Dad eats the right half of his plate and pushes the rest away. Is that his eyes or is something else going on?

#1Geoffswife(Joined Jan 2025 · 38 posts)July 2, 2026, 7:48 pm

Not about Geoff this time, it's my father in law, so I'm the second-generation carer in this house now and I am running out of jokes about it.

He came home six weeks ago after a stroke on the right side of his brain. Physically he is doing better than anyone expected, walking with a stick, dressing himself mostly. But every single meal he eats the right half of the plate, puts his knife and fork down, and says he's finished. If I turn the plate around he eats the rest quite happily and looks slightly baffled that there was more.

He also has a graze on his left shoulder from door frames and he shaves the left side of his face badly. When I asked whether his eyes were alright he got quite short with me and said there is nothing wrong with his eyesight, he can read the paper fine, thank you.

Is this his vision? He's been to an optician who said his eyes were healthy and sold him new reading glasses, which felt like eighty pounds for nothing. What do I even ask the GP for?

#2keithb57(Joined Oct 2024 · 51 posts)July 3, 2026, 8:05 am

The door frames on one side is the bit that jumped out at me. That was my neighbour after his stroke, exactly the same, and it turned out not to be his eyes at all in the way you'd think.

The optician was right and also useless, if that makes sense. His eyeballs are fine. The problem is further back.

#3Dr Paul HutchinsClinical moderator(Joined Nov 2024 · 64 posts)July 3, 2026, 2:26 pm

Geoffswife said:

If I turn the plate around he eats the rest quite happily and looks slightly baffled that there was more.

That detail you noticed, the plate turning, is close to a textbook description, so trust what you are seeing rather than what the optician measured.

Vision after a stroke can fail at four separate points, and they need different handling. The visual field can be genuinely cut, most often the same half missing in both eyes. The eyes can stop moving in agreement, which gives double vision or blurring. The brain can receive a good image but struggle to interpret it. Or one side of space simply stops being attended to, which is called neglect or visual inattention. An optician's test looks at the eye itself and will pass someone whose problem sits behind it, which is why that eighty pounds bought you a genuine finding and no answer.

The reason the distinction matters is awareness. Someone with a cut visual field usually knows something is missing and learns to turn their head towards it. Someone with neglect has no sense that the left side exists to be looked at, so they are not ignoring you when they say their eyesight is fine, they are reporting their experience accurately. That is also why it responds better to changed environments and practised scanning than to any lens. I have written the four types up properly in vision problems after stroke if you want something to take in with you.

What to ask for: an assessment of his vision as part of his stroke rehabilitation, specifically mentioning visual field and visual inattention, and say the words plate, door frames and shaving, because those observations from home are worth more than a clinic test. An orthoptist or an occupational therapist is usually the person who untangles it. What is actually going on in his case is something only a team who can assess him will settle, and it is worth asking sooner rather than later because of the door frames.

#4Geoffswife(Joined Jan 2025 · 38 posts)July 4, 2026, 7:19 am

Thank you. "You are not ignoring me, you are reporting your experience accurately" is the sentence I needed, because I have been quietly cross with him for weeks and feeling awful about it.

Will ask for the visual inattention assessment by name. He will hate the word inattention. I'll find another way to say it.

#5Moira G.(Joined Mar 2026 · 14 posts)July 6, 2026, 8:52 pm

Say it as "checking which bits of the room his brain is showing him". That's how the OT put it to my husband and he took it fine, whereas anything with the word attention in it sounds like an accusation about effort, and they've all had enough of those.

Small practical thing that helped us: we moved his water glass, his tablets and the remote to his good side permanently. Sounds trivial. Cut out about half the daily friction.

#6mattw_tbi(Joined Jun 2025 · 17 posts)July 9, 2026, 6:33 pm

Coming at this from a different injury but the same problem. After my TBI I lost a chunk of left field and I did know it was missing, which sounds like the easier version and mostly is, but I want to flag the bit nobody warns you about.

Reading was the killer. Not seeing, reading. I'd get to the end of a line and my eye had nothing to run back to, so I'd land two lines down and not notice for a paragraph. A ruler under the line fixed 80% of it. Free, stupid, worked better than anything else in the first year.

Also, the graze on his shoulder will keep happening for a while even after he understands the problem, so put something soft on the corner he hits most. Understanding it and automatically compensating for it are about a year apart.

#7Geoffswife(Joined Jan 2025 · 38 posts)August 18, 2026, 9:41 am

Update, six weeks on. Referred to an orthoptist through the stroke team, who confirmed inattention rather than a field cut, plus some field loss on top, which apparently can happen together and does complicate things.

He has scanning practice to do, we've moved the kitchen around, and there is now a ruler in the newspaper rack because of Matt. He still turns the plate himself half the time and pretends he always meant to.

Two things for anyone reading this later. The optician is not the answer, ask the stroke team. And write down the odd things you notice at home, because our list of five daft domestic observations did more than any question I asked.