Vision problems post-stroke: how eye exercises & acupuncture can help you recover

Updated: 3 days ago


People often think of a stroke as having a profound effect on a victim’s motor functions. But did you know that

as many as 60% of stroke victims experience vision impairments as a result of a stroke ?


Fortunately, like motor function, eye injuries can also improve following a stroke. With the help of specific eye-training exercises and acupuncture, you can rewire your brain to help improve your eye functions.


Acupuncture is recommended by the World Health Organization (WHO) as an alternative and complementary strategy for stroke treatment and for improving stroke care.

Post stroke visual impairments


There are four main types of eye problems that can occur after stroke. Each type of eye issue warrants a different treatment, since each affects the brain in different ways. After a stroke, you might also become more sensitive to light, and develop dry eye syndrome.


Sudden central vision loss: a sign of high emergency

A sudden loss of central vision is due to a type of stroke affecting the retina, the light sensitive area of nerves at the back of the eye. This is called a retinal vessel occlusion. It happens when there is a blockage in one of the blood vessels to your eye.

You may be aware of some brief periods of sight loss before having permanent vision loss.

It is possible to treat a blockage in a retinal artery if you are seen at a hospital within four hours.


However, the retina is very sensitive to loss of blood supply, and it may not be possible to avoid permanent sight loss. If you notice any sudden loss of vision, you should visit your local hospital emergency department straight away.


Visual field loss


When the vision areas of your brain responsible for vision have been damaged by the stroke, it can impact your ability to see. The location of visual field loss depends on where the stroke occurred in your brain.

The most common type is homonymous hemianopia, which means losing the left or right visual field of both eyes. Often people think that the vision in one eye has been affected, but it is actually one side of the visual field of both eyes.


Eye movement problems


If the nerve control to your eye muscles is affected, one of your eyes may not move correctly. This may cause you to

  • have blurred vision or double vision (diplopia). This is sometimes called a squint or strabismus.

  • be unable to move both eyes together

  • have eyes that move constantly or wobble




Visual processing problems


The commonest type of visual processing problem is visual neglect, which means that you are unaware of your surroundings to one side.


Neglect is more common in people who have had a stroke on the right side of the brain, which affects their awareness of the left side.


Acupuncture and Chinese medicine for stroke recovery


Acupuncture is a WHO recognized modality for stroke recovery

There are 5 major different mechanisms involved in the beneficial effects of acupuncture/EA on ischemic stroke rehabilitation:

(1) Promotion of neurogenesis and cell proliferation in the central nervous system

(2) Regulation of cerebral blood flow in the ischemic (stroke) area

(3) Anti-apoptosis in the ischemic area

(4) Regulation of neurochemicals

(5) Improvement of impaired long-term potentiation (LTP) and memory after stroke.


Herbal remedies


Many Chinese herbs are being studied for sequelae of strokes. They are believed to help thanks to their anti-inflammatory and antioxidant properties. They help cause vasodilation, increase cerebral blood flow velocity, inhibit platelet aggregation, protect against reperfusion injury, and increase tissue tolerance to hypoxia.[9]


In a study, the two patent medications ShuXueTong and BuchangNaoxintong were found most likely to improve stroke recovery in patients without acupuncture. Additionally, Mailuoning, Xuesaitong, Buchang Naoxintong were the patented Chinese herbal medicines most likely to improve stroke recovery when combined with acupuncture.


Eye movement therapy


Therapies focusing on eye movement help train a patient’s eyes to move within his or her new visual scope, therefore making it easier for the patient to read and scan objects within his or her visual field. This type of therapy can also help strengthen and train the eye muscles for increased eye movement control.

Other therapies

  • Optical therapy. This therapy uses mirrors and prisms to help position images in a way that the patient will be able to see them in his or her line of sight. Prisms can also help correct double vision, depth perception, and other visual impairments from stroke.


  • Eye movement therapy. Therapies focusing on eye movement help train a patient’s eyes to move within his or her new visual scope, therefore making it easier for the patient to read and scan objects within his or her visual field. This type of therapy can also help strengthen and train the eye muscles for increased eye movement control.


  • Visual restoration therapy (VRT). VRT uses lights to stimulate blind spots in a patient’s visual field. Blinking or moving lights can help spark the neurons in the brain that were damaged by a stroke.


  • Visual scanning training This encourages you to look to your left and right sides in a systematic way. It is commonly used to help you be more aware of your visual field loss, and reminds you to look into your blind side. Eyesearch and Readright are free online therapies designed to improve the speed and accuracy of eye scanning and reading


Talk to your acupuncturist to ask for help in stroke recovery !


References


[1] https://www.stroke.org.uk/sites/default/files/visual_problems_after_stroke.pdf


Han, Shi-You et al. “Therapeutic effect of Chinese herbal medicines for post stroke recovery: A traditional and network meta-analysis.” Medicine vol. 96,49 (2017): e8830. doi:10.1097/MD.0000000000008830


3.

Xu G , Zhao W , Zhou Z et al.

Danshen extracts decrease blood C reactive protein and prevent ischemic stroke recurrence: a controlled pilot study.

Phytother Res.2009; 23: 1721-1725


Chavez, Lina M et al. “Mechanisms of Acupuncture Therapy in Ischemic Stroke Rehabilitation: A Literature Review of Basic Studies.” International journal of molecular sciences vol. 18,11 2270. 28 Oct. 2017, doi:10.3390/ijms18112270


Zhao J.G., Cao C.H., Liu C.Z., Han B.J., Zhang J., Li Z.G., Yu T., Wang X.H., Zhao H., Xu Z.H. Effect of acupuncture treatment on spastic states of stroke patients. J. Neurol. Sci. 2009;276:143–147. doi: 10.1016/j.jns.2008.09.018.


Wu P., Mills E., Moher D., Seely D. Acupuncture in poststroke rehabilitation: A systematic review and meta-analysis of randomized trials. Stroke. 2010;41:e171–e179. doi: 10.1161/STROKEAHA.109.573576.