Dr Claire Howard

Research looks for answer to vision difficulties

More than two thirds of stroke survivors suffer vision problems – but it’s a symptom that isn’t always picked up and one that can leave patients struggling to adapt.

Although awareness of stroke and the need for fast treatment has increased in recent years, it’s often not recognised that for some patients sudden changes of vision may be the only symptom of stroke.

That might mean they seek treatment from an optician a few days later – too late for the ‘gold standard’ treatment of thrombolysis, clot-busting drugs given within four hours of the stroke.

Salford Royal is a specialist Comprehensive Stroke Centre with its own stroke specialist orthoptist, so that Salford patients who come here after stroke are offered specialist assessment and rehabilitation for their vision at an early stage.

Around half of those with vision problems following a stroke will make a recovery but for those who don’t, some will adapt well to coping with their problems and others won’t.

Stroke specialist orthoptist Claire Howard has been awarded a National Institute for Health Research (NIHR) Clinical Doctorate Fellowship to investigate how patients adapt to loss of visual field after stroke and why some adapt better than others.

She explained: “It’s an under-researched area and we simply don’t know why some people adapt quickly and others are still struggling and bumping into things a year later – the problems don’t seem to match age or severity of stroke, for instance.

“This can be very distressing for patients and have a major effect on their lives. They might recover well otherwise but if they have hemianopia (diminished or lost vision in the vision field) they won’t be able to drive and can struggle with other everyday tasks.”

Mrs Howard’s research, sponsored by the University of Liverpool, will involve about 200 stroke patients from the region admitted to Salford Royal for stroke treatment over the next two years. As well as the standard assessments, they will be given extra tests to check how they are adapting, have their eye movements formally measured with a special device and be given paper-based scanning exercises to carry out at home.

These exercises, which aren’t yet routinely available, have been shown to help improve patients’ visual searching.

She added: “We find that patients are very bothered by the impact of visual problems so we hope that this research will improve our knowledge of their experience and give us more information on how we can help them.”