Imagine standing in a room and not realizing an entire half of it exists. You’re trying to reach for a glass on the table, but your hand only moves toward one side. Or you’re dressing yourself, and without noticing, you forget to put your arm through one sleeve. For many stroke survivors, this isn’t just frustrating—it’s their everyday reality. The culprit? A condition called spatial neglect, and it’s far more common—and overlooked—than most people realize.
What Exactly Is Spatial Neglect?
Spatial neglect is a neurological condition that affects a person’s ability to perceive and respond to one side of space—typically the left—following a stroke or brain injury. It’s not due to vision problems or physical weakness, although it often occurs alongside those. Instead, it’s a disconnect in the brain’s spatial awareness system. The brain literally stops attending to part of the world.
The condition is especially prevalent in individuals who have suffered a right-brain stroke, since the right hemisphere controls much of our visual-spatial functioning. In fact, nearly half of all stroke survivors experience spatial neglect in the early recovery phase.
But here’s the real shocker: more than half of these cases go undiagnosed and untreated. That means hundreds of thousands of people are struggling with basic mobility and self-care—yet many caregivers and clinicians mistake their symptoms for apathy, depression, or simple motor impairment.
Everyday Challenges with Spatial Neglect
To those with spatial neglect, the world looks normal. They feel as if they’re moving straight or interacting normally. But from the outside, their behavior seems puzzling.
They may:
- Consistently veer or turn to one side when walking or maneuvering a wheelchair.
- Eat only half of their plate, unaware of the other side.
- Miss half of their medication, having only seen or reached one side of the pillbox.
- Ignore conversations or people on their neglected side.
- Sit with a pronounced lean—sometimes dangerously unbalanced—without realizing it.
Most heartbreaking, these individuals often aren’t aware of their condition, and may even resist help. Their brain’s internal “alarm system” that detects mistakes is impaired, so they believe they’re navigating the world just fine—even when they’re not.
Why It Happens: The Brain’s Spatial Maps
Spatial neglect stems from damage to brain networks responsible for mapping our surroundings and guiding movement. Think of these networks as your internal GPS. When damaged, the system can’t properly coordinate visual input with motor response.
For example, when a healthy person points to a sign, their brain calculates direction and distance seamlessly. But in someone with spatial neglect, that movement may be skewed—pointing too far to the right, even when they intend to aim straight ahead.
This misalignment doesn’t just make everyday tasks harder; it can lead to falls, injuries, and even setbacks in rehabilitation when the person attempts to move, stand, or walk without accurate spatial orientation.
Treatment Breakthrough: Optical Prism Therapy
Now for the good news: spatial neglect is treatable—and the solution is surprisingly simple and affordable.
Enter prism adaptation therapy, a non-invasive treatment using basic optical tools. Patients wear prism goggles that shift their visual field slightly. While wearing them, they engage in repetitive pointing or alignment tasks, such as touching a dot on a table or marking the center of a line.
Over 10 short sessions (20 minutes each), the therapy essentially retrains the brain to adjust for the neglected side. The process helps realign the brain’s spatial map and restores more balanced movement and perception.
Research shows that even a single session can yield measurable improvement in left-side movement. Over the full course, many patients regain enough awareness and control to resume basic self-care and mobility tasks.
Better yet, this approach is supported by the American Heart Association and American Stroke Association, and it has been used successfully for more than 15 years.
Why Prism Therapy Stands Out
Compared to other treatments for spatial neglect—which may require dozens of intensive sessions and highly trained professionals—prism therapy is refreshingly accessible. It uses off-the-shelf tools, is easy to administer, and doesn’t require costly equipment or complicated procedures.
This makes it a game-changer for reaching the estimated 350,000+ Americans living with spatial neglect long-term—and possibly many more who remain undiagnosed.
Where to Find Help
If you suspect a loved one is dealing with spatial neglect, don’t wait. Ask your healthcare team—including neurologists, rehabilitation specialists, speech and occupational therapists, or low-vision optometrists—whether they offer evidence-based treatments for spatial neglect, particularly prism adaptation therapy.
Our research team is currently engaged in a large, nationwide study funded by the Veterans Administration to better identify which patients benefit most from this approach. The goal? Bring this transformative therapy to as many stroke survivors as possible.
A Holistic Perspective on Healing
In the spirit of holistic care, it’s important to remember that spatial neglect is more than a medical diagnosis. It impacts independence, dignity, relationships, and daily life in subtle but profound ways. And when treated effectively, the recovery can be just as life-changing.
As more clinicians embrace neuroplasticity and integrative rehabilitation, we move closer to a future where every stroke survivor gets the personalized, brain-based care they deserve.
Awareness is the first step. Treatment is the next. Healing is possible.
