Neuro-Ophthalmologic Rehabilitation after Stroke

Cerebrovascular disease may affect vision in a variety of ways. Stroke involving the afferent visual pathways typically causes visual field loss with or without defects in higher cortical processing. Damage to the efferent visual system may result in gaze palsy, diplopia, or fixational instability. Treatment modalities for these deficits include optical devices, extraocular muscle surgery, and pharmacologic agents. Neuro-ophthalmo- logic evaluation of the patient with visual problems following a stroke should include a thorough examination, realistic prognostic information, assessment of vocational visual needs, and initiation of any appropriate treatment.