title: Vision problems in ischaemic stroke patients: effects on life quality and disability.
abstract: OBJECTIVE
  Vision problems after cerebral infarction are an increasingly acknowledged problem. Our aim was to investigate the effect on quality of life and post-stroke disability.
  
  
  METHODS
  Patients admitted to the Stroke Unit, Department of Neurology, Haukeland University Hospital, between February 2006 and July 2008 with acute cerebral infarction were prospectively registered in the NORSTROKE Registry. Patients received a postal questionnaire at least 6 months after stroke. The questionnaire included 15D©, EuroQol 5D (EQ-5D(™) ), the Hospital Anxiety and Depression Scale (HADS), the Fatigue Severity Scale (FSS) and the Barthel Index (BI).
  
  
  RESULTS
  Of 328 responders, 83 (25.4%) reported a vision problem. Vision problems were associated with older age (71.8 years vs. 66.5 years, P = 0.001), higher National Institutes of Health Stroke Scale score on admission (5.9 vs. 3.8, P < 0.001), higher modified Rankin Scale day 7 (2.0 vs. 1.4, P < 0.001) and lower BI day 7 (85.7 vs. 93.9, P = 0.002). Patients with vision problems had lower median EQ-5D utility score (0.62 vs. 0.80, P < 0.001), lower median 15D utility score (0.73 vs. 0.89, P < 0.001), higher median HADS score (12 vs. 5, P < 0.001), higher median FSS score (5.6 vs. 4.3, P < 0.001) and lower median BI (95 vs. 100, P < 0.001) on long-term follow-up. Patients with self-reported vision problems scored lower on all sub-scores of BI on follow-up (all P < 0.001).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Clinical Medicine, University of Bergen, Bergen, Norway.
authors.forename: K M
authors.initials: KM
authors.lastname: Sand
authors.affiliation: Department of Special Needs Education, Bergen University College, Bergen, Norway.
authors.forename: G
authors.initials: G
authors.lastname: Wilhelmsen
authors.affiliation: Department of Neurology, Haukeland University Hospital, Bergen, Norway.|Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway.
authors.forename: H
authors.initials: H
authors.lastname: Naess
authors.affiliation: Institute of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: A
authors.initials: A
authors.lastname: Midelfart
authors.affiliation: Department of Clinical Medicine, University of Bergen, Bergen, Norway.|Department of Neurology, Haukeland University Hospital, Bergen, Norway.
authors.forename: L
authors.initials: L
authors.lastname: Thomassen
authors.affiliation: Department of Neurology, Haukeland University Hospital, Bergen, Norway.
authors.forename: J M
authors.initials: JM
authors.lastname: Hoff
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications* / Q000453:epidemiology; D002544:Cerebral Infarction / Q000150:complications / Q000453:epidemiology; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011788:Quality of Life; D012042:Registries / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000453:epidemiology; D014481:United States; D014786:Vision Disorders / Q000453:epidemiology / Q000209:etiology*
keywords: cerebral infarction; homonymous hemianopia; post-stroke function; post-stroke quality of life; vision problem; visual field defect; visual rehabilitation