Table of Contents
Nearly two-thirds of stroke survivors experience impacts on their vision. Visual processing occurs throughout the brain, so vision is commonly affected. (Learn More)
The types of vision problems caused by stroke range from loss of parts of the visual field to eye movement disorders and dry eye. (Learn More)
It is possible to get LASIK following a stroke, though LASIK is only used to correct refractive errors impacting vision. Someone with myopia, hyperopia, or astigmatism may qualify for LASIK, though the procedure is usually performed for reasons unrelated to the stroke. (Learn More)
Many stroke survivors with cataracts receive cataract surgery after having a stroke. It is thought that the increased need for the best vision possible leads stroke survivors to get cataract surgery. (Learn More)
Experts stress the benefits of therapies that retrain the brain to see better after having a stroke. Promoting neuroplasticity via methods like visual rehabilitation therapy provides significant vision improvements in most stroke patients in a short period of time. (Learn More)
A Stroke & Your Vision
A stroke is a serious health condition that negatively affects the arteries leading to and within the brain. According to the American Stroke Association (ASA), stroke is the number five cause of death as well as the leading cause of disability in Americans.
When blood vessels that carry oxygen and other nutrients to the brain are blocked by a blood clot or burst, a stroke happens. As a result, the brain does not get the oxygen and nutrients it needs and brain cells die. Large strokes can lead to death.
Vision is impacted by stroke when the stroke occurs toward the back of the brain, explains the ASA. Approximately 65 percent of people who survive a stroke experience vision problems following it. Unfortunately, most of these people do not fully regain their vision, though partial recovery is possible.
If a stroke impacts the occipital lobe, vision will be affected. The occipital lobe is where most visual processing occurs and is thus the main vision center of the brain. All brain lobes, however, receive visual information.
If a stroke occurs in the brain stem, vision will also likely be affected. The brain stem, which is at the base of the brain, controls eye movement, the ability to identify objects, and the sense of balance and stability.
Types of Vision Problems Caused by Stroke
A variety of visual symptoms can occur after having a stroke. From partial vision loss to dry eye, strokes can make it challenging to see as well as you previously did.
Visual symptoms caused by stroke include:
Field cuts.Loss of some of the visual field, or the area we see in front of us, can occur and is known as field cuts. There are multiple types of field cuts.
Homonymous hemianopia.This type of field cut is loss of vision in the right or left half of the visual field in each eye.
Homonymous quadrantanopia.This refers to loss of vision in the upper or lower quarter of the visual field.
Spatial inattention.Also known as neglect, spatial inattention means that people do not respond to or are not aware of objects on the side that was impacted by their stroke.
Eye movement disorders.When nerves or muscles that control the movement of your eyes are damaged from a stroke, eye movement disorders can occur. Examples include rapid eye jiggling, eye turning, eye tracking problems, and double vision. These issues can in turn impact depth perception, balance, coordination, and overall vision.
Dry eyes.Following a stroke, people can have challenges with blinking or closing their eyelids all the way. This can lead to dry eye, which can cause irritation, burning, or blurry vision.
Not everyone who has a stroke will experience all of the above symptoms. However, it is likely that some visual challenges will occur.
A combination of therapies (including scanning, relaxation, and breathing techniques) as well as spatial awareness and balance techniques are highly effective at helping stroke survivors learn how to compensate for their visual losses and regain as much of their vision as possible.
Getting LASIK After Having a Stroke
If someone who has had a stroke also suffers from nearsightedness, farsightedness, or astigmatism, they may be a candidate for LASIK.
A history of stroke does not necessarily disqualify a person from getting LASIK, though complications from stroke could impact eligibility. Reasons someone might not be a good candidate for LASIK include:
- Refractive instability.
- Taking medications that impact vision.
- Taking medications or having a disease that impacts the body’s ability to heal.
- A history of eye disease, eye injuries, or eye surgeries.
- Inflammation of the eyelids.
- Large pupils.
- Thin corneas.
- Dry eyes.
General health conditions and medications must be discussed with an eye doctor before qualifying for LASIK, including a history of stroke. Your doctor will assess the potential risks and benefits of LASIK in your situation.
Also consider that LASIK will not fix vision problems caused by a stroke, as they are primarily neurological in nature. LASIK only helps to reshape the physical structure of the cornea in order to improve refractive errors and enhance clarity of vision.
Cataract Surgery Following a Stroke
It is possible to have cataract surgery following a stroke. In fact, scientists have found that survivors of acute strokes are 30 percent more likely to receive cataract surgery than people who did not have a stroke. This could be due to the increased need for achieving better vision after suffering the effects of a stroke.
Experts warn that it is best to wait at least three months after a stroke before undergoing surgery. A 2014 study found that patients who had a stroke within three months prior to receiving noncardiac surgery were at an increased risk for developing cardiovascular problems or death. After nine months, the risks stabilized.
Retraining the Brain After Stroke
While 100 percent recovery of vision lost due to a stroke is unlikely, many patients are able to retrain their brains to see better. A recent study found that visual rehabilitation therapy improved the vision of over 80 percent of stroke patients, some of whom were 90 years old.
With time and the neuroplasticity of the brain, patients who actively work to rehabilitate their vision are able to see better and complete everyday tasks as well as improve their overall quality of life. In the study, the beneficial effects of visual rehabilitation training were observed in people of all ages and genders.
Most people experienced major improvements in their vision within two to three weeks of starting therapy. It also did not matter which type of stroke the participants had or how long it had been since the time of the stroke.
While strokes can have detrimental effects on quality of life, the brain is a complex and powerful organism with significant healing potential.
Other Effects of a Stroke
There are many other effects that a stroke can have on individuals. Each person experiences the condition slightly differently, though there are many common symptoms. In general, the part of the brain that receives restricted blood flow due to the stroke will dictate the symptoms in the associated part of the body.
If the stroke occurs in the left part of the brain, the following symptoms can occur:
- Paralysis on the right side of the body
- Problems with speech and language
- Memory loss
- A slow and cautious style of behavior
If the stroke occurs in the right part of the brain, it can produce the following effects:
- Paralysis on the left side of the body
- Vision problems
- Memory loss
- A quick and inquisitive style of behavior
Both sides of the body may be affected by a stroke if it is severe and occurs in the brain stem. Such a stroke can leave the patient in a “locked-in” state that makes them unable to speak or move from the neck down.
About Stroke. American Stroke Association.
Cataract Surgery Utilization After Acute Stroke. (March 2013). Journal of Clinical Gerontology and Geriatrics.
Effects of Stroke. American Stroke Association.
Let’s Talk About Stroke and Vision Changes. (October 2019). American Stroke Association.
Vision Rehab Treatment Effective for Stroke and Injury Related Blindness. (February 2020). ScienceDaily.
Wait on Elective Surgery After Stroke. (July 2014). Medscape.
When Is LASIK Not for Me? (July 2018). U.S. Food & Drug Administration.