Orthoptic assessment and management of patients with stroke in Scotland

Abstract

Aims: To determine the current assessment and management strategies of orthoptists for patients with visual problems after stroke and to identify barriers to effective orthoptic management and priorities for future research. Methods: A questionnaire was designed to gather information about vision assessments, protocols and treatments during the management of patients with stroke. Information was also collected on barriers experienced and priorities for future research. One orthoptist from each hospital eye department in Scotland was identified, telephoned and sent a questionnaire. Results: We identified 14 orthoptists, covering the whole geographical area of Scotland. The questionnaire response rate was 100%. We collected detailed information on assessments and treatments used in the orthoptic management of patients with stroke. Twelve (86%) orthoptists reported that their unit did not have a protocol or management plan specific to stroke patients. The most commonly reported treatment strategies for patients with eye movement problems were provision of prisms, advice on head posture and convergence exercises. Provision of an explanation or advice was the most common management strategy for patients with visual field problems or visual neglect. The main barriers identified were a lack of a management plan (57%) and lack of funding (36%). Conclusions: We have determined key aspects of the orthoptic management of patients with visual problems after stroke in Scotland. The results of this survey support the need for management plans and protocols specific to patients with stroke, and confirm a number of priorities for future research into the orthoptic management of visual problems after stroke.

Keywords

• Barriers
• Orthoptists
• Priorities
• Stroke
• Vision assessment
• Vision management