Ischemic brain damage along the visual pathways frequently manifest with visual field defects. Most occipital lobe infarcts lead to homonymous hemianopia. Additionally, cognitive problems are often present. Visual field defects caused by occipital lobe infarction are often permanent causing long-term disability in vision and in daily life activities. Patients lose environmental control, give up their activities, have difficulties in reading and watching, lose their driving licence, are prone to accidents, and working-age patients often have to give up their work. Approximately 20–30% of ischemic stroke patients have some degree of visual field defect. Only half of these patients recover, most recovery occurring within 3 months. IV thrombolysis is the only approved acute treatment in ischemic stroke, but most patients having an occipital infarction score low on neurologic scores and do not usually receive thrombolysis. We have recently described that thrombolysis was safe in these patients and was associated with high rates of improvement. Future efforts must concentrate on disseminating thrombolytic therapy in this patient group and developing effective rehabilitation methods for reducing the burden of the disease, but current treatment options are limited.
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