Visual impairment in stroke patients – a review

Approximately 30% of all stroke patients suffer from post‐stroke visual impairment. Hemianopia is the most common symptom, but also neglect, diplopia, reduced visual acuity, ptosis, anisocoria, and nystagmus are frequent. Partial or complete recovery of visual disorders can occur, but many patients suffer permanent disability. This disability is often less evident than impairment of motor and speech functions, but is negatively correlated with rehabilitation outcome and can lead to a significant reduction in day‐to‐day functioning. To be visually impaired after stroke reduces quality of life and causes social isolation because of difficulties in navigating/orientating in the surroundings. A thorough diagnosis including targeted examination and later follow‐up with eye examination and perimetry is essential in order to establish the extent of the visual impairment and to select the best rehabilitation strategy. Patients seem to profit from visual rehabilitation focused on coping strategies.

[1]  U. Shahani,et al.  Interventions for age-related visual problems in patients with stroke. , 2012, The Cochrane database of systematic reviews.

[2]  A P Leff,et al.  Impaired reading in patients with right hemianopia , 2000, Annals of neurology.

[3]  H. Næss,et al.  Diagnosis and Rehabilitation of Visual Field Defects in Stroke Patients: A Retrospective Audit , 2012, Cerebrovascular Diseases Extra.

[4]  Sabel Ba Editorial: Residual vision and plasticity after visual system damage. , 1999 .

[5]  A. Johansen,et al.  Screening for visual impairment in older people: validation of the Cardiff Acuity Test. , 2003, Archives of gerontology and geriatrics.

[6]  B. Sabel,et al.  Restoration of vision by training of residual functions , 2000, Current opinion in ophthalmology.

[7]  H. Mallot,et al.  Assessment of vision-related quality of life in patients with homonymous visual field defects , 2007, Graefe's Archive for Clinical and Experimental Ophthalmology.

[8]  K. Muir,et al.  Prevalence, Predictors and Prognosis of Post-Stroke Hyperglycaemia in Acute Stroke Trials: Individual Patient Data Pooled Analysis from the Virtual International Stroke Trials Archive (VISTA) , 2011, Cerebrovascular Diseases Extra.

[9]  B. Sabel,et al.  Vision- and health-related quality of life before and after vision restoration training in cerebrally damaged patients. , 2008, Restorative neurology and neuroscience.

[10]  B A Sabel Editorial: Residual vision and plasticity after visual system damage. , 1999, Restorative neurology and neuroscience.

[11]  M. S. Fowler,et al.  Squints and diplopia seen after brain damage , 2004, Journal of Neurology.

[12]  G. Kerkhoff,et al.  Neurovisual rehabilitation: recent developments and future directions , 2000, American journal of ophthalmology.

[13]  R. Yee,et al.  The vertical field border in hemianopia and its significance for fixation and reading. , 1998, Investigative ophthalmology & visual science.

[14]  T. Köse,et al.  Recovery of visual-field defects after occipital lobe infarction: a perimetric study , 2010, Journal of Neurology, Neurosurgery & Psychiatry.

[15]  J. Attia,et al.  Access and participation in the community: a prospective qualitative study of driving post-stroke , 2012, Disability and rehabilitation.

[16]  A. Lotery,et al.  Correctable visual impairment in stroke rehabilitation patients. , 2000, Age and ageing.

[17]  Scott Whyte,et al.  Perimetric homonymous visual field loss post-stroke , 2007, Journal of Clinical Neuroscience.

[18]  F. Rowe The profile of strabismus in stroke survivors , 2010, Eye.

[19]  P. F. D. de Bruin,et al.  Obstructive sleep apnea and biomarkers of inflammation in ischemic stroke , 2012, Acta neurologica Scandinavica.

[20]  M. Kaste,et al.  Intravenous thrombolysis in ischemic stroke patients with isolated homonymous hemianopia , 2012, Acta neurologica Scandinavica.

[21]  A. Ferreras,et al.  International vision requirements for driver licensing and disability pensions: using a milestone approach in characterization of progressive eye disease , 2010, Clinical ophthalmology.

[22]  T. Gaber Rehabilitation of cortical blindness secondary to stroke. , 2010, NeuroRehabilitation.

[23]  R. Shinton,et al.  Improving outcome in stroke patients with visual problems. , 2006, Age and ageing.

[24]  G McGwin,et al.  Visual risk factors for driving difficulty among older drivers. , 2000, Accident; analysis and prevention.

[25]  Cynthia Owsley,et al.  Vision, attention, and self-reported driving behaviors in community-dwelling stroke survivors. , 2002, Archives of physical medicine and rehabilitation.

[26]  Jon Currie,et al.  Homonymous Visual Field Defects and Stroke in an Older Population , 2002, Stroke.

[27]  E. Brodtkorb,et al.  Visual field defects in patients taking vigabatrin. , 2000, Acta ophthalmologica Scandinavica.

[28]  J. Cohen-Mansfield,et al.  The Relationship between Low Vision and Performance of Activities of Daily Living in Nursing Home Residents , 1992, Journal of the American Geriatrics Society.

[29]  K. Ciuffreda,et al.  The frequency of occurrence, types, and characteristics of visual field defects in acquired brain injury: a retrospective analysis. , 2008, Optometry.

[30]  U. Shahani,et al.  Interventions for Visual Field Defects in Patients With Stroke , 2012, Stroke.

[31]  V. Hachinski,et al.  CT assessment of conjugate eye deviation in acute stroke , 2004, Neurology.

[32]  S. Trauzettel-Klosinski,et al.  Eye movements in reading with hemianopic field defects: the significance of clinical parameters , 1998, Graefe's Archive for Clinical and Experimental Ophthalmology.

[33]  N. Newman,et al.  Natural history of homonymous hemianopia , 2006, Neurology.

[34]  K. And,et al.  Patterns of Recovery from Homonymous Hemianopia Subsequent to Infarction in the Distribution of the Posterior Cerebral Artery , 1991 .

[35]  Birgitta Messing,et al.  Follow-up of visual field defects with vascular damage of the geniculostriate visual pathway , 1987 .

[36]  U. Shahani,et al.  Interventions for disorders of eye movement in patients with stroke. , 2011, The Cochrane database of systematic reviews.

[37]  P. Myint,et al.  Management of acute stroke. , 2006, British journal of hospital medicine.

[38]  S. Trauzettel-Klosinski Current methods of visual rehabilitation. , 2011, Deutsches Arzteblatt international.

[39]  B. Sabel,et al.  Beeinträchtigung der seh- und gesundheitsbezogenen Lebensqualität bei Schlaganfallpatienten mit homonymen Gesichtsfelddefekten in Abhängigkeit von der Schwere des visuellen Funktionsverlustes , 2009, Klinische Monatsblatter fur Augenheilkunde.

[40]  A. Sunderland,et al.  The natural history of visual neglect after stroke. Indications from two methods of assessment. , 1987, International disability studies.

[41]  C. Kennard,et al.  Can visual function be restored in patients with homonymous hemianopia? , 1997, The British journal of ophthalmology.

[42]  Hélène Corriveau,et al.  Evaluation of postural stability in the elderly with stroke. , 2004, Archives of physical medicine and rehabilitation.