One in four patients reported a vision problem on follow-up after cerebral infarction. Vision problems after cerebral infarction reduce quality of life and are associated with increased disability. Thorough diagnostic evaluation and targeted rehabilitation is important.

Objectives The aim of this study was to detect visual field defects (VFDs) after occipital infarction, investigate the rate of recovery and the impact of VFD upon vision‐related quality of life (QoL). Materials and methods Multicenter, prospective study including patients with MRI verified acute occipital infarction (NOR‐OCCIP project). Ophthalmological examination including perimetry was performed within 2 weeks and after 6 months. Vision‐related QoL was assessed by the National Eye Institute Visual Function Questionnaire 25 (VFQ‐25) at one and 6 months post‐stroke. Results We included 76 patients, reliable perimetry results were obtained in 66 patients (87%) at a median of 8 days after admittance and VFD were found in 52 cases (79%). Evaluation of VFD after 6 months revealed improvement in 52%. Patients with VFD had significantly lower composite score in VFQ‐25 at both test points (77 vs 96, P = .001 and 87 vs 97, P = .009), in nine out of eleven subscales of VFQ‐25 at 1 month and seven subscales after 6 months, including mental health, dependency, near and distance activities. Milder VFD had better results on VFQ‐25 modified composite score (95 vs 74, P = .002).VFD improvement was related to improved VFQ‐25 modified composite score (9.6 vs 0.8, P = .018). About 10% of patients with VFD reported driving 1 month post‐stroke and 38% after 6 months. Conclusion VFD substantially reduces multiple aspects of vision‐related QoL. Severity of VFD is related to QoL and VFD improvement results in better QoL. Neglecting visual impairment after stroke may result in deterioration of rehabilitation efforts. Driving post‐stroke deserves particular attention.