Seeing every stroke patient

Two out of three stroke survivors have some form of visual impairment, and yet more than half of all stroke units fail to test patients’ sight, new research has found.

With vision loss being such a significant factor in a patient’s quality of life after a stroke, University of Liverpool health researcher, Dr Fiona Rowe, told OT that practitioners working in stroke units are calling out for a tool that would allow non-vision specialists to easily assess stroke survivors’ sight.

"Some are unable to provide consistent screening for visual problems, but there is a recognition of this and the stroke teams do want to screen better," Dr Rowe explained.

Dr Rowe’s research team is currently evaluating a tool that will be able to simply and easily screen for all possible forms of visual impairment in stroke patients.

The assessment tool has been part of a pilot study and is now being assessed in a multi-centre trial, which will be finalised in 2017.

“It does not require training for anyone in the stroke unit to be able to use it, and we hope it will lead to fewer false positives and fewer false negatives,” she highlighted, adding: “We would like to see all stroke survivors assessed with it before discharge.”

Concurrently, a Scottish academic team is also testing out a comparable tool, she said.

Dr Rowe’s researchers have also evaluated current screening methods for stroke patients around the world, but found that none were able to pick up all forms of visual impairment that a post-stroke patient could suffer from, in a review published in The Journal of Disability and Rehabilitation.

With years of experience in the field, Dr Rowe noted that: “We weren’t really surprised that we didn’t find one tool that covered all sorts of visual impairment.”

She emphasised that, even with widespread deployment of an extensive assessment tool like the one her team is developing, optometrists will always be crucial in providing post-stroke patient care.

“Some patients come into hospital and go home very quickly – within 24 to 48 hours. We can’t always get to these patients, and they often turn up in High Street practices. Optometrists have a huge role to play with these patients, especially when there are pre-existing problems,” Dr Rowe emphasised.