Age and Ageing Advance Access published online on November 21, 2008
Age and Ageing, doi:10.1093/ageing/afn230
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Visual impairment following stroke: do stroke patients require vision assessment?
1 Directorate of Orthoptics and Vision Science, University of Liverpool, Thompson Yates Building, Brownlow Hill, Liverpool L69 3GB, UK
2 Department of Orthoptics, Royal United Hospitals NHS Trust, Combe Park, Bath BA1 3NG, UK
3 Department of Orthoptics, Sandwell and West Birmingham NHS Trust, City Hospital, Birmingham B18 7QH, UK
4 Department of Orthoptics, East Lancashire Hospitals NHS Trust, Royal Blackburn Hospital, Lancashire, BB2 3HH, UK
5 Department of Orthoptics, Bury PCT, Bury, Lancashire BL9 0EN, UK
6 Department of Orthoptics, Derby Hospitals NHS Foundation Trust, Derby City General Hospital, Derby, Derbyshire, DE22 3NE, UK
7 Department of Orthoptics, Ipswich Hospital NHS Trust, Ipswich, Suffolk IP4 5PD, UK
8 Department of Orthoptics, University Hospitals NHS Trust, Southampton, Hampshire SO16 6YD, UK
9 Department of Orthoptics, Oxford Radcliffe Hospitals NHS Trust, Headley Way Headington, Oxford OX3 9DU, UK
10 Department of Orthoptics, Salford Primary Care Trust, Pendleton Way, Salford M6 5FW, UK
11 Department of Orthoptics, Sheffield Teaching Hospitals Foundation Trust, Glossop Road, Sheffield S10 2JF, UK
12 Department of Orthoptics, Swindon and Marlborough NHS Trust, Marlborough Road, Swindon SN3 6BB, UK
13 Department of Orthoptics, Wrightington, Wigan and Leigh NHS Trust, Wigan Lane, Wigan WN1 2NN, UK
14 Department of Orthoptics, Worcestershire Acute Hospitals NHS Trust, Charles Hasting Way, Worcester WR5 1DD, UK
Address correspondence to: F. Rowe. Tel: (+44) 0151 7945732; Fax: (+44) 0151 7945781. Email: rowef{at}liverpool.ac.uk
Background: the types of visual impairment followings stroke are wide ranging and encompass low vision, eye movement and visual field abnormalities, and visual perceptual difficuilties.
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.
Keywords: visual impairment, stroke, ocular motility, visual field, visual perception, elderly
Received 18 February 2008; accepted in revised form 26 August 2008.
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