Quadrantanopia after stroke: what it is and how to work around it

Losing a quarter of your field of view has the same practical answer as losing a half: train your eyes to scan into the missing area.

What is quadrantanopia?

Quadrantanopia is the loss of one quarter of the visual field — for example an upper or lower quarter on one side — usually the same quarter in both eyes (homonymous). It happens when a stroke or injury damages part of the visual pathway in the brain. As with hemianopia, the eyes themselves work; part of the picture no longer reaches the brain.

How it differs from hemianopia

Hemianopia is loss of a half of the field; quadrantanopia is loss of a quarter. Which quarter is affected depends on where the injury is: damage in the temporal lobe tends to affect an upper quarter, and damage in the parietal lobe a lower quarter. A lower-field loss in particular can make steps, kerbs and obstacles on the ground easier to miss.

The same idea helps: compensatory scanning

Because a quarter of the field is missing rather than half, the practical approach is the same as for hemianopia — building the habit of scanning deliberately into the affected corner so you take in more of what is there. You are not restoring the lost quarter; you are getting better at working around it.

Exercises you can try at home

Check with your rehabilitation team first — these are general techniques.

1. Scan toward the affected corner

Before you reach, read or step, make a deliberate sweep of your eyes toward the missing quarter. For a lower loss, glance down and across before moving.

2. Visual search

Find named objects on a busy table or page, consciously checking the affected corner each time.

3. Anchored reading

If the loss affects reading, use a finger or ruler to keep your place and return to the start of each line.

When to get help

An orthoptist or neuro-optometrist can map exactly which quarter is affected and recommend strategies or aids. Ask your GP or stroke team for referral, get urgent advice for any sudden new vision change, and check the rules on driving with a field loss.

Common questions

Is quadrantanopia less serious than hemianopia?

It affects a smaller part of the field (a quarter rather than a half), but it can still affect reading, mobility and safety — and the same scanning strategies help.

Can the lost quarter of vision be restored?

Some natural recovery can happen early on; later, the reliable approach is compensation — scanning training — rather than trying to restore the field itself.

Does it affect driving?

A visual field loss can affect driving eligibility. Check the rules with the relevant authority and your eye-care professional before driving.

This guide is general information, not medical advice, and does not diagnose or treat any condition. Always follow the guidance of your own care team. Stroke Sight and ReWrite are wellness support tools, not medical devices.