By Carole Thomas, MD, Virtua Neurologist 

There are some more well-known stroke symptoms—weakness specific to a side of the body and loss of speech or facial control. But vision changes can also be a sign of stroke. This guide will help you learn what to look for and determine other possible causes.

What is a stroke?

A stroke is a “brain attack” that occurs when blood that brings oxygen to your brain stops flowing. This causes brain cells to die. According to the National Stroke Association, nearly 795,000 people in the U.S. have a stroke each year.

What are some of the neurological causes of vision changes or loss?

There are many neurological causes of vision loss or change including stroke, a transient ischemic attack (TIA, also known as a mini-stroke) or multiple sclerosis.

How does vision loss relate to stroke?

Temporary vision loss can be a sign of an impending stroke—it requires immediate medical attention. Or, it can be a symptom of a stroke that's already occurred. 

Vision complications due to a stroke depend on where the stroke occurs. The majority of visual processing occurs in the occipital lobe, in the back of the brain. Most strokes affect one side of the brain. If the right occipital lobe is injured, the left field of vision in each eye may be affected. A stroke that affects the left occipital lobe may disturb the right field of vision in each eye. Rarely, both sides of the brain are affected, but this can result in blindness.

What is a transient ischemic attack (TIA)?

A TIA is a warning sign of a stroke, like chest pain is a warning sign of a heart attack. It means not enough blood got to a part of the brain, and it creates symptoms, but then it resolves on its own.

What is a stroke of the retina?

A stroke of the retina occurs just as strokes occur in other parts of the body—the blood flow is blocked cutting off nutrients and oxygen, in this case, to the eye. Many of these patients have underlying high blood pressure and/or significant carotid artery disease (plaque with narrowing of the artery lining), valvular heart disease (heart valve damage or disease) or diabetes.

How does multiple sclerosis affect vision?

Multiple sclerosis (MS) is an autoimmune disease that targets the brain and central nervous system. Vision problems often are the first symptom of MS, indicating issues within the optic nerve. More than 80 percent of patients with MS will experience eye complications related to the condition including nystagmus (involuntary, rapid eye movement), diplopia (double vision) and optic neuritis (optic nerve inflammation).

Are some individuals more prone to this type of problem?

Yes, vision issues occur more often in people with stroke risk factors like hypertension, diabetes, atrial fibrillation and carotid artery disease as well as those with multiple sclerosis.

What should someone do if they develop a sudden vision problem or loss?

They should call 911 so they can get to the best place for care as soon as possible.

How do you treat the vision changes or loss? 

Treatment for vision changes depends on the cause. The only way to find out what's causing the problem is to go to the ER and have testing done, even if the symptoms have resolved.

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