Many people who have had a stroke experience changes in their vision that affect their ability to read, drive, and perform activities of daily living. This video briefly describes common ways vision is affected by a stroke and provides examples of home exercises, activities, and adaptations to enhance vision and gain functional independence.
Changes in Vision (0:00-2:35)
Homonymous Hemianopsia and Visual Inattention
Hemianopsia affects one’s ability to see either the right or left side of their environment, while visual inattention inhibits the ability to notice, attend, or react to stimuli on the affected side.
Diplopia, Hand-Eye Coordination, and Oculomotor Dysfunction
Double vision, deficits with hand eye coordination, and oculomotor dysfunction are other common visual changes after a stroke.
Occupational Therapy's Role (2:36-3:02)
Occupational Therapists can help clients learn how to use compensatory strategies to perform activities of daily living, adapt their living environment, and teach home exercises to continue to enhance vision.
Hand-Eye Coordination and Attention
Sorting cards or groceries are great ways to practice hand-eye coordination and scanning to the affected side. This video gives examples of ways to modify this activity to increase or decreased the level of difficulty.
Near/Far Exercises for Double Vision
Switching focus from a near object to a far object can reduce double vision. One can either switch their gaze from near to far, or can alternate reading words on the near and far object. Place the far object about 10 feet away and the near object about 10 inches away at eye level.
Saccades help coordinate eye movements. Switch from looking at post-it notes from left to right, up and down, or diagonally as fast as you can.
Eye Range of Motion/ Ocular Pursuits
Tracking an object can also improve eye coordination and range of motion. A helper can move an object in vertical, horizontal, diagonal, and circular movements at a steady pace as you follow the object with both eyes. Try to keep your head still!
Reaching across the body to grasp items can promote hand-eye coordination. Ask your partner to place the item to the right, left, below the waist, and above the head. Make sure to sit in a sturdy chair and have your helper nearby to prevent falls! You can make this activity more challenging by putting an item into a container, such as a straw into a water bottle.
Playing sudoku, completing a word search, or playing connect 4 are games that promote visual scanning. All 3 games require the use of fine motor skills; if it is difficult to hold a writing utensil or grasp the game tokens, one can describe or point to their answer.
Compensatory Strategies (10:53-11:38)
This section provides examples of adaptations to call attention to an object, such as brightly colored tabs and utensils. This section also introduces the lighthouse mantra, which is a great way to remember to use visual scanning to perform daily activities.