Neurological Vision Loss

Neurological Vision Problems

• Oculomotor Dysfunction

  • Displopia & Convergence

• Visual Field Loss

  • Homonymous

  • Hemianopsia

• Hemispatial neglect

  • Neglect

Neurological Vision Problems: Oculormotor Dysfunction

• Vision is a MOTOR activity that requires the eyes to work and move together to maintain a single visual image

  • Two common disorders:

    • Diplopia: images blurred or doubled

    • Convergence: coordination of the eyes to look at very close objects

Oculomotor Imparments

• Impairments

  • Slower scanning of the enviorment

  • Headaches and eye strain

  • Difficulty with close up tasks

  • Difficulty reaching for objects (diplopia)

• Interventions

  • Scanning issues: Scanning & tracking exercises

  • Reading difficulties: Anchors & line guides

  • Convergence issues: Brock string

  • General Oculomotor problems: Computer games, dynavision (white board w/ dots), modify environment ( eliminate clutter)

Diplopia Management

• Occlusion: covers an eye (patch)

• Prims: redirect an eye (glasses)

  • Both are meant to achieve a single image

  • Both most be prescribed by a vision specialist

Visual Field Loss

• Is when you are missing part of your vision

  • Homonymous hemianopsia is typical following a CVA

    • Mostly common in PCA or anything affecting the occipital Lobe

Visual Loss Impairments

• Mobility safety concerns: constant constantly bumping into objects

• Problems finding everyday items

  • Interventions

    • Unable to locate items: Organization of envionment

      • (Affected vs unaffected side)

    • Bumping into environment: Organized scanning, awareness training, organize enviorment

    • Difficulty reading: Anchors & Line guides

Hemispatial Neglect

• Also known as Neglect or Hemi-inattention, OFTEN CONFUSE with VISUAL FIELD Deficits

  • Visual field deficit: lost track of something or didn’t notice it, don’t realize they can’t see it

    • When they see it, they are surprise

  • Hemi-inattention or neglect: Unable to attend to affected side (not necessary a vision loss deficit)

    • They don’t realize something is wrong

      • INSIGHT is the BIG difference between both!

A patient presents with a visual impairment. Upon showing them an object on their affected side, they genuinely express surprise at its presence, stating they 'didn't even realize it was there.' Based on this reaction and the provided notes, which condition is MOST consistent with this presentation?
A) Oculomotor Dysfunction with Diplopia
B) Hemispatial Neglect (Hemi-inattention)
C) Homonymous Hemianopsia (a type of Visual Field Loss)
D) Convergence insufficiency

C) Homonymous Hemianopsia (a type of Visual Field Loss)

Which of the following oculomotor impairments is specifically addressed by interventions like 'occlusion' or 'prisms', and typically results in images appearing blurred or doubled?
A) Slower scanning of the environment
B) Difficulty with close-up tasks
C) Diplopia
D) Headaches and eye strain

C) Diplopia

While both Visual Field Deficits and Hemispatial Neglect can affect a patient's interaction with their environment, what is the SINGLE most critical distinguishing factor between these two conditions according to the provided information?
A) The affected side of the visual field (left vs. right).
B) The presence of nystagmus during ocular pursuit.
C) The patient's level of awareness or 'insight' into their deficit.
D) The common etiological cause (e.g., CVA affecting PCA vs. MCA).

C) The patient's level of awareness or 'insight' into their deficit.

A patient with a neurological vision problem consistently bumps into objects on one side while ambulating, despite no overt visual field cut identified on formal testing. Which of the following interventions, if applicable, would be LEAST effective given the likely underlying issue?
A) Organized scanning techniques
B) Awareness training specific to the affected side
C) Prescribing prism glasses
D) Environmental modifications to reduce clutter

C) Prescribing prism glasses