Annals of Indian Academy of Neurology
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Eye signs in stroke

1 Department of Neurology, Christian Medical College and Hospital, Ludhiana, Punjab, India
2 Department of Neurology, St. Stephen's Hospital, Delhi, India
3 Department of Neurological Sciences, Neurology Unit, Vellore, Tamil Nadu, India
4 Ophthalmology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India

Correspondence Address:
Jeyaraj D Pandian,
Principal (Dean) and Professor of Neurology, Christian Medical College, Ludhiana - 141 008, Punjab
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aian.aian_157_22

A large part of the central nervous system is involved in the normal functioning of the vision, and hence vision can be affected in a stroke patient. Transient visual symptoms can likewise be a harbinger of stroke and prompt rapid evaluation for the prevention of recurrent stroke. A carotid artery disease can manifest as transient monocular visual loss (TMVL), central retinal artery occlusion (CRAO), anterior ischemic optic neuropathy or ocular ischemic syndrome (OIS). Stroke posterior to the optic chiasm can cause sectoranopias, quadrantanopias, or hemianopias, which can be either congruous or incongruous. Any stroke involving the dorsal stream (occipito-parietal lobe), or ventral stream (occipito-temporal lobe) can manifest with visuospatial perception deficits. Similarly, different ocular motility abnormalities can result from a stroke affecting the cerebrum, cerebellum, or brainstem. Among these deficits, vision and perception disorders are more difficult to overcome. Clinical, experimental, and neuroimaging studies have helped us to understand the anatomical basis, physiological dysfunction, and the underlying mechanisms of these neuro-ophthalmic signs.

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