Vince has left visual field loss (also called left homonymous hemianopia). Nigel has left visual neglect and also a possible left visual field defect.
| What information and advice would you give? |
| 1. Visual Field Loss |
- The patient should be advised that they have visual field loss – they may not be aware of their visual problems nor that it affects both eyes. This information can help them develop their own coping strategies.
- The diagnosis and explanation should be provided by appropriately trained staff. They may explain what visual field loss is, how it has occurred, and its possible effects on function and the likelihood of recovery.
- The effects on patients’ functional abilities on the ward can include:
- Difficulty with mobility due to bumping into obstacles or people
- People may be more likely to fall
- Problems reading
- Difficulty with activities of daily living e.g. personal care and feeding
- Carers and family should be advised to approach patients initially from their non-affected side and to position objects of interest e.g. food and TV, to their non-affected side. Once they are aware of the person/object the patient can be encouraged to scan to their affected side.
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| 2. Visual Neglect |
- An accurate diagnosis and explanation should be given by appropriately trained staff. Staff should explain what neglect is (and also possible coinciding field loss) and its effects on function.
- Neglect patients commonly have a poor understanding of their visual problems and it is therefore important to explain the defect to family and carers too.
- Family and carers should approach the person in the area they are attending to and encourage attention to the neglected side by moving gradually to the affected side and by speaking and presenting objects on this side. The purpose is to try and improve the patient’s awareness of the neglected side (often to their left).
- If giving stimuli predominantly to the neglected side causes anxiety, stimulation should be given more equally to both sides.
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| 3. Visual Field Loss and Visual Neglect |
- Staff should be advised of the visual problems and they should be noted clearly in the patients case records.
- Advice should be provided to all drivers. Patients who suffer from a stroke, irrespective of impairment, are not allowed to drive for a period of 1 month. (See below for further information)
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This information and advice can be reinforced and supported by other resources:
General Information:
Chest, Heart & Stroke Scotland: Visual problems after a stroke [PDF]
Visual Field Loss:
British and Irish Orthoptic Society: Stroke Visual Field Loss leaflet. (PDF, 72 KB)
Visual Neglect:
British and Irish Orthoptic Society: Stroke Visual Inattention leaflet (PDF, 27KB)
Driving:
Chest, Heart & Stroke Scotland: Essential Guide to Driving with a medical condition [PDF]
The Stroke Association: Driving after stroke [PDF]
Page last reviewed: 29 Jul 2021
