Ocular–visual defect and visual neglect in stroke patients – A report from Kathmandu, Nepal

Abstract

Purpose: To find out the type of visual defects, ocular defects or visual neglect occurring in patients with stroke. Methods: In this cross-sectional study including 40 subjects diagnosed as stroke, assessment included visual acuity with the Sheridan-Gardner chart, objective and subjective refraction, duction and version eye movement, cover test at distance and near, anterior segment examination with the slit lamp, posterior segment examination after pupil dilatation, color vision test with the Farnsworth D-15 test, diplopia charting, the Hess charting, and visual field examination on Goldmann perimetry. 33 subjects (82.5%) having stroke underwent star cancellation test for visual neglect evaluation. Chi-square test with Yate's correction was performed to evaluate associations between visual neglect and neurological findings. Results: The mean age of the subjects was 52.1 ± 15.7 years with male/female ratio of 0.7. Neurological findings included hemiplegia/hemiparesis in 84.8%, ischemic stroke in 80%, left hemisphere involvement in 60%, and cortical area involvement in 65%. Ocular finding included extraocular muscle palsy in 17.5%, exotropia in 12.5%, and ptosis in 7.5%. Co-morbid ocular findings such as cataract, retinopathy, and age-related macular degeneration were also reported. Visual neglect was present in 54.5% subjects predominantly affecting the left side. Conclusion: This study reports the relationship between ocular–visual disorders and stroke. There should be a formal screening for visual problems in stroke patients in hospital and rehabilitation settings.

Keywords

• Stroke
• Visual defects
• Ocular defects
• Visual neglect