Post-stroke Vision Impairments Warrant Early Specialist Screenings

A stroke is a medical condition which shares many similarities to a heart attack. The blood supply of affected regions in the brain is cut off and cells suffer damage from the lack of nutrients and oxygen.

The damage inflicted during stroke can affect a survivor’s eyesight, speech, movement and even their personality and behaviour. The consequence of stroke damage on the eyesight of survivors has been studied by a group from the University of Liverpool, establishing that the subsequent conditions are extremely varied and common.

The large cohort study included 915 patients who were suspected of having a visual impairment, with 92% having this confirmed. This study follows up on previous work by lead author Dr. Fiona Rowe and her group, with increasing sample sizes leading to this large scale cohort study.

Compulsory Specialist Eye Screens

Worryingly, 16% of patients in this study showed no symptoms of impaired vision, even though many of them were confirmed to have extreme visual impairments when assessed by a visual specialist.

The widespread damage to eyesight caused by stroke, linked with the potential assistance in recovery from an accurate and early diagnosis, led the primary author of this study to suggest that specialist visual screenings should be compulsory in the early recovery days of a stroke.

Loss Of Independence

The wide variety of visual symptoms and impairments included visual field loss, blurred or double vision, uncontrolled eye movement, visual perceptual difficulty and low central vision. Without proper diagnosis and treatment these conditions can affect stroke recovery and quality of life drastically, diminishing the ability to work or perform regular tasks.

The early diagnosis of visual impairments allows for the early implementation of a treatment regime. Although there are multiple types of stroke induced impairments, there are also a range of treatments for these conditions.

These treatments can be tailored to the type of visual impairment, with various surgeries and therapies being available. Although treatment through physical means is not always a viable option for the condition, targeted advice has been shown to be a valuable mode of therapy to aid recovery.

Stroke Burden

Stroke places a burden upon healthcare systems, families and carers. The World Health Organisation estimates that 15 million people have a stroke every year, resulting in 5 million fatalities and 5 million cases of severe disability.

In spite of stroke cases potentially being reduced by better dietary and lifestyle choices, the hard fact is that in our modern society the aftermath of stroke needs to be better understood and dealt with.

Hope For The Future

In this study the median wait for an appointment with a visual specialist was 22 days, mainly because of waiting times for eye clinic appointments. Earlier specialized visual screening on stroke units would increase the potential for improvement drastically.

Medical research into reducing the damaging effects post-stroke could also develop crucial advancements to aid patients. Revolutionary treatments utilizing nanoparticles, gene edited cells and novel biomaterials could lead to the regeneration of damaged brain tissues and subsequent improved outcomes in the future.

Disclaimer: This article presents a summary of work presented from the VIS study. The views expressed are those of this author and not necessarily those of the VIS authors.

Rowe FJ, the VIS writing Group
Vision In Stroke cohort: Profile overview of visual impairment
Brain Behav. 2017;e00771. https://doi.org/10.1002/brb3.771

Author: Geoffrey Potjewyd; Regenerative Medicine & Neuroscience PhD student at the University of Manchester. Image: U.S. Air Force