This is Not an Issue to “Neglect.”

This is Not an Issue to “Neglect.”

With Christina Esposito, O.D., FAAO, FCOVD 


Course Objectives

  • To better understand what is unilateral spatial inattention, what causes it, and review the different types
  • To discuss the different testing options in the clinic to help identify unilateral spatial inattention and differentiate it from a true field loss
  • To discuss treatment options to help the patient become aware of the “neglected” side both in office and at home.


Abstract: A 45-year-old white female presents with a history of two cerebrovascular accidents and having trouble seeing items on her left hand side. After extensive testing, she was found to have unilateral spatial attention. The patient was then enrolled in 4 sessions of vision therapy to perform visual training with yoked prism in an attempt to “break” the patients USI. Following the completion of therapy and with a home therapy regimen, the patient was able to appreciate items on her left hand side and complete the appropriate testing in office.


I.                 Case Presentation

    1. Chief complaint
    2. Exam Data
    3. Videos and Photos


II.               What is Unilateral Spatial Inattention

    1. What causes it?
    2. What are the different types?


III.              Testing for Unilateral Spatial Inattention

    1. Extinction Phenomenon
    2. Clock Dial
    3. Star Cancellation Test
    4. Line Bisection
    5. Davis Scan Test

IV.             Treatment Options

    1. Yoked Prism (How to prescribe)
    2. Vision Therapy Activities

                                                    i.     In-office

                                                   ii.     Home



Dr. Christina Esposito works in Vision Therapy and Rehabilitation at the Midwestern University Eye Institute. She is also an alumna from Midwestern University’s Arizona College of Optometry.

Dr. Esposito graduated from the University of Arizona in 2009 with a Bachelor of Science degree in General Biology. She earned her Doctor of Optometry degree from the Arizona College of Optometry in 2013, and then served as a vision therapy/vision rehabilitation resident at the Southern College of Optometry in Memphis, Tennessee.


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