Learning About Eye Movement Problems After a Stroke
A stroke can affect how your eyes move or how your eyelids work. This may include:
- Strabismus (crossed eye): one eye may turn in a different direction.
- Eye movement problems: trouble looking left, right, up, or down.
- Nystagmus: eyes may shake or move without control.
- Eyelid problems: an eyelid may droop or not close properly.
If you have any of these problems, you may notice double vision, blurry vision, trouble judging distance, shaky or wobbly vision, or feeling dizzy or off balance.
It is important to see an eye doctor within 1 month after your stroke to examine your eyes. To see an optometrist, you can book an appointment yourself or be referred. If you need to see an ophthalmologist (a medical eye doctor) or their orthoptist, your doctor can refer you.
Strabismus (crossed eye)
Strabismus is a condition where the eyes are misaligned (crossed) and do not focus in the same direction at the same time. If you have strabismus, you might notice:
- double vision (seeing 2 of the same thing)
- trouble seeing in 3D (depth perception)
- double vision can be worse when looking in certain directions
Eye movement problems
Eye movement problems after a stroke may include:
- Nerve palsy: A stroke can damage the nerves that control your eye muscles. This can make one eye turn in, out, up, or down. It often causes double vision.
- Gaze palsy: Both eyes can’t move in the same direction (like both eyes may not be able to look to the right).
- Scanning and tracking eye movement difficulties.
Nystagmus
Nystagmus is when your eyes shake or move without control. This can happen in any direction you look. If you have nystagmus, you may feel like your surroundings are moving. This can make it harder to see clearly and may affect your balance.
Eyelid problems
A stroke can affect how your eyelids work. You may notice:
- Droopy eyelid (ptosis): One eyelid may be lower than normal. This often occurs with double vision.
- Incomplete eyelid closure: Using eye drops or eye gel, especially at night, can help keep your eye moist and comfortable.
Management and recovery
Everyone recovers differently after a stroke. Some people may fully recover from eye movement problems, while others continue to have symptoms. It may take 3 to 6 months, and sometimes up to a year, for double vision to get better.
Ways to manage double vision:
- Eye patch or tape: Covering 1 eye or 1 side of your glasses can help reduce double vision. This is a quick and easy solution, especially in the first month after your stroke.
- Prisms: If double vision continues, you may need a Fresnel prism. It is a thin, flexible piece of plastic that sticks to your glasses and helps your eyes work together. If your double vision does not go away, you may need new glasses with the prism built into the lens. These glasses are more comfortable and give clearer vision than the plastic prism.
- Eye muscle surgery: If double vision does not improve over time, surgery may be an option.
To see this information online and learn more, visit MyHealth.Alberta.ca/health/aftercareinformation/pages/conditions.aspx?hwid=custom.ab_eye_movement_stroke_inst.
Related to eye movement problems after stroke:
For 24/7 nurse advice and general health information call Health Link at 811.
Current as of: March 19, 2026
Author: Provincial EyeSee After Stroke Working Group, Acute Care Alberta
This material is not a substitute for the advice of a qualified health professional. This material is intended for general information only and is provided on an "as is", "where is" basis. Although reasonable efforts were made to confirm the accuracy of the information, Alberta Health Services does not make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness, applicability or fitness for a particular purpose of such information. Alberta Health Services expressly disclaims all liability for the use of these materials, and for any claims, actions, demands or suits arising from such use.
