Effect of Eye Patching in Rehabilitation of Hemispatial Neglect

Abstract

Eye patching (EP; monocular or right hemifield) has been proposed to improve visuospatial attention to the ignored field in patients with hemispatial neglect. The aim of this paper is to review the literature on the effects of EP in hemispatial neglect after stroke in order to convey evidence-based recommendations to clinicians in stroke rehabilitation. Thirteen intervention studies were selected from the Medline, EMBASE, Scopus, Cochrane Library, CINAHL, PsychINFO, EBRSR, and Health Star databases. Methodological quality was defined according to the Physiotherapy Evidence Database. Overall, seven studies used monocular EP, five used right hemifield patching, and one compared right monocular with right hemifield patching. Seven studies compared normal viewing to monocular or hemifield patching conditions. Six studies included a period of treatment. As to the monocular EP, four studies reported positive effects of right monocular patching. One study showed an improvement in hemispatial neglect with left monocular patching. Two studies found no superiority of right vs. left monocular patching. One study found no effects of right monocular patching. As to the right hemifield EP, one study showed improvements in neglect after right hemifield patching. Three studies found that right hemifield patching combined with another rehabilitation technique was more effective than that treatment alone. One study found no differences between right hemifield patching combined with another treatment and that treatment alone. One study found the same effect between right hemifield patching alone and another rehabilitation technique. Our results globally tend to support the usefulness of right hemifield EP in clinical practice. In order to define a level of evidence with the standard rehabilitation evidence rating tools, further properly powered randomized controlled trials or meta-analysis are needed.

Studying the neural bases of prism adaptation using fMRI: A technical and design challenge

“…This binocular benefit is greater than what would be predicted on the basis of statistical considerations alone (i.e., probability summation), suggesting that binocular summation reflects neural interaction between the signals from the eyes. Furthermore, monocular occlusion alters spatial perception in neglect patients (Smania, Fonte, Picelli, Gandolfi, & Varalta, 2013;Walker, Young, & Lincoln, 1996) and neurologically healthy participants (Roth, Lora, & Heilman, 2002), and these effects may be different depending on which eye is occluded (Burtis, Williamson, Mishra, & Heilman, 2014;Chen, Erdahl, & Barrett, 2009;Roth et al, 2002). This could impact upon the interpretation of functional results of prism adaptation studies, Table 1 Design requirements for fMRI-compatible prism adaptation and the extent to which these were fulfilled by existing studies particularly when different eyes are used for the sham and prism exposure conditions (as in Chapman et al, 2010, andLuauté et al, 2009).…”

The Effect of the Left-Field Eye Patching on Left Spatial Neglect

“…Smania et al [10] suggested the Sprague effect theory, the interhemispheric balance theory, and the visual exploration constraint theory as a mechanism of the eye patching effect for hemispatial neglect. However, this research was focused on spatial inattention.…”

Neglected-Field Eye Patching Improves Visual Inattention in Hemispatial Neglect: A Case Study

“…Moreover, both positive and negative effects were reported by similar studies. 6,7,11,13) Smania et al 19) suggested three theories for the rationale of eye patching in hemispatial neglect: the Sprague effect theory, the interhemispheric balance theory, and the visual exploration constraint theory. These theories focus on spatial inattention.…”