Care provision for poststroke visual impairment.
BACKGROUND
We sought to explore the care provision for poststroke visual impairment and variations in this in the United Kingdom.


METHODS
Survey questions were developed and piloted with clinicians, academics, and users. Questions addressed types of visual problems; how these were identified, treated, and followed up; care pathways in use; links with other professions; and referral options. The survey was accessed via a Weblink, which was circulated through UK professional organizations to multiprofessional members of ophthalmic and stroke teams.


RESULTS
A total of 548 completed electronic surveys were obtained. In all, 49.5% of respondents represented stroke teams, 42.5% eye teams, and 8% from other teams, for example, emergency care. Many respondents (41%) saw patients within 1 week of stroke. Nineteen percent did not personally test vision: 11% had a visiting clinician to test vision, and 22% used screening tools. Validated tests were used for the assessment of visual acuity (39.5%), visual field (57.5%), eye movement (48.5%), and visual function (58.5%). Visual problems suspected by family or professionals were high (88.5%). Typical overall follow-up period of vision care was less than 3 months. In all, 46% of respondents used designated care pathways for stroke survivors with visual problems; 33.5% of respondents did not provide visual information leaflets.


CONCLUSIONS
Significant inequality exists in care for stroke survivors who experience visual problems. There is great variability in how vision screening is undertaken, which vision tests are used, methods of referral to eye care services, how visual problems are managed, and what vision information is provided to stroke survivors/carers. Further work is required to ensure equality and effective care.
Department of Health Services Research, University of Liverpool, Liverpool. Electronic address: rowef@liverpool.ac.uk.
Fiona J
FJ
Rowe
Department of Stroke Rehabilitation, University of Nottingham, Nottingham.
Marion
M
Walker
Speakability North West, London.
Janet
J
Rockliffe
Nursing, Midwifery and AHP Research Unit, Glasgow Caledonian University, Glasgow.
Alex
A
Pollock
Department of Ophthalmology, Aintree University Hospital NHS Foundation Trust, Liverpool.
Carmel
C
Noonan
Department of Orthoptics, Salford Royal NHS Foundation Trust, Manchester.
Claire
C
Howard
GfK NOP Social Research, London.
Richard
R
Glendinning
GfK NOP Social Research, London.
Rachel
R
Feechan
Different Strokes (London South East), Milton Keynes, United Kingdom.
Jim
J
Currie
D019538:Health Care Surveys; D006801:Humans; D020521:Stroke / Q000150:complications*; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D014787:Vision Tests; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology
Visual impairment; care provision; professional; stroke; survey; unmet need