Seeing Half the Picture: Understanding Hemianopsia After Stroke

Maureen Harrop
2 days ago
3 min read

When we think of vision problems, we often assume the issue lies in the eyes. But for stroke survivors, visual challenges can originate deep within the brain. One such condition is hemianopsia — a common yet under-discussed effect of stroke.

What Is Hemianopsia?

Hemianopsia refers to a loss of half of the visual field in both eyes. The most common type seen after stroke is homonymous hemianopsia, where the same half of the field of vision is missing in both eyes (either left or right). This occurs when a stroke damages parts of the brain responsible for processing visual information, such as the occipital lobeor optic pathways.

It’s important to note that hemianopsia is not caused by problems in the eyes themselves — the eyes may be perfectly healthy. The problem lies in the way the brain interprets what the eyes see.

According to published studies, up to 52–70% of homonymous hemianopsia cases result from stroke, and about 8–10%of all stroke patients develop some form of permanent visual field loss.(Source: PMC Journal)

Can Hemianopsia Be Cured?

This is one of the most common — and complex — questions stroke survivors ask. The short answer is:

Hemianopsia is rarely curable, but it can often be managed.

In some cases, especially within the first 3 to 6 months after stroke, the brain may partially recover on its own. This is known as spontaneous recovery. But if vision loss persists beyond that window, complete reversal is unlikely.

Still, there’s hope. Visual function and quality of life can be significantly improved with proper strategies and support.

How Is It Managed?

There is no single fix — but a variety of tools and therapies can help survivors adapt and regain independence:

Visual scanning training teaches individuals to turn their heads and scan the environment more effectively, making up for the blind side.
Prism glasses shift images from the blind field into the area the brain can still process.
Occupational therapy focuses on adapting daily tasks, improving safety and function.
Assistive technology — including screen readers, contrast-enhancing filters, and mobility apps — can also help.

These interventions don’t “cure” hemianopsia, but they can dramatically improve day-to-day life and confidence.

Living with Hemianopsia — And Possibly Aphasia

Many stroke survivors experience more than one challenge at the same time. When a stroke affects the left hemisphere of the brain, it’s possible to have both hemianopsia and aphasia (a language disorder that affects speech and comprehension). This can make therapy even more complex, as both vision and communication may be compromised.

In these cases, coordinated care involving speech-language therapists, occupational therapists, and neuro specialists is essential. When both vision and language are impacted, recovery may take more creativity — but it is absolutely possible.

What Does Hemianopsia Feel Like?

Survivors often describe bumping into objects, missing items on one side of a plate, or feeling disoriented in busy spaces. Reading can become difficult, as words and letters may “disappear” from view. These frustrations are real — and valid.

But with the right support, many survivors find ways to thrive. Therapy, training, and adaptive tools make a meaningful difference.

You’re Not Alone

If you or someone you love is living with hemianopsia after stroke, know this: you're not alone. Many in our community are walking a similar path — and learning, adapting, and healing along the way.

It may not be about “fixing” the brain the way we once hoped. But it is about building new ways of seeing, living, and connecting.

Sources & Links

National Library of Medicine (PMC) – Homonymous Hemianopsia OverviewIncludes data on prevalence and stroke-related cases.👉 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4181645
American Academy of Ophthalmology – What Is Homonymous Hemianopsia?Basic explanation of the condition and its neurological basis.👉 https://www.aao.org/eye-health/diseases/what-is-homonymous-hemianopsia
Stroke Foundation Australia – Vision Loss After Stroke FactsheetCovers management options including scanning, prisms, and therapy.👉 https://strokefoundation.org.au/what-we-do/for-survivors-and-carers/after-stroke-factsheets/vision-loss-after-stroke-fact-sheet
Stroke Association UK – Visual Scanning Training for HemianopiaDescribes rehabilitation techniques and research into visual scanning.👉 https://www.stroke.org.uk/research/visual-scanning-training-effective-treatment-stroke-survivors-hemianopia