In short, vision changes are common after a stroke, and they are often not a problem with the eyes at all. A stroke can affect the parts of the brain that receive what the eyes send, or that pay attention to one side of the world. That is why someone may lose half of their field of view, or stop noticing one side without realising it. Any vision change after a stroke should be assessed by an orthoptist or eye specialist, via the stroke team or the GP.
If vision changes suddenly, or suddenly gets worse, call 999 and treat it as a possible new stroke. The NHS lists "blurred vision or loss of sight in 1 or both eyes" among stroke symptoms in its stroke symptoms guidance (Last verified July 2026).
This post is for people recovering from a stroke and the families and carers around them. It is general information rather than medical advice, and it describes services in England; the changes are the same across the UK, but referral routes differ in Scotland, Wales and Northern Ireland.
What are the most common vision changes after a stroke?
Four changes come up most often: losing part of the field of vision, not attending to one side, seeing double, and struggling to move the eyes smoothly. The Stroke Association covers all four in its guidance on vision problems after stroke, and reports that almost two thirds of people have vision problems after a stroke (Last verified July 2026).
- Hemianopia, or field loss. The same half of the picture is missing in both eyes.
- Visual neglect, sometimes called visual inattention. The eyes take the information in, but the brain does not attend to one side of it.
- Double vision, or diplopia. The two eyes no longer line up, so one object looks like two.
- Eye movement changes. The eyes may be slow to follow something moving, jump past it, or refuse to settle, so things look blurred or unsteady.
Double vision and eye movement changes happen because a stroke can affect the nerves and brain areas that aim and steady the eyes. An orthoptist may suggest prisms, a temporary patch or specific exercises. These are decisions for a specialist after an in-person assessment, not things to try first at home: covering an eye or using prisms changes depth perception and balance, which can make falls more likely. Some changes settle over the first months and some stay, and which happens varies from person to person.
What is hemianopia, and how does it show up in everyday life?
Hemianopia means losing the same half of the field of vision in both eyes, usually the half on the same side as any weakness. It is not blindness in one eye. Both eyes still see, and the same slice of the world is missing whichever eye is open. In ordinary life it tends to show up as:
- Catching a shoulder or a hip on door frames, and knocking mugs off the worktop.
- Leaving the food on one half of the plate, because that half is not in view.
- Losing the start or the end of a line when reading, so sentences stop making sense.
- Missing kerbs and steps, or startling when someone appears from the affected side.
Many people with hemianopia sense that something is missing, even if it is hard to describe. That awareness is often what makes it possible to practise turning the head towards the missing side, with guidance from the orthoptist or stroke team.
What is visual neglect, and why might someone not realise it?
Visual neglect is an attention problem rather than an eye problem. The eyes work and the information arrives, but the brain does not give one side of the world its share of attention. It is more common after a stroke on the right side of the brain, so the left side is often the side that goes unnoticed.
The hard part is that the person often does not know it is happening, because you cannot notice something your brain has not flagged as missing. Someone may shave one side of their face, put one arm in a sleeve, or turn only to the right when spoken to, and feel they have finished. This is not carelessness or a lack of effort.
Specific prompts such as "have a look over to your left" tend to land better than "you have missed a bit". How neglect changes over time varies a great deal: some people notice it easing over the early weeks, and for others it stays. It is often more obvious when someone is tired.
What practical things help at home?
The aim is to make the missing side easier to find, and the room forgiving when it is missed.
Get an in-person assessment first, from an occupational therapist, physiotherapist or orthoptist arranged through the stroke team or the GP, before changing how someone moves around the home, before any scanning practice, and before anything involving hot drinks, cooking, stairs or steps. Field loss and neglect change how someone judges edges, distances and hazards, so what is safe for one person is not safe for another. Treat the ideas below as things to raise at that assessment, not instructions to follow unassessed.
- Approach from the stronger side at first. Say your name as you come in, and speak before you touch. Later, with the stroke team's advice, encourage a look towards the affected side.
- Turn the plate. Serve food on the seeing side, then turn the plate halfway through the meal. Keep hot drinks and hot dishes on the seeing side, because anything on the missed side can be knocked without being seen.
- Ask about scanning practice rather than starting it alone. An orthoptist or therapist can say whether it suits the person and what form it should take, such as turning the head to find the kettle, or running a finger down the margin when reading.
- Declutter and keep things put, so items can be found by memory as well as by sight. Our note on adapting the home and everyday equipment goes further.
- Treat kerbs, steps and stairs as a question for a professional. Missing a step edge is a common way people fall when part of the field is gone. Ask the GP or stroke team for a falls and mobility assessment, and let an occupational therapist check any change to stairs, rails or step markings in person.
- Use contrast and light. A dark mug for milk and a contrasting toilet seat give the eyes something to lock onto, and even, generous light beats dim corners and glare.
- Allow for tiredness. Scanning takes real effort, and vision often gets worse late in the day.
Who should assess vision changes after a stroke?
An orthoptist or another eye specialist should assess any vision change after a stroke, arranged through the stroke team or the GP. An orthoptist tests eye movements, visual fields and how the two eyes work together. Some stroke units include a vision check and refer on, but do not assume it has happened; it is worth asking. The NHS names vision as one of the areas stroke rehabilitation can work on in its guidance on stroke recovery (Last verified July 2026).
A high street sight test is still worth having, and an optometrist can pick up field loss and refer on, but it is not a substitute for an orthoptic assessment, because these changes usually sit in the brain rather than in the eye.
Driving is a legal duty rather than a question of confidence, so it is not something to settle at home. gov.uk says you must stop driving for at least one month after a stroke or TIA, and you must tell the DVLA if eyesight problems such as visual field loss or double vision continue past that month. Bus, coach and lorry licences are stricter: tell the DVLA and stop driving for at least a year. Not declaring a condition that affects your driving can bring a fine of up to £1,000. A hemianopia close to the centre of vision does not usually meet the DVLA's visual field standard, so ask the orthoptist and the DVLA rather than judging it yourself. See the gov.uk stroke and driving page (Last verified July 2026) and our post on driving again after a stroke or brain injury. These are DVLA rules, covering England, Scotland and Wales; in Northern Ireland it is the DVA.
Frequently asked questions
Will vision come back after a stroke?
It varies a great deal. Some people see improvement over the first weeks and months, and for others the change stays and life is rebuilt around it. It is not something anyone can predict at the start, and no service can promise a result.
Is hemianopia the same as being blind in one eye?
No. Both eyes are still seeing, and the same half of the scene is missing from each. Covering one eye does not bring it back, which is often the clue that the change sits in the brain.
Can glasses correct hemianopia or neglect?
Ordinary glasses correct focusing, so they will not put the missing field back. An orthoptist may discuss prisms or scanning training, and the benefit differs from person to person.
How do I tell hemianopia and neglect apart?
Only an assessment can tell you properly, and the two can occur together. As a rough guide, people with hemianopia sense something is missing, while someone with neglect often feels nothing is wrong.
Is it safe to cook or make a hot drink with hemianopia or neglect?
That has to be answered in person, not in general. Hot water, hobs and ovens sit on the risky side of a missed field, and burns happen faster than bumps. Ask the GP or stroke team for an occupational therapy assessment of kitchen tasks, and treat cooking as supervised until that has happened.
What can family do without taking over?
Prompting tends to help more than doing. Say your name, approach from the stronger side to begin with, cue a look to the neglected side, and let the person find things themselves where it is safe.
Talk to us about everyday life after a stroke
Axon Neuro is a neuro-rehabilitation reablement service working in people's own homes, built around the goals that matter to the person. Our reablement support workers are not orthoptists or therapists, and this post is general information rather than a substitute for an assessment. What we do is help carry an orthoptist's or therapist's advice into ordinary days, at a comfortable pace. If vision changes are making ordinary days harder at home, you are welcome to get in touch when the time feels right, with no pressure.