Assessment and Rehabilitation of Post-Stroke Visual Field Impairments: Current Approaches and Emerging Technologies

Abstract

Background

Visual field defect following stroke can severely impair activities of daily living, such as visual exploration, reading, and mobility – significantly reducing quality of life. While neuroplasticity enables partial visual recovery in the first few months after stroke, the potential for recovery diminishes over time. Therefore, timely identification and treatment of visual field defects is critical.

Objective

This narrative review explores traditional methods and emerging technologies in visual assessment and rehabilitation. We examine traditional visual field screening methods, including static and kinetic perimetry. We also review current approaches to visual field rehabilitation, which include (1) visual substitution therapy, (2) eye movement-based therapy, and (3) visual restitution therapies such as border-field training, blindsight training, and brain stimulation. To address the limitations of current modalities, we explored technologies like wearable virtual reality headsets.

Results

Visual substitution therapies such as prisms expand the perceived visual field but are limited by adherence and side effects. Eye movement-based training improves scanning efficiency and functional performance. Visual restitution approaches, such as border-field and blindsight training, show inconsistent evidence for visual field restoration. Technologies such as virtual reality may offer more accessible and precise approaches to visual field screening and rehabilitation.

Conclusion

Current rehabilitation strategies show variable effectiveness in restoring visual fields. Further studies are needed to evaluate the effectiveness of virtual reality technologies.