Visual neglect after stroke: what it is and exercises that help

Neglect is a problem of attention, not eyesight — and building the habit of looking to the neglected side can make daily life safer.

What is visual neglect?

After a stroke — most often to the right side of the brain — some people stop paying attention to one side of the world, usually the left, even though their eyes work perfectly well. This is hemispatial (visual) neglect. It can show up as eating food from only one side of the plate, bumping into door frames on one side, not noticing people who approach from that side, or reading and drawing only half of things.

How it differs from hemianopia

Hemianopia is a loss of part of the visual field — the picture doesn’t reach the brain. Neglect is different: the vision is intact, but the brain doesn’t attend to that side. Some people have both. Telling them apart matters because the strategies overlap but aren’t identical — which is why an assessment is worthwhile.

The idea behind the exercises

Because the neglected side is under-attended rather than unseen, the aim is to build a deliberate, cued habit of turning attention there. With practice, actively “checking the left” can become more automatic.

Exercises you can try at home

Check with your rehabilitation team first — these are general techniques, not a personalised plan.

1. Anchor the neglected side

Place a bright marker (a coloured strip or sticky note) at the edge of the neglected side of a page or tray. Train yourself to find that anchor first, every time, before starting.

2. Scan and search

Practise finding named objects on a busy table or page, consciously sweeping all the way to the neglected edge. Say out loud what you find on that side to reinforce it.

3. Describe the whole scene

Pause at a doorway or in a room and deliberately describe what’s on the neglected side. Turning it into a verbal routine strengthens the habit.

When to get help

Neglect is best assessed by a stroke team, occupational therapist or neuropsychologist, who can gauge its severity and its impact on safety, including driving. Ask your GP or rehabilitation team for referral, and seek urgent advice for any sudden new symptoms.

Common questions

Is visual neglect the same as hemianopia?

No. Hemianopia is loss of part of the visual field; neglect is a failure to attend to one side even though vision is intact. Some people have both.

Does visual neglect get better?

It often improves, especially in the first months, and structured attention strategies can help. Recovery varies from person to person.

What can carers do?

Gentle, consistent prompts to “check” the neglected side during everyday activities — eating, dressing, walking — are among the most helpful supports.

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