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Stroke and transient ischaemic attack - Management
Visual impairments and hemianopia
- Stroke often causes visual problems, such as diplopia (due to disruption of control of eye movement), nystagmus, blurred vision, loss of depth perception, visual agnosia (difficulty in recognizing objects), and visuospatial neglect.
- Loss of part of a visual field (hemianopia) is also common.
- Age-related visual problems may also be present and include cataract, glaucoma, macular degeneration, and uncorrected refractive errors.
- Everyone who has had a stroke should have their visual acuity assessed (while wearing their glasses) — check whether they can read the print in a newspaper and whether they can clearly see distant objects.
- People with a visual field defect should be:
- Informed about the consequences for driving — see the section on Driving after a stroke or TIA.
- Taught compensatory techniques if the defect causes practical problems — this may require referral.
- Treatment with prisms should only be considered if the person is aware that prisms might not have any benefit for them and if the treatment is provided and evaluated by an expert.
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