ISC 2025 | Visual deficits after stroke: visual field impairment and visual neglect
Shashank Shekhar, MD, MSc, FAHA, Duke University School Of Medicine, Durham, NC, comments on the impact of stroke on vision. Dr Shekhar explains that visual field impairment is the most common visual consequence of stroke, with around 30% of all stroke patients having some form of visual field impairment, as well as other issues such as visual neglect. This interview took place at the 2025 International Stroke Conference (ISC), held in Los Angeles, CA.
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Transcript
First, I’ll tell you how much brain function is involved in visual processing. So for the primary visual processing, around 30% of the brain is involved. And if you add on to the eye movement and awareness around the surroundings, that adds up to more than 50% of brain activity. So, you know, it’s a large area of the brain that could be involved in visual processing. So damage to any of these areas can lead to impairment...
First, I’ll tell you how much brain function is involved in visual processing. So for the primary visual processing, around 30% of the brain is involved. And if you add on to the eye movement and awareness around the surroundings, that adds up to more than 50% of brain activity. So, you know, it’s a large area of the brain that could be involved in visual processing. So damage to any of these areas can lead to impairment. So for vision impairment, the most common is visual field impairment that we see in a lot of patients. So the range could be all the way from 20 to 70 percent based on the various studies. Typically what I have seen around 30% of all stroke patients could have some form of visual field impairment so they cannot see from both eyes half of their visual field depending on the location it may be the right side maybe the left side it may be a quarter of the vision or the central vision depending on the location. So beyond the visual field deficit where they can’t see they could have other problems like visual neglect, which is not in the primary visual cortex area, it’s more in the parietal cortical lesions from the stroke predominantly, but it could also happen after traumatic brain injury too, so just keep in mind. Or it could be because of any brain tumor, or any lesion in the brain that affects the visual pathway can give you the impairment.
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