An Overview of Hemianopsia

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Hemianopsia, or homonymous hemianopsia, is a condition which causes a person to see only one side of the visual field in each of their eyes. This presents in an unusual way, causing individuals who are unaware of their condition to believe they have lost vision in one entire eye. Hemianopsia is not the result of damage to the structures of the eye, rather the result of damage to the brain which causes impaired ability to visually perceive the environment.

Symptoms

It may be difficult for an individual to determine they have homonymous hemianopsia if they are not aware of what it entails. As this can make it appear as if vision has been lost in one entire eye, this means attention to each individual symptom will be important in determining if you truly have hemianopsia.

Symptoms of homonymous hemianopsia include:

  • Lack of awareness where the hemianopsia is present
  • Difficulty walking in a straight line
  • Frequent turning of the head away from the side where hemianopsia is present
  • Visual hallucinations
  • Clumsiness

People with homonymous hemianopsia may become frustrated with visual tasks, and may also have difficulty reading.

Causes

Homonymous hemianopsia is not a condition which develops in isolation, as this is solely the result of injury to the brain.

With hemianopsia, the structures of the eyes themselves are not damaged and are functioning properly. Instead, the brain is not properly perceiving what the eyes are seeing.

Hemianopsia may result from any type of trauma to the brain, including:

Hemianopsia can result from injury within several parts of the brain, all of which play different roles in vision and visual processing.

Diagnosis

Hemianopsia itself is diagnosed after an in-depth visual evaluation.

Imaging, such as magnetic resonance imaging (MRI), can assist with determining what and where the injury in the brain is. This will also assist in getting appropriate treatment to restore function both to the brain and an individual's visual skills.

Treatment

While hemianopsia cannot be directly treated with medications or surgery. Instead, the causes and symptoms of hemianopsia can be rehabilitated by an occupational therapist, low vision specialist, or driving specialist.

Occupational and Vision Therapy

Each specialist will bring a different set of skills in treating an individual with hemianopsia, depending on the severity and type of deficits which someone experiences. Some individuals may wish to regain their ability to safely drive and may benefit from seeing a driving specialist.

An occupational therapist may also function as a low vision specialist or driving specialist (if they possess the appropriate certifications) and train individuals to improve visual skills such as tracking, scanning, balance, and overall coordination.

These skills can assist in improving an individual’s interaction with the environment, ability to read, drive, and complete other daily tasks. An occupational therapist then focuses on rehabilitating an individual to once again complete such meaningful daily tasks, with a focus on self-care such as dressing, grooming, bathing, eating, and toileting.

While this may be a difficult diagnosis to adjust to, therapy services can assist in improving quality-of-life and functional performance, while improving one's ability to cope with remaining visual symptoms.

Treating Brain Injury

Therapy treatment related to the associated brain injury can also assist with vision changes and symptoms of hemianopsia. For example, removal of a brain tumor, or surgical and medical treatment of brain inflammation can assist in improving the associated visual deficits.

Coping

If you believe you may have hemianopsia or are struggling to cope with your diagnosis of hemianopsia, please contact your doctor to discuss available treatments and supports in your community and beyond.

Organizations such as the American Foundation for the Blind, or the Association for the Blind and Visually Impaired (ABVI) in conjunction with Goodwill Industries can provide low vision materials and resources for those who cannot afford it.

Support groups and other online resources can also assist with tips for improved engagement in activities such as reading, driving, and navigating your environment. These resources can also assist with providing emotional support and encouragement from others dealing with similar issues.

There are often some mental health symptoms and conditions associated with injury to the brain, so ensuring these are addressed is also important to maintaining a good outlook on prognosis and motivation for improvement. A global approach to therapy for hemianopsia will allow individuals to return to activities of meaning with modifications and adjustments as needed.

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  1. Cleveland Clinic. Homonymous hemianopsia. Updated April 17, 2015.