The prevalence of visual problems in stroke patients and the effectiveness of the current screening tool used

Abstract

Aim: To identify the types and prevalence of visual problems in a small series of acute stroke patients and identify the effectiveness of the existing screening tool used by occupational therapists (OTs) at the Royal London Hospital. Strategies will be suggested for improving this screening process and for aiding rehabilitation. Methods: A prospective study is presented comprising a small series of patients referred to the acute stroke unit at the Royal London Hospital with a confirmed diagnosis of stroke. On admission to the ward, all patients underwent an OT screen for visual problems prior to a full orthoptic assessment that included visual fields to confrontation and assessment of visual inattention/neglect. This was performed without the benefit of the OT screen findings to prevent bias. A comparison was made between orthoptic and OT findings to determine the effectiveness of the existing screening tool. Results: Twenty-eight patients were recruited with a mean age of 67 years (range 39-89 years). Orthoptic assessment revealed reduced visual acuity (<0.300 logMAR) in 43% of patients, with most stroke survivors demonstrating good binocular function (94%) and a full range of ocular motility (57%). No patient had visual inattention and 7% were found to have visual field defects. In 68% of stroke survivors the findings of the OT and the orthoptist were comparable. Conclusions: The OT screening tool was found to be effective in this study. Ways to improve the detection of visual deficits in acute stroke patients are discussed.