The eyes are known as our windows to the world, but we need more than just our eyes to make sense of the colours, shapes and movement taking place all around us every day. Our brains are a vital part of this skill, processing the complex signals received from the eyes and interpreting them so that we can ‘see’.  

When the brain is injured, a number of visual problems can occur. This does not simply mean someone ‘cannot see’ after their injury. In fact, complete blindness after brain injury is quite rare. Rather, there are a number of different types of visual problems affecting the quantity and interpretation of our perceived world. Here, we take a look at some of the different types of visual problems that can occur after brain injury.

Types of visual problems

Visual acuity loss

Visual acuity refers to how clear the visual information is. When visual acuity is affected, it can result in blurred vision. Some people also report having blurred vision when they feel fatigued.

Visual field loss

The visual field is the full area that can be seen by the eyes when they are held still. After a brain injury, visual field loss can cause fuzzy or black patches of space in the visual field. Vision may be affected around the edges, towards the centre, or on entire halves or quarters of the visual fields.

Double vision

Also known as diplopia, double vision causes two images of a single object to be seen at the same time. 

Nystagmus 

This is a condition in which the eyes rhythmically shake, which can subsequently affect the quality of information received by the brain and cause issues such as vertigo or nausea. 

Visual agnosia 

Damage to parts of the brain responsible for recognising objects can cause visual agnosia – apperceptive agnosia causes problems with processing basic perceptual aspects of an object such as colour and shape. Associative agnosia causes problems with giving meaning to this information to recognise an object. 

Visual neglect 

Sometimes referred to as ‘hemineglect’ or simply ‘neglect’, this causes a person to have difficulties with attending to visual information on one of their sides, although if they are reminded to turn to look at that side, they can actually see it. While visual neglect is, strictly speaking, more of a problem with attention than vision, it can be misinterpreted as a visual problem unless careful observation or testing is done.

Photophobia 

An increased sensitivity to light, to the point where it causes discomfort or pain, is known as photophobia. In some cases this sensitivity might be to a particular type of light. 

Colour vision changes 

After a brain injury, some people may perceive colours differently – colours may appear to be washed out or different shades from those seen prior to the injury. 

Stereopsis 

Depth perception, known as stereopsis, can be affected after a brain injury, causing difficulties with judging the distance between objects or assessing how far away something is. 

Akinetopsia

The ability to process the movement of objects can be affected by brain injury, causing things that are moving smoothly to appear as static moving images instead.

Top tips for coping with visual problems

The following tips are only general coping tips and do not replace clinical guidance. You should always follow any advice given by your neurologist or other medical professional. 

Consider how an optician can help

Less complex visual problems such as double vision can sometimes be corrected with the use of adjusted glasses or contact lenses, so an optician may be able to help with these.

Explore adapted technology

Adapted technology or accessible settings can make it more comfortable for you to use devices such as mobile phones and computers. For instance, many devices come with settings that can make the screen brighter, change to larger text or make colours more contrasted. You could use software such as a screen reader that reads text out loud. 

Larger features 

Use items with bigger features, such as clocks with large numbers or books and screens with large text. Some items such as telephones and remote controls are also available with larger buttons. 

Keep areas clutter-free 

Keep walkways around the house or elsewhere clutter-free where possible to minimise the risk of tripping.

Take your time

Take things at a slower pace where you can, especially if you have issues such as dizziness in addition to visual problems. This can include walking, reading or moving more slowly, or taking more time to think about things before doing them. 

Use visual prompts

Visual prompts can help with some types of visual problems. For example, reminding people with visual neglect to turn their attention towards the neglected side of space can sometimes help. You could also explore using colourful ribbons, highlighters or stickers as visual prompts. 

Consider registering as visually impaired 

If your vision is affected to the point where you are struggling to cope on a day-to-day basis, consider whether it would be helpful to register as visually impaired. An ophthalmologist can assess whether you would be eligible to register as either Sight Impaired or Severely Sight Impaired, depending on the severity of your visual issues. Registering as visually impaired makes your GP and local social services team aware of your visual problems, which can help with accessing appropriate support.

It is important to seek professional support for the effects of brain injury. For information on professionals that can help with visual problems after brain injury and further helpful tips, see Headway’s factsheet Visual problems after brain injury.

Contact our helpline on 0808 800 2244 or helpline@headway.org.uk to talk through your concerns about visual effects and get further information and support.