Treatment for post stroke visual impairment – clinical practice versus literature evidence
Reviewed by Claire Howard

The aim of this paper is to compare the treatments reported in a large scale stroke study (Vision in stroke (VIS) Study) against the treatments identified in a full systematic literature review. The purpose was to identify which treatment / rehabilitation options for post stroke visual impairment have an evidence base, and which are being used in clinical practice, without formal supporting evidence. During the systematic review of the literature, treatments were identified for visual field, visual neglect, visual perception and ocular motility disorders. A total of 44 articles were included in the review. During the VIS study, 840 stroke survivors were confirmed as having visual impairment, across 20 recruiting sites in the UK. All recruited patients received treatment or advice, with interventions consisting of verbal or written advice (99%), refraction (39.3%), prisms (12%), typoscopes (8.9%), occlusion (7.8%) and low vision aids (3.8%). Many of the orthoptic treatment options offered matched those identified through the review of literature, with the exception of visual restorative therapy which is not available within the UK NHS. Visual scanning therapies for hemianopia and neglect have an established evidence base. However, a number of options such as typoscopes and advice options have limited detail of their effectiveness and require further research.

Clinical versus evidence-based rehabilitation options for post-stroke visual impairment.
Hanna KL, Rowe FJ.
NEURO-OPHTHALMOLOGY
2017;41(6):297-305.