Visual Impairment Following Stroke - The Impact on Quality of Life: A Systematic Review

Hepworth, Lauren R.; Rowe, Fiona

doi:10.9734/or/2016/23272

Cited by 33 publications

(42 citation statements)

References 21 publications

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“…Poststroke visual impairment leads to impact on daily life. Studies reporting impact through collated responses from quality of life questionnaires outline the impact including loss of confidence, fear in independent mobility/navigation, inability to drive, inability to read, social isolation and depression (Hepworth & Rowe, ). Responses from patient‐reported outcome measures are directed by the items included in these questionnaires.…”

Section: Introductionmentioning

confidence: 99%

Stroke survivors’ views and experiences on impact of visual impairment

Rowe

2017

Brain and Behavior

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ObjectivesWe sought to determine stroke survivors’ views on impact of stroke‐related visual impairment to quality of life.Materials and MethodsStroke survivors with visual impairment, more than 1 year post stroke onset, were recruited. Semistructured biographical narrative interviews were audio‐recorded and transcribed verbatim. A thematic approach to analysis of the qualitative data was adopted. Transcripts were systematically coded using NVivo10 software.ResultsThirty‐five stroke survivors were interviewed across the UK: 16 females, 19 males; aged 20–75 years at stroke onset. Five qualitative themes emerged: “Formal care,” “Symptoms and self,” “Adaptations,” “Daily life,” and “Information.” Where visual problems existed, they were often not immediately recognized as part of the stroke syndrome and attributed to other causes such as migraine. Many participants did not receive early vision assessment or treatment for their visual problems. Visual problems included visual field loss, double vision, and perceptual problems. Impact of visual problems included loss in confidence, being a burden to others, increased collisions/accidents, and fear of falling. They made many self‐identified adaptations to compensate for visual problems: magnifiers, large print, increased lighting, use of white sticks. There was a consistent lack of support and provision of information about visual problems.ConclusionsPoststroke visual impairment causes considerable impact to daily life which could be substantially improved by simple measures including early formal visual assessment, management and advice on adaptive strategies and self‐management options. Improved education about poststroke visual impairment for the public and clinicians could aid earlier diagnosis of visual impairments.

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Section: Introductionmentioning

confidence: 99%

Stroke survivors’ views and experiences on impact of visual impairment

Rowe

2017

Brain and Behavior

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“…It is important to raise awareness of the field loss and improve awareness to the affected side to help with detection of objects on that side and improve navigation (Jones & Shinton, ; Rowe, ). There can be considerable impact including altered mood, depression, impaired activities of daily living, increased falls, and reduced quality of life (Hepworth & Rowe, ).…”

Section: Discussionmentioning

confidence: 99%

Sight Impairment registration due to stroke—A small yet significant rise?

et al. 2017

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ObjectivesIn the United Kingdom, when an individual's sight falls to and remains at a certain threshold, they may be offered registration as sight impaired. Recent analysis of causes of registrable sight impairment in England/Wales indicated that visual impairment due to stroke had increased as a proportionate cause of sight loss. We aim to assess whether there is evidence of an increase in incidence of certification for sight impairment due to stroke in England/Wales between 2008 and 2014.Materials and MethodsThe number of certifications with a main cause of sight impairment being stroke was obtained from the Certifications Office London. Directly standardized rates per 100,000 were computed with 95% confidence intervals and examined. Poisson regression was used to assess evidence of trend over time.ResultsIn the year ending 31st March 2008, 992 people were newly certified with stroke with an estimated DSR of 2.1 (2.0 to 2.2) per 100,000 persons at risk. In the year ending March 31st 2014, there were 1310 certifications with a DSR of 2.5 (2.4 to 2.7). Figures were higher for men than women. Poisson regression indicated an estimated incidence rate ratio of 1.03 per year with 95% confidence intervals of 1.028 to 1.051, P < .001.ConclusionsThese data suggest a small but statistically significant increase in the incidence of certifiable visual impairment due to stroke between 2008 and 2014. Figures are, however, considerably lower than estimated, perhaps suggesting that more should be done to address the visual needs of those who have suffered stroke.

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“…The point prevalence of visual impairment in stroke survivors has been reported as 72% (Hepworth et al., ; Rowe, Hepworth, Hanna, & Howard, ). Visual impairment as a result of stroke takes different forms across four main categories: visual field loss, ocular motility defects, reduced visual acuity, and visual perception problems (Hepworth et al, ). These impairments have the potential to affect an individual's ability to perform activities of daily living (ADLs), for example, self‐care, mobility, and socializing (Hepworth & Rowe, ).…”

Section: Introductionmentioning

confidence: 99%

“…Visual impairment as a result of stroke takes different forms across four main categories: visual field loss, ocular motility defects, reduced visual acuity, and visual perception problems (Hepworth et al, ). These impairments have the potential to affect an individual's ability to perform activities of daily living (ADLs), for example, self‐care, mobility, and socializing (Hepworth & Rowe, ). An individual with visual impairment may have reduced level of independence.…”

Section: Introductionmentioning

confidence: 99%

Using Delphi methodology in the development of a new patient‐reported outcome measure for stroke survivors with visual impairment

Hepworth

Rowe

2018

Brain and Behavior

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IntroductionThe aim of this study was to ascertain what items stroke survivors and stroke care professionals think are important when assessing quality of life for stroke survivors with visual impairment for inclusion in the new patient‐reported outcome measure.MethodsA reactive Delphi process was used in a three‐round electronic‐based survey. The items presented consisted of 62 items originally sourced from a systematic review of existing vision‐related quality of life instruments and stroke survivor interviews, reduced and refined following a ranking exercise and pilot with stroke survivors with visual impairment. Stakeholders (stroke survivors/clinicians) were invited to take part in the process. A consensus definition of ≥70% was decided a priori. Participants were asked to rank importance on a 9‐point scale and categorize the items by relevance to types of visual impairment following stroke or not relevant. Analysis of consensus, stability, and agreement was conducted.ResultsIn total, 113 participants registered for the Delphi survey of which 47 (41.6%) completed all three rounds. Response rates to the three rounds were 78/113 (69.0%), 61/76 (81.3%), and 49/64 (76.6%), respectively. The participants included orthoptists (45.4%), occupational therapists (44.3%), and stroke survivors (10.3%). Consensus was reached on 56.5% of items in the three‐round process, all for inclusion. A consensus was reached for 83.8% in the categorization of items. The majority (82.6%) of consensus were for relevant to ‘all visual impairment following stroke’; two items were deemed ‘not relevant’.ConclusionThe lack of item reduction achieved by this Delphi process highlights the need for additional methods of item reduction in the development of a new PROM for visual impairment following stroke. These results will be considered alongside Rasch analysis to achieve further item reduction. However, the Delphi survey remains important as it provides clinical and patient insight into each item rather than purely relying on the psychometric data.

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Visual Impairment Following Stroke - The Impact on Quality of Life: A Systematic Review

Cited by 33 publications

References 21 publications

Stroke survivors’ views and experiences on impact of visual impairment

Stroke survivors’ views and experiences on impact of visual impairment

Sight Impairment registration due to stroke—A small yet significant rise?

Using Delphi methodology in the development of a new patient‐reported outcome measure for stroke survivors with visual impairment

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