Strokes are medical emergencies that occur when blood flow to the brain is interrupted, leading to brain cell death. They are primarily categorized into two types: ischemic and hemorrhagic.

Ischemic Stroke

  • What it is: An ischemic stroke happens when a blood clot blocks an artery supplying blood to the brain. This is the most common type of stroke, accounting for about 87% of all cases.
  • Causes: The clot can either form in the brain artery itself (thrombotic stroke), often related to plaque buildup (atherosclerosis), or travel from another part of the body, such as the heart (embolic stroke).
  • Mechanism: The blockage deprives the brain tissue downstream of oxygen and nutrients, causing damage.

Hemorrhagic Stroke

  • What it is: A hemorrhagic stroke occurs when a blood vessel in the brain ruptures and bleeds into the surrounding brain tissue.
  • Causes: This rupture is frequently caused by conditions that weaken blood vessels, such as long-term high blood pressure (hypertension), a ballooning of a blood vessel (aneurysm), head injury, or certain blood-thinning medications.
  • Mechanism: The bleeding both deprives the area supplied by the ruptured vessel of blood, and the pooled blood puts excessive pressure on the surrounding brain tissue, damaging it.

Both types of stroke can have a profound and complex impact on vision because the areas of the brain that process visual information (the visual pathway) are highly susceptible to damage from interrupted blood flow or bleeding.

The Padula Institute of Vision, which focuses on Neuro-Optometric Rehabilitation, would address the resulting visual symptoms through specialized therapy.

Key visual impacts of stroke include:

    • Visual Field Loss (Homonymous Hemianopsia): The most common visual consequence, where the stroke damages the visual processing centers (often in the occipital lobe) resulting in a loss of the same half of the visual field in both eyes (e.g., losing the entire right half of vision).
    • Oculomotor Dysfunction: Difficulty with eye movement control, leading to double vision (diplopia), eye strain, or problems with tracking objects.
    • Visual Processing and Perception Deficits: The brain may struggle to interpret what the eyes see, resulting in:
      • Visual Neglect: The patient ignores objects or space on one side, even if their vision is technically intact.
      • Balance and Posture Issues: Distorted visual input affects spatial awareness, leading to dizziness or instability.
      • Reading Difficulties: Trouble maintaining gaze on a line of text or skipping words.

    The institute’s research demonstrates that when there is a visual field loss or a neglect of visual space it causes a visual midline shift, which then complicates the condition by adding balance difficulties, as well as difficulty with spatial orientation producing neglect. The Padula Institute of Vision specializes in rehabilitating these acquired visual disorders using Neuro-Optometric Rehabilitation and has discovered that we can utilize yoked prisms to realign the visual midline, thereby reducing or eliminating the balance problems and reducing risk of fall(ROF).