Visual Dysfunction in Neurological Rehabilitation

Which hemisphere initially processes visual–spatial information?

The right hemisphere.

Which hemisphere focuses on detail and fine analysis in vision?

The left hemisphere.

What causes visual–perceptual processing difficulty?

Asymmetry between hemispheres.

What are key frontal lobe functions related to vision and behavior?

Movement, voluntary eye movements, sequencing, ideation, executive functions, expressive speech.

What are effects of frontal lobe damage?

Paralysis, decreased attention, impulsivity, mood lability, personality changes, motor aphasia.

What are parietal lobe functions?

Processing sensation, distinguishing size/shape/color, spatial and visual perception.

What are temporal lobe functions?

Understanding speech, memory, hearing, sequencing, organization.

What are effects of temporal lobe damage?

Wernicke’s aphasia, difficulty recognizing faces, memory issues, behavioral changes.

What are occipital lobe functions?

Visual reception, synthesis and integration, visuospatial perception, visual memory formation.

What are components of the visual cortex?

Primary Visual Cortex and Visual Association Cortex.

What does the ventral stream process?

Object identification — “What am I looking at?”

What does the dorsal stream process?

Spatial awareness — “Where is the object located?”

What are effects of occipital lobe damage?

Visual impairment, hallucinations, difficulty reading or writing.

What are symptoms of visual acuity and accommodation deficits?

Blurred vision, visual fatigue, poor concentration.

What is homonymous hemianopsia?

Loss of half of the visual field.

What are symptoms of oculomotor dysfunction?

Excessive head movement, poor tracking, headaches, skipping words.

What does poor vergence cause?

Difficulty focusing, impaired depth perception, poor spatial judgment.

What is strabismus?

Eye misalignment causing double vision and poor coordination.

What is functional scanning impairment?

Losing place while reading, exaggerated head movement, omissions.

What are symptoms of color perception deficits?

Faded colors or difficulty distinguishing colors.

What is stereopsis?

Depth perception — ability to judge distance and 3D relationships.

What does Warren’s Visual Hierarchy describe?

Levels of visual processing from basic visual skills to complex visuocognition.

Why are foundational visual skills important?

Higher-level visual skills depend on intact basic skills like acuity and oculomotor control.

Which neurological conditions often involve visual–perceptual deficits?

Acquired brain injury, CVA, neurodegenerative diseases, autism, neuropsychiatric disorders, cerebral palsy.

What is BiVABA?

Brain Injury Visual Assessment Battery for Adults — assesses acuity, oculomotor control, fields, contrast sensitivity, inattention.

What is perimetry testing?

An eye test by an optometrist/ophthalmologist to assess visual fields.

What is the purpose of OT visual assessment?

To evaluate how visual deficits affect performance and participation.

What is form constancy?

Recognizing objects despite changes in size, shape, or orientation.

What are functional impacts of poor form constancy?

Difficulty reading, locating items, or navigating spaces.

What is figure–ground perception?

Ability to distinguish an object from its background.

What are functional impacts of poor figure–ground perception?

Trouble identifying objects in cluttered environments.

What is visual closure?

Ability to perceive a whole object from incomplete information.

What are functional impacts of poor visual closure?

Trouble reading or recognizing partially hidden objects.

What is visual organization?

Ability to structure and make sense of visual input.

What are functional impacts of poor visual organization?

Difficulty understanding visual relationships and patterns.

What is spatial orientation?

Understanding object location in relation to self or other objects.

What are functional impacts of poor spatial orientation?

Poor spatial awareness during mobility or self-care.

What is depth perception?

Judging distance and 3D relationships using visual cues.

What are functional impacts of poor depth perception?

Safety issues and frustration during mobility, dressing, or hygiene.

What are compensation strategies for depth perception deficits?

Teach use of monocular cues like shadowing, texture, and overlap.

How can visual acuity deficits be treated?

Increase lighting, contrast, organization, and enlarge key items.

What is diplopia?

Double vision from oculomotor misalignment.

How can diplopia be treated?

Patching, prism glasses, or vision therapy.

What are visual field deficits (VFD)?

Loss of part of the visual field, often due to PCA lesion.

What is hemianopsia?

Loss of half of the visual field.

What is scanning training?

Rotation and tracking practice, progressing from static to mobile targets.

What is the Lighthouse Strategy?

A scanning training technique that teaches turning head/eyes systematically toward affected side.

What is visual inattention or unilateral neglect?

Failure to attend to one side of space, not due to sensory loss.

What hemisphere lesion causes neglect?

Usually right hemisphere (MCA).

How does visual inattention differ from visual field deficit?

Neglect is due to inattention and lack of awareness; field loss is due to actual visual loss.

What tests screen for visual inattention?

Bell’s Test, Clock Drawing Test, Single Letter Cancellation.

What are functional impacts of neglect?

Missing information while reading, driving, or navigating.

What is awareness training?

Educating clients about neglect through meaningful activities.

What are near and far space training examples?

Near: tabletop tasks; Far: navigation or watching TV.

What are specific compensations for neglect?

Prisms, scanning training, audiovisual stimulation, video feedback.

Which type of movement improves neglect?

Unilateral movement on neglected side.

What are interventions for pattern recognition deficits?

Computer-based remediation and compensatory strategies like environmental adjustment.

What are foundational concepts for visual perceptual interventions?

Remove sensory deficits, increase awareness, provide consistent training.

What general strategies improve visual rehabilitation?

Discuss purpose, use behavior modification, integrate tasks into routines, use graded cues, begin early.

What are task adaptations for visual field loss?

Vertical layout, anchoring cues, placing objects on affected side, prism glasses.

What is the goal of environmental adaptation?

To improve safety and participation when awareness is limited.

What caregiver training supports visual deficits?

Modify environment, use color cues, organize items within visual field.

Which brain areas are involved in visuospatial processing?

Temporal (object recognition), parietal (spatial navigation), prefrontal (decision-making), brainstem (eye coordination).

What are common visuospatial deficits?

Stereopsis, spatial relations, right/left discrimination, topographic orientation, figure–ground.

What are symptoms of visuospatial impairment?

Confusion with object placement, disorientation, poor reach or transfer accuracy.

What functional tasks are affected by visuospatial deficits?

Dressing, grooming, meal prep, locating food, wheelchair positioning.

What are interventions for spatial relations deficits?

Teach awareness, use orientation aids, color coding, preposition practice.

What are interventions for right/left discrimination?

Practice spatial directions with body and environment.

What are interventions for figure–ground issues?

Simplify environment, increase contrast, organize space, practice sorting.

What are interventions for topographical disorientation?

Practice routes with visual cues and maps, fade prompts gradually.

What are interventions for agnosia?

Teach awareness and use of alternate senses like touch.