Prevalence of visual problems among stroke survivors in Hong Kong Chinese

Background: Stroke, a common cerebrovascular accident, usually results in various extents of functional disability. Extensive studies have shown that ocular and visual problems are common in patients with stroke. Unfortunately, current stroke rehabilitation programs rarely address stroke-related ocular and visual problems in Hong Kong. Methods: To examine how visual impairment (for example, deterioration in visual acuity and restriction in visual field) affects the stroke population in Hong Kong, vision screening was conducted for post-stroke patients attending in-patient and out-patient stroke clinics at two hospitals. Results: One hundred and thirteen stroke patients were recruited. The percentage of various aspects of visual problems in Hong Kong post-stroke patients was generally lower than that reported in Western countries; however, a high percentage of patients had deficits in oculomotor (53.1 per cent) and vergence functions (11.5 per cent), restrictions in binocular visual field (11.5 per cent) and impairment in visual acuity (worse than 0.30logMAR, 29.8 per cent). Conversely, only a small proportion of patients noticed problems with their vision (for example, diplopia and blurry vision) through subjective reports. This revealed that many post-stroke patients had undetected or undiagnosed ocular and visual problems. Appropriate referral was given to patients with visual problems for further evaluation and treatment. Conclusion: Neglecting visual problems may impose deteriorating effect on patients' stroke rehabilitation and functional independence and lead to increased incidents of injury. To address this potential hindrance in rehabilitation, formal screening for visual problems in stroke patients in a rehabilitation setting is essential.