Hemianopia: Symptoms, Causes, Treatment, and More
Hemianopia, sometimes referred to as hemianopsia, is a condition characterized by the partial loss of vision in half of your visual field. People with hemianopia can’t see objects or people on one side, either the left or the right. This condition doesn’t involve an issue with your eyes themselves, but rather damage to the visual pathways located in the brain.
Types of Hemianopia
Hemianopia can be categorized into different types based on the location and extent of vision loss.
Homonymous hemianopia: This is the most common type, affecting the same half of each visual field. It can be further categorized into:
- Right homonymous hemianopia: Loss of vision in the right half of both eyes.
- Left homonymous hemianopia: Loss of vision in the left half of both eyes.
Heteronymous hemianopia: This affects different halves of each visual field. There are two types:
- Bitemporal hemianopia: Loss of vision in the outer (temporal) half of both eyes.
- Binasal hemianopia: Loss of vision in the inner (nasal) half of both eyes.
Quadrantanopia: This affects only a quarter of the visual field, either the upper or lower, in one or both eyes. It can be further categorized into:
- Superior quadrantanopia: Loss of vision in the upper quarter of one or both eyes.
- Inferior quadrantanopia: Loss of vision in the lower quarter of one or both eyes.
Symptoms of Hemianopia
The primary symptom of hemianopia is the loss of vision in half of your visual field. However, the specific symptoms can vary depending on the type and severity of hemianopia. Other common symptoms include:
- Blind spots
- Difficulty reading
- Bumping into objects
- Difficulty navigating
- Dimmed vision
- Blurry or distorted vision
- Visual hallucinations
- Double vision
- Impaired spatial awareness
- Worsened night vision
- Impaired color vision
Causes of Hemianopia
Several factors can cause damage to the visual pathways in the brain and lead to hemianopia. These include:
- Stroke: This is the most common cause of hemianopia, accounting for over 70% of cases. Strokes affect the occipital lobe of the brain responsible for vision processing.
- Brain tumors: Tumors growing in the visual pathways can compress or damage these nerves, causing hemianopia.
- Head injury: Traumatic brain injuries can damage the optic nerve or visual areas in the brain.
- Multiple sclerosis: This autoimmune disease can affect various parts of the nervous system, including the visual pathways.
- Migraines: In rare cases, migraines can cause temporary hemianopia.
- Aneurysm: A ruptured aneurysm in the brain can put pressure on the visual pathways, leading to hemianopia.
- Infections: Certain infections, such as encephalitis, can inflame the brain and affect the visual pathways.
- Dementia: In post-stroke vascular dementia, over 30% of patients also experience visual impairment, like hemianopia.
How Can Hemianopia Impact Your Daily Life?
Unfortunately, hemianopia may disrupt a person’s daily routine and even reduce their quality of life. For example, someone with hemianopia may be at an increased risk for falls. They may also face mobility challenges and struggle to navigate their environment, bumping into objects or struggling to find their way through public spaces. Driving with hemianopia can be dangerous due to the limited field of vision. Many countries have restrictions on driving with certain types of hemianopia. Unfortunately for bookworms with this type of vision impairment, reading can also become difficult. Words and sentences can disappear from the field of vision, making a once-fun hobby a frustrating endeavor.
How Is Hemianopia Diagnosed?
Hemianopia is diagnosed through a combination of tests and examinations. Although brain damage is usually the cause of this condition, the doctor still diagnoses this condition with a comprehensive eye exam. This is the initial step to rule out any underlying eye problems that could be causing vision loss. Generally, the eye doctor will assess your visual acuity, eye pressure, and eye movements. Additionally, a doctor may recommend that you undergo brain imaging or an MRI test to help pinpoint the location and cause of the brain damage.
Treatment of Hemianopia
Unfortunately, there’s no cure for hemianopia. However, various treatment options can help manage the symptoms and improve overall functioning. First, it’s important to address the cause of hemianopia. In up to seventy percent of cases, this means treating the underlying causes of stroke. This, in turn, can help restore or preserve vision function. Others may gradually regain their field of vision without any sort of treatment. Other common treatment options include:
Visual field rehabilitation
Visual field rehabilitation is a specialized therapy program designed to help individuals with vision loss caused by damage to the visual pathways in the brain, such as hemianopia. It aims to improve overall visual function, independence, and quality of life.
Prism glasses
These specially designed glasses can shift the image in the affected field of vision towards the healthy field, improving awareness. Prism glasses work by redirecting light rays before they reach the retina, the light-sensitive layer at the back of your eye. By doing this, the two images that your eyes are seeing are brought closer together or aligned, allowing you to perceive a single, clear image.
Occupational therapy
This therapy helps individuals adapt their daily tasks and environment to accommodate their vision limitations. Some common forms of occupational therapy for patients with hemianopia include vision scanning, attention training, and visual field stimulation.
Psychological counseling
When it comes to something like vision loss, many people also experience emotional challenges. Some become depressed, while others may also develop anxiety about their condition. Fortunately, counseling can be helpful for someone struggling with the emotional distress and frustration associated with vision loss.
The specific treatment approach will depend on the underlying cause of hemianopia and the severity of vision loss. Early diagnosis and intervention are crucial for maximizing the effectiveness of treatment and improving the quality of life for individuals with hemianopia.
How Can I Cope with This Condition?
Life with hemianopia is no doubt challenging. However, there are some strategies you can use to make living with the condition a little easier. For example, if your vision shows no signs of improving, you may want to consult a low vision specialist. These are optometrists specifically trained to improve the quality of life for patients with 20/70 or worse vision. Additionally, visual scanning training helps you systematically scan your environment to be aware of obstacles and objects in your blind spot. Other helpful strategies may include:
- Making environmental modifications (i.e. removing obstacles and clutter, adjusting lighting, etc.)
- Using technology like text-to-speech software and electronic readers.
- Utilizing visual and mobility aids.
- Turning your head at a ninety-degree angle to help your eyes focus more clearly.
- Trying out low vision therapy.
- Walking with a partner or guide.
- Acknowledging the limitations of your vision and adapting accordingly.
- Seeking emotional support through counseling or support groups.
Bottom Line
Coping with hemianopia is a journey, not a destination. Be patient with yourself, explore different coping strategies, and don’t hesitate to seek help from professionals. With the right support and resources, you can manage your vision loss and live a happy, fulfilling life.
Additional Resources
- National Eye Institute: https://www.nei.nih.gov/
- American Academy of Ophthalmology: https://www.aao.org/
- VisionAware: https://aphconnectcenter.org/visionaware/
- Fight for Sight: https://www.fightforsight.org.uk/
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Originally published December 06, 2023
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