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BioMed Research International
Volume 2013 (2013), Article ID 719096, 12 pages
http://dx.doi.org/10.1155/2013/719096
Research Article

A Prospective Profile of Visual Field Loss following Stroke: Prevalence, Type, Rehabilitation, and Outcome

1Department of Health Services Research, Whelan Building, University of Liverpool, Brownlow Hill, Liverpool L69 3GB, UK
2Altnagelvin Hospitals HHS Trust, Altnagelvin BT47 6SB, UK
3NHS Ayrshire and Arran, Ayr KA6 6DX, UK
4Royal United Hospitals Bath NHS Trust, Bath BA1 3NG, UK
5Fairfield Hospital, Bury BL9 7TD, UK
6Durham and Darlington Hospitals NHS Foundation Trust, Durham DH1 5TW, UK
7Ipswich Hospital NHS Trust, Ipswich IP4 5PD, UK
8Gloucestershire Hospitals NHS Foundation Trust, Gloucester GL1 3NN, UK
9St Helier General Hospital, Jersey JE1 3QS, UK
10University Hospital NHS Trust, Nottingham BG7 2UH, UK
11Oxford Radcliffe Hospitals NHS Trust, Oxford OX3 9DU, UK
12Salford Royal NHS Foundation Trust, Salford M6 8HD, UK
13Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK
14Swindon and Marlborough NHS Trust, Swindon SN3 6BB, UK
15Wrightington, Wigan and Leigh NHS Trust, Wigan WN1 2NN, UK
16Worcestershire Acute Hospitals NHS Trust, Worcester WR5 1DD, UK

Received 23 April 2013; Revised 23 June 2013; Accepted 22 July 2013

Academic Editor: Alberto Raggi

Copyright © 2013 Fiona J. Rowe et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aims. To profile site of stroke/cerebrovascular accident, type and extent of field loss, treatment options, and outcome. Methods. Prospective multicentre cohort trial. Standardised referral and investigation protocol of visual parameters. Results. 915 patients were recruited with a mean age of 69 years (SD 14). 479 patients (52%) had visual field loss. 51 patients (10%) had no visual symptoms. Almost half of symptomatic patients ( ) complained only of visual field loss: almost half ( ) also had reading difficulty, blurred vision, diplopia, and perceptual difficulties. 31% ( ) had visual field loss as their only visual impairment: 69% ( ) had low vision, eye movement deficits, or visual perceptual difficulties. Occipital and parietal lobe strokes most commonly caused visual field loss. Treatment options included visual search training, visual awareness, typoscopes, substitutive prisms, low vision aids, refraction, and occlusive patches. At followup 15 patients (7.5%) had full recovery, 78 (39%) had improvement, and 104 (52%) had no recovery. Two patients (1%) had further decline of visual field. Patients with visual field loss had lower quality of life scores than stroke patients without visual impairment. Conclusions. Stroke survivors with visual field loss require assessment to accurately define type and extent of loss, diagnose coexistent visual impairments, and offer targeted treatment.