Regaining Vision: Post-Stroke Eye Recovery Guide

Vision loss is a common occurrence after a stroke, with about 65% of stroke survivors experiencing changes to their vision or even complete vision loss. However, there is hope for recovery, and with the right approach, many survivors can regain their vision, at least partially. The key to recovery lies in early intervention and targeted vision rehabilitation techniques.

The ability to regain eyesight after a stroke depends on the extent and location of the brain tissue affected. Strokes can impact various areas of the brain involved in visual processing, including the occipital lobe, parietal lobe, temporal lobe, brain stem, and cerebellum. These areas play a crucial role in interpreting visual information, controlling eye movements, and maintaining balance and stability.

While complete recovery of eyesight may not be possible for everyone, proper diagnosis and vision rehabilitation can significantly improve daily activities and enhance the quality of life for stroke survivors.

Seek medical advice from an ophthalmologist or optometrist

Seeking medical advice from an ophthalmologist or optometrist is crucial for managing vision problems after a stroke. These eye specialists play a vital role in diagnosing and treating vision issues stemming from brain disorders. Here's what you need to know about seeking their help:

Understanding the Role of Ophthalmologists and Optometrists:

Ophthalmologists are medical doctors who specialize in diagnosing and treating eye diseases and disorders. They have extensive knowledge of the eye's anatomy and can prescribe treatments, including medications and surgeries. Ophthalmologists often work in hospitals and collaborate with other healthcare professionals to manage complex cases.

Optometrists, on the other hand, are primary eye care professionals. They focus on comprehensive eye health examinations, prescribing corrective lenses, and screening for common eye conditions. Optometrists typically work in clinics or private practices and may refer patients to ophthalmologists for specialized care.

Diagnosis and Assessment:

When you visit an ophthalmologist or optometrist, they will perform a comprehensive eye examination to understand the extent and nature of your vision problems after a stroke. They will assess various aspects, including:

• Overall vision clarity
• Visual field, including any missing areas of your vision (visual field loss)
• Eye movement and coordination
• Visual processing and interpretation
• Eye health, including any dryness or irritation

Treatment Options:

Based on the diagnosis, ophthalmologists and optometrists can offer a range of treatment options to help manage your vision problems:

• Prisms and Lenses: They may recommend prisms, which are added to glasses to change the way you perceive objects and reduce double vision. They can also prescribe corrective lenses to improve visual clarity.
• Eye Patches: In some cases, they may suggest using an eye patch over one eye to eliminate double vision, particularly when reading or watching television.
• Visual Training and Exercises: These specialists may advise you on specific eye exercises, such as visual scanning techniques, to improve your eye movement and coordination. This can include computer-based rehabilitation programs or eye movement patterns to compensate for visual field loss.
• Magnifiers and Optical Aids: They can also prescribe magnifiers or other optical aids to enhance your remaining vision and make daily tasks easier.
• Artificial Tears and Ointments: For issues like dry eye, they may recommend artificial tear eyedrops and ointments to keep your eyes lubricated and comfortable.
• Light Sensitivity Management: If you experience light sensitivity, they can suggest tinted glasses or specially designed eye shields to reduce glare and improve visual comfort.
• Referrals: In some cases, ophthalmologists and optometrists may refer you to other specialists, such as neuro-ophthalmologists or neuro-optometrists, who focus on the relationship between the eyes and the brain.

Ongoing Care and Support:

Vision rehabilitation after a stroke is an ongoing process, and these eye specialists will work closely with you to monitor your progress and make any necessary adjustments to your treatment plan. They can also provide referrals to other healthcare professionals, such as orthoptists, low vision specialists, or occupational therapists, who can assist with specific aspects of your rehabilitation.

Remember, early intervention is crucial for optimizing your vision recovery after a stroke. Don't hesitate to seek the expertise of ophthalmologists and optometrists, as they are instrumental in helping you regain and improve your vision.

Consider eye exercises and visual training

Vision problems are a common occurrence after a stroke, with about 60% to 65% of stroke survivors experiencing changes to their vision or even complete vision loss. However, there is hope for recovery, and early intervention is key. Research has shown that survivors of occipital strokes—strokes that occur in the occipital lobe of the brain and affect vision—may retain some visual capabilities immediately after the stroke. However, these abilities diminish over time and can disappear permanently after approximately six months. Therefore, early vision training interventions are crucial to help stroke patients recover more of their lost vision and prevent further degradation.

Directional Tracking:

Hold a pencil about 18 inches from your face at eye level. With your eyes focused on the pencil, slowly move it from left to right and then up and down within your field of vision, without moving your head. Repeat this several times in both directions. This exercise helps retrain the eye muscles and improves blood flow and eye health.

Clock Rotations:

Fix your gaze straight ahead, and then, picturing a clock in front of your face, look directly at each number on the clock with your eyes, without moving your head. Hold your gaze at each position for 3-5 seconds, feeling a gentle stretch in the eye muscles. This exercise helps improve eye mobility and flexibility.

Near/Far Focusing:

Extend your arm and focus on your finger. Breathe in while looking at your finger, then breathe out while gazing into the distance past your finger. Switch between focusing on your finger and a distant object about 10 times. This exercise helps improve your ability to shift focus between near and far objects.

Visual Tracing:

Try visually tracing lines or picture outlines. This exercise helps to improve both visual perceptual and oculomotor skills. You can also try drawing half of an object or shape and challenging yourself to complete the drawing of the second half without looking down at the paper. This exercise helps improve hand-eye coordination and visual-motor integration.

Word Searches and Letter Searches:

Practicing word searches or letter searches can improve visual tracking skills, visual discrimination, and attention. Additionally, it can help identify any visual field cuts or neglect you may be experiencing. For example, you may completely skip an entire side of the activity, indicating a possible visual neglect issue.

Peripheral Vision Stimulation:

Ask a caregiver or family member to hold two pencils, one on each side of your face or at the far sides of your visual field. Look straight ahead and ensure you can see both pencils with your peripheral vision. Then, have the person move one pencil slightly closer and the other slightly further away, and guess which pencil is closest. This exercise helps improve your peripheral vision and increases your understanding of visual spatial relationships.

Computer Games and Visual Training Websites:

Download word search games or visual training games on your computer or mobile device. Websites like Eye Can Learn and Lumosity offer free games that can improve your visual-tracking skills and visual perceptual skills. These games make vision training engaging and enjoyable, motivating you to continue practicing regularly.

Scanning Exercises:

Work on scanning exercises to improve your visual field deficits. For example, make lines of letters and search for specific letters within the lines. You can also practice scanning by reading a book and marking passages with a vertical line on the side where you have decreased vision. This helps improve your ability to scan and navigate text.

Optical Therapy:

Optical therapy uses mirrors and prisms to help position images in your line of sight. Prisms can be added to your glasses to bend light and allow both eyes to see the same image, correcting double vision. This therapy can also help improve depth perception and other visual impairments resulting from the stroke.

Eye Movement Therapy:

Eye movement therapy helps train your eyes to move within your new visual scope, making it easier to read and scan objects within your visual field. This therapy also helps strengthen and improve control over the eye muscles.

Remember, it is always best to consult with a vision therapist, optometrist, or other medical professionals who can provide individualized recommendations and guidance based on your specific needs and visual impairments. They can help determine the precise visual skills that have been affected and create a tailored treatment plan for your recovery journey.

Try optical aids, such as glasses, prisms, or patches

Vision problems are a common outcome of a stroke, with about 60% of survivors sustaining vision issues. The good news is that vision rehabilitation is possible, and there are many ways to improve your eyesight and enhance your daily life. One way to do this is by trying optical aids, such as glasses, prisms, or patches.

Glasses

Specially prescribed glasses can help you see more clearly. These are different from ordinary eyesight glasses and magnifiers, as they are stronger and provide higher-quality optics. They are often prescribed by an eye doctor and can be either optical or electronic. Optical glasses include handheld and stand magnifiers, strong magnifying reading glasses, loupes, and small telescopes. Electronic glasses include wearable headsets, such as the IrisVision, which has the widest field of view and a powerful camera with auto-focus capabilities.

Prisms

Prisms can be added to your glasses to help with double vision. They bend light so that your eyes see the same image and do not see double. Prisms can be added to your existing glasses or cut into a new prescription.

Patches

Eye patches can be used to treat double vision, particularly when doing visually heavy tasks like reading or watching television.

In addition to these optical aids, there are other low-vision aids that can be used to improve your quality of life. These include magnifiers, tablet computers and phones, and large-print products.

Manage dry eyes with eye drops or ointment

Dry eyes are a common issue after a stroke. This can be caused by issues with blinking or closing the eyes, or as a side effect of certain medications.

Eye drops, or artificial tears, can be an effective way to manage dry eyes. They work by softening, soothing, and protecting irritated tissue, as well as attracting water to moisturize the eyes. There are a variety of eye drops available, both over-the-counter and by prescription, and the best type for you will depend on your symptoms and their underlying causes.

For mild dry eyes, artificial tears or lubricating eye drops can provide quick lubrication and moisture. These drops are available in gel-based or liquid formats and typically come in multi-dose bottles. Lubricating gels and ointments, on the other hand, are thicker and often come in tubes. They are typically used overnight for longer-lasting relief but can cause temporary blurry vision, so they are best used at bedtime.

If you have dry eyes due to allergies, antihistamine eye drops may be a good option. These block histamine, a substance released by the body during an allergic reaction, and can provide relief from dryness, redness, and itchiness. However, antihistamine eye drops should not be used for more than 2-3 days, as prolonged use can worsen allergy symptoms.

For more severe cases of dry eyes, prescription eye drops may be necessary. These include cyclosporine (Restasis), lifitegrast (Xiidra), and cholinergics (cevimeline, pilocarpine). These eye drops help the eyes produce more tears and reduce inflammation.

When choosing eye drops, it is important to consider the ingredients and your specific needs. Some eye drops contain preservatives that can irritate sensitive eyes, so preservative-free options are available for frequent use. Additionally, if you wear contact lenses, it is important to select eye drops that are safe for use with contacts.

In addition to eye drops, there are other ways to manage dry eyes. For example, treating any underlying health issues, such as eyelid conditions, can help improve dry eye symptoms. Warm compresses or eye masks used daily can also help clear blocked oil glands, improving tear production.

Learn relaxation techniques to cope with stress and anxiety

Vision loss after a stroke is a common occurrence, with around 60%-65% of stroke survivors experiencing changes to their vision or vision loss. While some may regain their vision over time, others may have to deal with long-term changes.

Vision rehabilitation is an important aspect of recovery for stroke survivors with vision problems. This involves healing the brain and improving either neuromuscular control or visual processing skills. Here are some techniques to help cope with stress and anxiety during this challenging time:

Deep Breathing

Deep breathing is a simple yet powerful relaxation technique that can be practiced almost anywhere. It involves taking long, slow, deep breaths, also known as abdominal or belly breathing. As you breathe, gently guide your mind away from distracting thoughts and sensations.

Progressive Muscle Relaxation

This technique involves systematically tensing and relaxing different muscle groups in the body. Starting with your feet, work your way up to your face, tensing and relaxing the muscles in each area. This helps you become familiar with the feeling of tension and complete relaxation, allowing you to better recognise and release muscular tension.

Body Scan Meditation

Lie on your back with your legs uncrossed and arms relaxed at your sides. Focus on your breathing until you start to feel relaxed. Then, shift your attention to your toes and notice any sensations you feel. Move your focus gradually up your body, tuning into the sensations in each area. This meditation helps you become more aware of your body and any areas of discomfort.

Mindfulness Meditation

Find a quiet place where you won't be disturbed. Sit comfortably with your back straight and close your eyes. Focus your attention on your breathing and bring your mind into the present moment. If your mind wanders, gently bring your attention back to your breath without judgement. This practice helps to reduce stress and anxiety by keeping you grounded in the present.

Yoga and Tai Chi

Yoga and Tai Chi are ancient practices that combine rhythmic breathing with a series of postures or flowing movements. They offer a mental focus that can help distract you from racing thoughts and improve your flexibility, strength, balance, and stamina. It is recommended to learn these practices from a qualified instructor or by following video instructions.

Frequently asked questions