Stroke is a common diagnosis in rehabilitation and resultant visual field disorders can be a significant barrier to a successful rehabilitation program.
- Homonymous hemianopsia is a common visual field impairment following stroke and is described as the loss of the right or left halves of the visual fields of both eyes.1
- Unilateral spatial neglect, described as a spatial inattention to one side of the body, occurs in 23% of stroke patients and is more common in those with right-sided lesions than left.2
Visual field defects after stroke may result in significant disability and a reduction in quality of life. Visual field defects impact ADL performance, independent living, mobility, socialization, and contribute to a higher fall risk.1
Strategies to address visual field loss include visual scanning tasks and activities that promote awareness of the loss of vision due to field cut or inattention. The clinician is highly influential in this process by providing individualized task gradation, cues, and prompting to integrate the full visual field throughout the activity.
ACP’s OmniVR® is a tool that can be used to therapeutically challenge visual skills and can be programmed to purposely provide stimulus to the affected field.
How does this work?
The parameter feature on each activity allows the clinician to provide visual challenge specific to the individual’s impairment, and the activity report provides objective data regarding accuracy and response time measures. This supports skilled service provision and documentation, as the clinician engages in the process by “analyzing and modifying” the task to meet the client’s level of skill.
Note: The clinician is an active participant in the intervention, by providing verbal, visual, or tactile dues to promote scanning
and attention to the affected side.
- The Fox activity allows for scanning of the entire visual field and discrimination of objects
- The Carnival activity allows for visual scanning to be directed to either the right or left side via a moving target
- The Puzzle activity allows for cross-midline visual scanning to a stationary target
- The Cognitive activities (mental math, word to object, object to object) provide a combination of visual, cognitive, and physical challenge which allows for therapeutic co-treatment
1. Luu, S., Lee, A.W., Daly, A., & Chen, C.S. (2010). Visual field defects after stroke. Australian Family Physician, 39(7), p. 499-503.
2. Stroke Rehabilitation Clinician Handbook, 2014. www.esbr.com