Visual impairment following stroke: do stroke patients require vision assessment?
BACKGROUND
the types of visual impairment followings stroke are wide ranging and encompass low vision, eye movement and visual field abnormalities, and visual perceptual difficulties.


OBJECTIVE
the purpose of this paper is to present a 1-year data set and identify the types of visual impairment occurring following stroke and their prevalence.


METHODS
a multi-centre prospective observation study was undertaken in 14 acute trust hospitals. Stroke survivors with a suspected visual difficulty were recruited. Standardised screening/referral and investigation forms were employed to document data on visual impairment specifically assessment of visual acuity, ocular pathology, eye alignment and movement, visual perception (including inattention) and visual field defects.


RESULTS
three hundred and twenty-three patients were recruited with a mean age of 69 years [standard deviation (SD) 15]. Sixty-eight per cent had eye alignment/movement impairment, 49% had visual field impairment, 26.5% had low vision and 20.5% had perceptual difficulties.


CONCLUSIONS
of patients referred with a suspected visual difficulty, only 8% had normal vision status confirmed on examination. Ninety-two per cent had visual impairment of some form confirmed which is considerably higher than previous publications and probably relates to the prospective, standardised investigation offered by specialist orthoptists. However, under-ascertainment of visual problems cannot be ruled out.
Rowe
Fiona
F
Directorate of Orthoptics and Vision Science, University of Liverpool, Thompson Yates Building, Brownlow Hill, Liverpool L69 3GB, UK. rowef@liverpool.ac.uk
Brand
Darren
D
Jackson
Carole A
CA
Price
Alison
A
Walker
Linda
L
Harrison
Shirley
S
Eccleston
Carla
C
Scott
Claire
C
Akerman
Nicola
N
Dodridge
Caroline
C
Howard
Claire
C
Shipman
Tracey
T
Sperring
Una
U
MacDiarmid
Sonia
S
Freeman
Cicely
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015835:Ocular Motility Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D020521:Stroke / Q000453:epidemiology*; D014787:Vision Tests; D015354:Vision, Low / Q000175:diagnosis* / Q000453:epidemiology*; D014794:Visual Fields; D014796:Visual Perception; D055815:Young Adult