Hemianopia vs visual neglect: aphasia

Hemianopia vs visual neglect

*Hemianopia* 1. Retino-optic deficit 2. Affects seeing areas of visual field 3. Patients eventually show awareness of the visual loss 4. Patients learn to compensate *Visual Neglect* 1. A spatial attentional deficit 2. Affects looking and searching 3. Patients show unawareness of the deficit 4. Paitents have difficult compensatingu ho

List visual neglect treatment

1. Verbal cueing 2. Visual and tactile cues 3. Anchors 4. Environmental manipulation 5. Left-side searching tasks (A. cancellation tasks B. Manipulation of stimuli dimensions C. Right-left alternation tasks D. Edgeness and bookness tasks) 6. Lighthouse strategy

Hemianopia definition

A visuosensory deficit resulting from an interuption of the visual pathways (optic tract) that send visual sensation to the visual cortex Images are not getting back to the occipital lobe

Visual neglect Definition

An attention deficit where patients fail to respond to information presented on the side opposite of their brain lesion There is not damage at a point but the patients are not attending to the visual information

Research on visual neglect shows

At the subconcois level, patients with visual neglect can see their left visual field, but have difficulty attending to the left side stimuli if cue them to look left will see it

Right-left alternation tasks

Do one task on the left then alternate and do it on the right Ex: folding dish towels on their right and stacking them on the left

Cancellation task

Draw a line through each item on the paper Easier- with boarder around task Difficult- different objects "x" "o" only need to cross out "x"

Visual and tactile cues

For reading- heavy red line on left margin. Pt cued to start reading only when see red line

Environment manipulation

Items in patients environment (phone, self care object) can gradually be moved from right side placement to left side

Left and right hemisphere analogy

Left hemisphere lets you see the trees, tells you what to say Right hemisphere- lets you see the forest, tells you how or where to say it

Lighthouse strategy

Patient imagine themselves as a lighthouse and their eyes are the light scanning the horizon Item placed in visual field, pt cued to scan visual field for the item After working with items on the table, move to items in the room Pt can be asked to find and physically go to the items a lot of cueing in the beginning fade as they progress

Anchors

Placements of large letters or numbers to left and right of a printed sentence A I came here from Europe with him. A

Verbal cueing

SLP can give repeated verbal cues to increase attention to the left

Bookness

Sit next to client Start right, move left to increase difficulty Need: big book Open book have them feel all around it Turn page have them point to some pics on the right, then maybe some on the left, then mostly on the left

Manipulation of stimuli dimensions

if asymmetrical would need to see the rest to identify what it is Ex: anchor angled-- to determine its anchor and not scissors need to see the other side Father apart letter more difficult than closer Sentences- if seems like full sentence on right side, wont search the left for the rest of the sentence

Patients with visual neglect can show

impulse visual searching and respond far too quickly to questions about things in their visual field

Edgeness

need: tray with border Sit next to patient. Right side would make it easier when first teaching. Go to left if drawing too much attention to the right side Have them take their hand and follow edges o the boarder Place 3 chess pieces on tray and have them point them out (pt forced to explore the left side) Start with large items then to make it difficult go to smaller and smaller items