinations. Visual neglect, or spatial inattention, is a common issue where individuals become unaware of things on one side of their visual field.

Other Sight Problems

Other issues that can affect your vision after a stroke include increased sensitivity to light, dry eye, and visual balance disorders. Light sensitivity can cause discomfort in bright lights, while dry eye can lead to irritation and a gritty feeling in the eyes.

Treatment for an eye stroke includes medication, laser treatment, and eye massage

An eye stroke, or retinal artery occlusion, occurs when there is a blockage in the artery that supplies blood to the retina. This blockage is often a blood clot. The retina is the part of the eye that communicates with the brain to turn light into images. As a result, an eye stroke can cause permanent damage and sight loss.

Treatment for an eye stroke should be given as soon as possible to minimise damage to the retina and includes:

Medication

Medications can be used to reduce pressure in the eye or to dissolve blood clots. Tissue Plasminogen Activator (tPA) is a clot-busting medication that must be administered intravenously within four-and-a-half hours of the onset of eye stroke symptoms.

Laser Treatment

Laser treatment can be used to close up leaking blood vessels.

Eye Massage

Massaging the closed eye in a specific way can help to open up the retina.

Other treatments for an eye stroke include:

• Paracentesis: Using a needle to take fluid from the eye to relieve pressure.
• Hyperbaric oxygen therapy: Breathing pure oxygen in a special chamber to preserve the retina's energy supply and optimise recovery.
• Clot-dissolving medications: Such as anti-vascular endothelial growth factor drugs, which are injected directly into the eye.
• Corticosteroids: Injected into the eye to reduce inflammation.
• Pan-retinal photocoagulation therapy: For new blood vessel formation after an eye stroke.

Frequently asked questions