Visual field deficit (VFD) is one of the most commonly observed symptoms following brain injury. Persistent VFD and defective exploratory oculomotor scanning patterns often cause severe impairment in daily activities, particularly as regards visual exploration and reading. Homonymous hemianopia is consequently a powerful negative predictor of patient outcome. In spite of these quantitative and qualitative factors, there currently exists no consensus on rehabilitative therapy and treatment. Different approaches have nevertheless been developed, all of them having one therapeutic principle in common; repeated practice of a specific visual task, with the hope/expectation that improved performance will extend to a wide range of ecologically useful visual functions. The four main available methods aim at replacing part of the intact visual field with part of the damaged visual field (optical therapy using prisms), at partially restoring the lost visual field region (restorative therapies), at stimulating detection capacities in the blind field (stimulation or blindsight) or at substituting for the lost region by reorganizing the control of visual information processing and eye movements (compensatory therapies). This review explores the key data relative to these different approaches in terms of behavioral or imagery results. It also aims at critically analyzing the advantages and limits of each one. The importance of strict assessment in terms of deficiencies or disabilities is underlined. Finally, upon consideration of these data taken as a whole, it is suggested that efficient treatment would probably have to associate general components and more specific elements, according to what may be done with regard to other aspects of cognitive rehabilitation.

Saccades allow us to visually explore our environment. Like other goal-directed movements, their accuracy is permanently controlled by adaptation mechanisms that, in the laboratory, can be induced by systematic displacement of the "real" visual target during the saccade. However, in an anti-saccade (AS) task, the target is "virtual" because gaze has to be shifted away from the "real" visual target toward its mentally defined mirror position. Here, we investigated whether the brain can adapt movements aimed at a virtual target by trying, for the first time, to adapt AS. Healthy human volunteers produced leftward AS during three different exposure phases in which a visual target provided feedback after the AS. In the adaptation condition, the feedback target appeared after completion of the AS response at a location shifted outward from final eye position (immediate non-veridical feedback). In the two control conditions, adaptation was prevented by delaying (800 ms) the shifted feedback target (delayed-shift) or by providing an immediate but veridical feedback at the mirror position of the visual target (no-shift). Results revealed a significant increase of AS gain only in the adaptation condition. Moreover, testing pro-saccades (PS) before and after exposure revealed a significant increase of leftward PS gain in the adaptation condition. This transfer of adaptation supports the hypotheses of a motor level of AS adaptation and of a visual level of AS vector inversion. Together with data from the literature, these results also provide new insights into adaptation and planning mechanisms for AS and for other subtypes of voluntary saccades.