Significant visual improvement with vision rehabilitation delayed three decades from disease onset

PURPOSE: This is a report of an adult patient showing improvement in visual function from rehabilitation for longstanding homonymous hemianopsia. We present his medical history and visual function testing pre- and post-therapy, demonstrating an improvement in both subjective and objective measures. OBSERVATIONS: A 40-year-old male with history of a ruptured arteriovenous malformation at age 10 years, treated with embolization therapy, was referred to the neuro-ophthalmology clinic for evaluation of right homonymous hemianopsia noted on Humphrey visual field (HVF) testing. At the most recent neuro-ophthalmology exam, the HVF showed a right homonymous hemianopsia with a mean deviation of −11.92 decibels (dB) in the right eye (OD) and −17.97 dB in the left eye (OS). He was referred to visual rehabilitation and showed marked improvement in visual functioning after a standard course of therapy. CONCLUSIONS AND IMPORTANCE: The efficacy of visual therapy is demonstrated in the literature. Notably lacking from the literature is a consideration of whether vision rehabilitation is similarly effective in patients that present distantly from the original insult. This case presents the potential for efficacy of visual rehabilitation even decades after the original insult.