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.
Aims. To profile site of stroke/cerebrovascular accident, type and extent of field loss, treatment options, and outcome. Methods. Prospective multicentre cohort trial. Standardised referral and investigation protocol of visual parameters. Results. 915 patients were recruited with a mean age of 69 years (SD 14). 479 patients (52%) had visual field loss. 51 patients (10%) had no visual symptoms. Almost half of symptomatic patients (n = 226) complained only of visual field loss: almost half (n = 226) also had reading difficulty, blurred vision, diplopia, and perceptual difficulties. 31% (n = 151) had visual field loss as their only visual impairment: 69% (n = 328) had low vision, eye movement deficits, or visual perceptual difficulties. Occipital and parietal lobe strokes most commonly caused visual field loss. Treatment options included visual search training, visual awareness, typoscopes, substitutive prisms, low vision aids, refraction, and occlusive patches. At followup 15 patients (7.5%) had full recovery, 78 (39%) had improvement, and 104 (52%) had no recovery. Two patients (1%) had further decline of visual field. Patients with visual field loss had lower quality of life scores than stroke patients without visual impairment. Conclusions. Stroke survivors with visual field loss require assessment to accurately define type and extent of loss, diagnose coexistent visual impairments, and offer targeted treatment.
The visual function of 35 patients with a diagnosis of idiopathic intracranial hypertension was assessed prospectively over a 3 year period. In assessing the visual function of cases of idiopathic intracranial hypertension a number of tests were employed including visual field assessment with Humphrey and Goldmann perimeters and documentation of visual acuity and contrast sensitivity. Loss of visual function is the only serious complication and may occur early or late in the course of the condition. An appropriate and sensitive clinical assessment regime is therefore of importance in the outpatient situation. Visual field assessment was documented as the most sensitive to detection of visual loss, with statistically greater sensitivity in comparison with visual acuity and contrast sensitivity testing. Detection of asymptomatic visual loss indicates the necessity for visual monitoring to ensure detection of insidious visual loss. The types of visual field defects noted in this study were typical of anterior optic nerve pathology of raised intracranial pressure and commonly included arcuate defects, nasal steps and global constriction. Visual loss was noted at presentation and during follow-up in up to 87% of patients using Goldmann perimetry and up to 82% of patients using Humphrey perimetry. The visual status improved significantly throughout the follow-up period and the final visual outcome was excellent or good in 83% of patients.
Background Visual problems are an under-reported sequela following stroke. The aim of this study is to report annual incidence and point prevalence of visual problems in an acute adult stroke population and to explore feasibility of early timing of visual assessment. Methods and findings Multi-centre acute stroke unit, prospective, epidemiology study (1 st July 2014 to 30 th June 2015). Orthoptists reviewed all patients with assessment of visual acuity, visual fields, ocular alignment, ocular motility, visual inattention and visual perception. 1033 patients underwent visual screening at a median of 3 days (IQR 2) and full visual assessment at a median of 4 days (IQR 7) after the incident stroke: 52% men, 48% women, mean age 73 years and 87% ischaemic strokes. Excluding pre-existent eye problems, the incidence of new onset visual sequelae was 48% for all stroke admissions and 60% in stroke survivors. Three quarters 752/1033 (73%) had visual problems (point prevalence): 56% with impaired central vision, 40% eye movement abnormalities, 28% visual field loss, 27% visual inattention, 5% visual perceptual disorders. 281/1033 (27%) had normal eye exams. Conclusions Incidence and point prevalence of visual problems in acute stroke is alarmingly high, affecting over half the survivors. For most, visual screening and full visual assessment was achieved within about 5 days of stroke onset. Crucial information can thus be provided on visual status and its functional significance to the stroke team, patients and carers, enabling early intervention.
A n estimated 20% to 57% of people have visual field defects after stroke, affecting function, quality of life, ability to participate in rehabilitation, depression, anxiety, and social isolation. There are many interventions for visual field defects, which are proposed to work by either restoring the visual field (restitution); compensating for the visual field defect by changing behavior or activity (compensation); or substituting for the visual field defect by using a device or extraneous modification (substitution). ObjectivesThe objective of this review was to determine the effects of interventions for people with visual field defects after stroke.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.