What is Hemianopia

People who have suffered a Stroke or even a Transient Ischaemic Attack (mini-stroke) may be left with a defect in their vision known as a Hemianopia.  Hemianopias can take different forms but in this article we have tried to give an idea of how it may affect a persons day to day life.

Hemianopia is blindness or a reduction in vision in one half of the visual field. 

So what does that mean?

A stroke, a TIA, a tumour, or a head trauma, can result in a serious loss of vision known as hemianopia. 
The person loses all vision to one side and is usually unaware that this has happened.  Both eyes are affected and the person quite literally only sees half of their world. 

For the people with whom we work the most common cause is Stroke or TIA and the resulting behavioural effects can all too often be attributed to dementia.  However understanding the condition and making the necessary physical adjustments are the key to improving the person's quality of life.

How does it affect the person?

When someone suffers a hemianopia following a Stroke or TIA the effects on their life and their ability to do everyday tasks can be profound.  They will have lost half their vision and quite literally only see half of anything they look at.

The added problem is that often they do not realise this and believe that their eyesight is perfect and unaffected.  This seems odd as you would think if you lost half of your sight you would know about it, but because we are dealing with a brain injury it is not as simple as that.  The brain tricks the person into believing that what they see is all that is there.

The effect on a person is that they cannot see to one side.  This means that walking unaided can be difficult.  Eating and drinking can be difficult if the food and drink is not positioned correctly.  Reading can be almost impossible and certainly very frustrating.  The person can also appear nervous, uncommunicative and aggressive simply because they may be sitting in the wrong position and unaware of what is going on around them.  This can lead to isolation, anxiety and a loss of social interaction all of which may be then attributed to progressing dementia.

We may not be able to fix the hemianopia but with some simple adjustments to the environment we can make life dramatically better.

Key Learning Points

Hemianopia occurs in around 20% of all strokes but can go undetected.

It is important for all carers and family members to understand the specific difficulties that the person faces

Where a person sits in a room, how they are approached and where their meals and drinks are positioned is very important.

Corridors and walkways need to be kept clear to limit the risk of a fall.

Key Action Points

Behaviours can be greatly affected by vision.  Make sure that the person always enjoys the best possible vision

Contact optomise to ensure regular eye examinations

Notify optomise if you feel there has been a change in a person’s sight

Ensure that spectacles are worn at the right time for the right task

Keep glasses clean and in good condition.  Phone optomise for any repairs, replacements or adjustments.

This is a brief introduction to the subject of hemianopia.  If you would like to know more or if you would like to book a session please call on 028 9182 7780 or email This e-mail address is being protected from spambots. You need JavaScript enabled to view it

A Short Story

Since his stroke my Dad’s very confused.

A year or so ago we were asked to test a man in his own home who had had a stroke 4 months previously.  Since the stroke the family felt that he had become very confused but they were determined to do everything they could to keep him at home.  The four sisters had set up a rota system to cover breakfast, lunch, dinner and bedtime but were becoming ever more concerned with their father’s strange behaviours.  They were starting to think about residential care as they felt that the stoke had triggered a degree of dementia and perhaps it was getting worse.

They noticed that their dad was unable to find things that were literally sitting right in front of him.  They would leave him with a cup of tea only to return hours later to find the drink cold and still sitting where it had been left and their father complaining.  He was bumping into things, knocking things over and they were worried that he was going to have a fall.

We had an easy job to do.  The family wanted an eye test as it had been well over a year and it was too difficult to get him out to a practice.  We arrived to find a great man full of jokes and craic, ready and able to have a full eye examination.  It all went very smoothly and with no usual problems until we carried out our test for hemianopia.  There was no doubt that the man had a classical right side hemianopia and was seeing absolutely nothing to that side. 

Suddenly for the family so many things fell into place.  His behaviours and much of his ‘dementia’ could be explained by understanding how this man saw the world.  It was a great and unexpected relief for the family to be able to get an explanation to so many of his problems. 

Understanding was the key to improving this man’s quality of life.