Hemianopsia is the loss of half of the visual field. A person with hemianopsia only sees a portion of the visual field from each eye. Hemianopsia is classified by where the missing visual field is located:
Vision loss can be mild to severe.
Hemianopsia is caused by conditions that affect the brain or optic nerves.
The most common causes are:
Other less common causes that have been reported include:
Having a condition that affects the brain or optic nerves puts you at risk for hemianopsia.
Vision problems are the main symptom and may include:
You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor may refer you to a neurologist, a doctor who treats brain conditions. You may also need to see an ophthalmologist, a doctor who specializes in eye care.
Your field of vision will be tested. This can be done with a visual field test that makes a map of your field of vision.
Images may be taken of structures inside your brain. This can be done with an MRI.
Talk with your doctor about the best treatment plan for you. If an underlying condition is found, treatment will be based on that illness.
Your hemianopsia may improve over time, depending on the cause. The likelihood that it will improve depends on the cause, the area of the brain affected, and how badly the optic nerves or other portions of the visual pathways were damaged. Treatment options include the following:
Aids may be used to help increase your visual field. They must be fitted by an eye care professional. Prisms may be attached to glasses. A prism is a clear plastic sheet that fits the lenses of your glasses. You may have a permanent prism mounted into the lens. It shifts the location of an image so that it is within your field of vision. You will be trained on how to use the prism to make up for your visual field defect. Mirrors or inverted telescopes can also be used to increase your visual field.
Reading can be difficult if you have hemianopsia because you may have trouble finding the beginning or end of a word or line of text. You may be taught strategies that will make reading easier.
You may want to use a ruler or sticky note to mark the beginning or end of the text. For example, if you have right homonymous hemianopsia, use a sticky note to mark the end of a line of text. You will know that you have not reached the end of the line until you see the sticky note.
Some people with hemianopsia benefit from turning a text and reading it vertically (up and down), rather than horizontally (side to side).
Other changes can help you deal with hemianopsia in daily life:
American Academy of Ophthalmology
Canadian Ophthalmological Society
Canadian Stroke Network
Goodwin D. Homonymous hemianopia: challenges and solutions. Clin Ophthalmol. 2014; 8: 1919–1927.
Homonymous hemianopia. North American Neuro-Ophthalmology Society. Available at: http://www.nanosweb.org/files/public/Homonymous_hemianopia.pdf. Accessed June 14, 2017.
Kedar S, Zhang X, Lynn MJ. Pediatric homonymous hemianopia. J AAPOS. 2006 Jun;10(3):249-52.
Loss of visual field due to brain injury hemianopsia and neglect. Optometrists Network website. Available at: http://www.braininjuries.org/hemianopsia_field_loss.html. Accessed June 5, 2017.
One-side neglect: improving awareness to speed recovery. American Heart and Stroke Association website. Available at: http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/RegainingIndependence/EmotionalBehavioralChallenges/One-side-Neglect-Improving-Awareness-to-Speed-Recovery_UCM_309735_Article.jsp. Accessed June 5, 2017.
Visual field loss in children. Perkins School for the Blind website. Available at: http://www.perkins.org/assets/downloads/low-vision-clinic/handout-visual-field-loss-child-rev1-31-11.pdf. Accessed June 5, 2017.
What is hemianopia? Lighthouse international website. Available at: http://www.lighthouse.org/about-low-vision-blindness/vision-disorders/hemianopia/. Accessed June 5, 2017.
Last reviewed May 2017 by Michael Woods, MD, FAAP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.