


Vision & Balance
Are closely interconnected aspects of our sensory and motor systems, and they play a crucial role in maintaining stability and coordinating movements. Various conditions, environments and situations can impact both vision and balance. Some common deficits related to vision and balance include motor coordination, ataxia, central vertigo, diplopia, visual pursuit, saccadic eye movement and visual inattention.
Vision
Our team can assist with helping patients complete eye range of motion exercises and learn compensatory strategies for specific vision deficits, such as scanning the environment more deliberately or using head movements to expand the visual field. We do not provide vision therapy programs as these are led by neuro-ophthalmologists, ophthalmologists or optometrists. Here are some common vision symptoms related to a stroke or brain injury:
Visual Field Loss (Hemianopsia): A loss of half of the visual field in one or both eyes. For example, if the right visual field is affected, individuals may not see objects on their right side.
Visual Processing Issues (Visual Inattention): A condition where individuals may ignore or be unaware of stimuli on one side. This is not due to a vision problem but rather a lack of attention to that side.
Blurred/Double Vision(Diplopia): Damage to the nerves or muscles controlling eye movement can lead to double vision.
Reduced Visual Acuity(Amblyopia): Also known as "lazy eye," amblyopia can result in reduced visual acuity.
Eye Movement Disorders (Nystagmus): Involuntary, rapid eye movements that can affect vision.
Light Sensitivity (Photophobia): Increased sensitivity to light, which can cause severe headaches.

Balance
Balance deficits are common after a stroke and brain injury due to the disruption of brain areas responsible for coordinating movement and maintaining stability. These deficits can significantly impact the ability to stand, walk, and perform daily activities safely. The severity and specific nature of balance impairments vary among individuals. Here are some common balance symptoms related to a stroke or brain injury:
Central Vertigo: A sensation of spinning or dizziness, that originates from a problem in the brainstem or cerebellum which is responsible for balance and spatial orientation, resulting in vertigo. Unlike peripheral vertigo, which arises from issues in the inner ear, such as benign paroxysmal positional vertigo (BPPV) or vestibular neuritis, central vertigo is less common but often more serious.
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Postural Instability: Difficulty maintaining an upright posture, leading to a higher risk of falls.
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Impaired Weight-Shifting: Difficulty shifting body weight from one side to another, affecting the ability to step or turn.
Reduced Trunk Control: Weakness or lack of coordination in the muscles supporting the trunk can compromise balance.
Altered Gait: Changes in the walking pattern, such as uneven steps, shuffling, or dragging a foot.
Difficulty with Turning: Challenges with making turns or changing direction while walking.
Loss of Coordination: Impaired coordination between the upper and lower limbs, affecting overall stability.

Fall prevention education to patients and their caregivers about fall prevention strategies, such as proper footwear, home safety measures, and awareness of environmental hazards may be beneficial. Individuals who have experienced a stroke or brain injury should work closely with a healthcare team, including occupational therapists, physical therapists and rehabilitation specialists, to address balance and vision deficits.