ISC 2025 | The progression and recovery of vision after stroke

Visual recovery after stroke is a big chunk. So there is a big improvement that happens. Again, based on the studies, it could be from 7% recovery, spontaneous recovery to 80% of recovery. Again, it’s a wide range, hard to pinpoint based on the prior observational studies. But typically, 30% of patients, in my experience, could recover after a stroke. And around 16 to 20% of patients could have a permanent visual deficit. The rate of recovery goes like this. So in the beginning, you have a rapid recovery, especially in the first three months or so. When you have an acute insult, your brain swells and then there is a dysfunction of the neurons. So that all leads to the initial disruption. Even though you don’t have 100 percent damage, you present like 100 percent damage, because there is a lot of cytotoxicity happening in the brain, there’s a lot of swelling. So people usually present with more deficit in the beginning. So within the first 30 days or so, there’s a rapid improvement in those patients. And again, that recovery kind of starts to slow down at three months and then at six months. By the six months, most of the spontaneous recovery happens. And after that, it’s kind of flattens out after that. After that, actually, there are studies that show actually degradation of vision because once you hit the nerve there is a process called retrograde or anterograde degeneration of neurons, so these are post-synaptic neurons that get affected after damage to the pre-synaptic neurons. So then after six months you may start having a decline in your vision because of that pathology.

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