Tag Archives: vision

Left Neglect vs. Field Cut

It is possible for multiple distinct symptoms of an acquired brain injury to present in remarkably similar fashions.  For instance, a brain-injured survivor’s failure to take medication could be due to a memory deficit leading that survivor to simply forget his or her medication or it could be due to an attention deficit leading the survivor to be too distracted to take the medication in question.  In each case the medication was missed, but for acutely separate reasons.  A similar issue comes to light in observation of post-injury visual deficits.  Did a survivor fail to notice information to his or her left due to left neglect or due to a field cut?

Let’s start off with outlining precisely what a field cut is, as it is the simpler of the two to understand.  Under the effects of a field cut, the survivor has actually permanently lost the ability to perceive a portion of the field of vision.  That area of the field formerly available has now been “cut” away.  Due to his or her injury, the survivor is now in effect partially blind.  In medical terms, this loss of vision is often called “hemianopsia.”  So a survivor contending with a field cut has had actual visual loss  in his or her left visual field and thereby misses seeing information on his or her left side.

Left neglect is an attention issue which often manifests in the visual attention domain.  It is associated with an injury to the right side of the brain.  With left neglect, the brain fails to pay attention to information to the left side of the survivor.  If you ask a survivor with left neglect to turn his or her head all the way to the right, he or she will generally turn until the chin reaches the right shoulder.  However if you ask the same survivor to turn to the left, he or she may only bring the chin half-way to the the left shoulder despite fully understanding the request and giving a best effort to fulfill it.  It is almost as if the survivor’s brain is saying, “the left side of the world does not exist.”  The survivor’s eyesight can be perfectly intact, yet his or her brain is ignoring information generated from the left side.  This ignoring is not voluntary; as far as the survivor is consciously aware, he or she did look all the way to the left even though an outside observer can clearly see that the survivor did not make it all the way over.  Again, though it appears functionally as if the survivor has lost vision, the underlying issue is one of attention.

In the case of a field cut, most survivors do reasonably well after becoming sufficiently aware of their field cuts.  They will after enough practice naturally turn and make that extra effort to look for the information in their blind spots.  For a survivor with left neglect, improvement requires not just awareness but also daily repetition of scanning exercises and consistent use of visual aids.  As example, a survivor with left neglect may practice scanning techniques by slowly looking for information on a piece of paper being sure to start all the way on the left of that page before scanning across.  It can also be helpful to put a brightly colored highlighter mark on the paper to identify the far left of the page.  Sadly, in some cases a survivor will suffer from both left neglect and a field cut.  This combination can of course make successful functioning especially difficult, but with appropriate dedication and determined effort most any such goal gains entrance into the realm of the attainable.

I hope this clarifies the differences between left neglect and a field cut.  Please leave me a comment below with any questions, thoughts or ideas!

Learn about brain injury treatment services at the Transitional Learning Center!  Visit us at: tlcrehab.org

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Harry Carson Is a Survivor

New York Giants Hall of Fame linebacker Harry Carson was one of the most feared football players of his era.  However, behind that tough exterior he was terrified of the symptoms of brain injury which he experienced following many concussions on the playing field.  Harry was eventually able to confront his fears and is now a spokesman for the Brain Injury Association.

In this article from Sports Illustrated, Harry talks about his experiences with brain injury and how he made adjustments to his life in order to better manage his symptoms.  Though the article is almost 15 years old, it’s still just as relevant as a sincere and affecting portrait of the struggles faced by a brain injury survivor.

http://sportsillustrated.cnn.com/vault/article/magazine/MAG1013015

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org

Making Windows Easier

There are a few tricks to making life on a computer easier after a brain injury.  One trick will work on most Windows based computers/programs and helps to remedy problems caused by vision deficits.  To increase the size of items on your computer’s display, simply click the mouse so the cursor is somewhere on the screen and then hold down the Control key while rolling forward the scroll wheel on top of the mouse.  This will allow you to greatly increase the size of items shown on your computer’s monitor.  For instance, I can increase the size of icons on my computer’s desktop from roughly 1 square inch to 4 square inches with this simple method.  To shrink enlarged items, simply follow the above instructions but roll the wheel backwards.  This method works on diverse programs such as Internet Explorer and all Microsoft Office applications but does not cause any kind of damage or permanent changes to work being done in those programs.  I hope this little trick can help you or a loved one make computer use more pleasant if this is a problem that’s been encountered.

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org 

Visual Scanning Skills With I Spy

As I stated in a previous post, many people with brain injuries have visual scanning deficits.  Often this is due to an injury to the right side of the brain.  An easy (and free) way to practice visual scanning skills is through an adaptation of the game I Spy.

The adapted version of I Spy is a very simple game to play.  At least two people are needed to play.  To start, pick a location or room with lots of items to see but which is not so familiar that everyone knows the location of all the items by heart.  One person is the “spy” and has to find an item that is visible to everyone.  The spy then says “I spy with my little eye ____ (the item).”  It is the job of the other players to point to the item to show that they have found it.

When I Spy is used to practice scanning skills after a brain injury, it is important to vary the location of the items that are being “spied.”  For instance, you may first want to “spy” an item on the right side and then an item on the left side.  Varying locations forces a person to scan the entire visual field.  If this game is being played with someone in a wheelchair, make sure that each item can be seen from his or her visual perspective.  Often items that are easy to see when standing are obstructed when sitting.  Also, make sure that the item is big enough to be clearly seen by all the players.  Sometimes a person with a brain injury loses some of their visual acuity due to the effects of the injury and may not be able to clearly see  small items.  If the person playing has left neglect, they will likely need extra help and direction to scan the left side of the visual field.

I Spy is an easy, portable method to practice visual scanning skills while still having fun!

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org