Screening methods for post-stroke visual impairment: a systematic review

Abstract

There is currently no standardised visual screening tool which can accurately assess all potential post-stroke visual impairments. The current tools screen for only a number of potential stroke-related impairments, which means many visual defects may be missed. The sensitivity of those which screen for all impairments is significantly lowered when patients are unable to report their visual symptoms. Future research is required to develop a tool capable of assessing stroke patients which encompasses all potential visual deficits and can also be easily performed by both the patients and administered by health care professionals in order to ensure all stroke survivors with visual impairment are accurately identified and managed. Implications for Rehabilitation Over 65% of stroke survivors will suffer from a visual impairment, whereas 45% of stroke units do not assess vision. Visual impairment significantly reduces the quality of life, such as being unable to return to work, driving and depression. This review outlines the available screening methods to accurately identify stroke survivors with visual impairments. Identifying visual impairment after stroke can aid general rehabilitation and thus, improve the quality of life for these patients.

Short-Listing the Program Choice for Perimetry in Neurological Conditions (PoPiN) Using Consensus Methods

“…Perimetry programmes should aim to capture this wide range of visual field loss (Keltner et al 2003;Hayreh & Zimmerman 2005;Keltner et al 2010). Stroke may affect any part of the visual pathway from the eye (in ocular stroke with altitudinal visual field defects) through to the occipital cortex with typical retrochiasmal visual field defects of homonymous hemianopia, quadrantanopia and scotomas; peripheral and/or central visual fields may be involved so quire appropriate perimetry programme choice (Rowe et al 2013;Hanna et al 2017). The use of consistent methods of visual field assessment brought about by glaucoma recommendations have streamlined clinical practice (National Institute for for Health and Clinical Excellence 2009).…”

Development of core outcome sets for vision screening and assessment in stroke: a Delphi and consensus study

“…In order to develop a preliminary list of outcomes for a Delphi survey we undertook an overview of seven systematic reviews of studies/trials reporting vision screening, assessment and treatment of post-stroke visual impairment 2 15–20. We extracted 119 outcomes, many of which were variations on test choices for specific visual functions.…”

Non-surgical correction of diplopia after stroke- a strong impact factor on quality of life-minireview

“…Another possible association of diplopia may be the bidirectional horizontal nystagmus due to a posteroinferior cerebellar strokes (15). Unfortunately visual problems after stroke are under estimated in patients with stroke (16) Hanna et al (17) developed a screening tool for visual impairment post stroke.The authors concluded that the existing tools gave incomplete evaluation of visual troubles after stroke (17).Retinal ischemia can accompany diplopia and may act like a prelude for stroke as it stipulates the American Stroke Association guidelines, that is why neuroimaging is recommended immediately to identify a possible concomitant cerebral ischemia (18). There are studies (19) which demonstrates that 18.2% of patients with retinal ischemia developed a recurrent stroke after 1 month follow-up.…”