Vision at the UK Stroke Forum 2015

Excitingly there's a session on management of visual impairment following stroke at the UKSF this year. The exciting thing is the emphasis on management - is it finally being accepted that there really is something that can be done about stroke-related visual impairment?!

The UKSF is in Liverpool this year, December 1st-3rd.
The vision session is on Wed 2nd December in Room 4, details as follows:

11.45 – 13.00
Room 4
Parallel session 1D

Management of visual impairment following stroke
Chair: Claire Howard (British and Irish Orthoptic Society Lead for Stroke and Neuro Rehab) 

1 - Management of visual field loss following stroke – including research results from VISION trial Dr Fiona Rowe (Reader in Orthoptics and Health Services Research / NIHR Fellow, University of Liverpool)

2 - Management and advice for visual perception difficulties following stroke including visual hallucinations Carmel Noonan (Consultant Ophthalmologist, Aintree University Hospitals)

3 - Management of eye movement problems following stroke Caroline Dodridge (Stroke Specialist Othoptist, Oxford University Hospital)

Getting Stroke Survivors the Sight Loss Support they Need - NB Live 2014

This video shows Fiona Rowe, Research Lead for the British and Irish Orthoptic Society at NB Live 2014, a conference organised by the Royal National Institute for Blind People (RNIB)

Dr Rowe is a tireless researcher and campaigner for people with vision problems after stroke.

She asserts:

1. We need to better identify stroke survivors with visual impairment

2. Information for stroke survivors with vision problems exists and needs to be more widely used

3. There is a care pathway for stroke survivors with vision loss

4. There are free rehabilitation resources for stroke survivors with vision problems

5. Good practice post-stroke vision care exists around the country [UK]

The page on the RNIB's web site devoted to Fiona Rowe's talk can be reach following the link below:

RNIB - Getting Stroke Survivors the Sight Loss Support they Need

Collision avoidance devices for the visually impaired

SMART GLASSES TO ENHANCE VISION
Researchers at Oxford University, UK, have developed "Residual Vision Glasses" (RVGs) or "Smart Glasses" to help people with vision impairment avoid obstacles and see the world more clearly.

Led by Dr Stephen Hicks, the most recent work using these glasses was published in this abstract presented as a poster at the Association for Research in Vision and Ophthalmology (ARVO)

The movie below is a news article describing and showing the glasses. More information is available at www.assisted-vision.com.

A WEARABLE DEVICE FOR OBSTACLE AVOIDANCE
Massachusetts Eye and Ear are developing a different device to help people with vision impairment avoid collisions.  You wear it on your clothes and it beeps when you're in danger of walking into something. They've done a pilot study in people with tunnel vision and hemianopia, presented as this abstract at Association for Research in Vision and Ophthalmology (ARVO).

Here's a man using the device to walk through some inflatable palm trees!

Help with employment and visual impairment for employers and employees (UK)

Visual impairment such as hemianopia can cause difficulties at work, both for employees and also employers.  But don't worry, help is at hand!

For employees:

If you have difficulties because of your visual impairment (or any other disability) then you have protection in law from the Equality Act if you're having problems.  For example employers need to make reasonable adjustments to help you in your work (see this link: Reasonable Adjustments - Equality and Human Rights Commission).  Many people with hemianopia can be registered partially sighted by an ophthalmologist, which may help.  See this link: RNIB - registering your sight loss

For employers:

If you're an employer the RNIB has put together some advice to help you navigate the difficulties you might come across.  See this link: RNIB advice to employers - employing visually impaired people



(The RNIB is a charity, so do consider donating: follow this link - they have nothing to do with this blog by the way, and I'm not getting any money for suggesting you donate)

Free Online Therapy for Stroke-Related Visual Loss (again)

Now and again I put up a post about online vision training, designed for stroke but potentially beneficial for other brain-related causes of vision loss. I've done this more than once because it's such an easy way of trying to improve your vision and it doesn't cost anything. Evidence for its effectiveness is limited but studies do seem to show it helps.  Why not give it a go?

The Stroke Association describes these methods on >THIS PAGE<.

A brief article by >Dr ALEX LEFF< which outlines these and other visual rehab methods can be found >HERE<.  He developed the online visual rehab methods described at University College London.

I should declare that I've been awarded The Stroke Association Thompson Family Senior Clinical Lectureship and know Alex Leff, so have a potential conflict of interest here, but the therapies are free and I don't have any direct relationship with the research group or the therapies.

VISION MODULE for STROKE NURSES and ALLIED HEALTH PROFESSIONALS

Are you a nurse or allied health professional working with stroke survivors?  Make sure you know about visual problems, how to recognise them, and what sort of problems they can cause.  Those are the first steps towards giving them the care they deserve.

STARS (Stroke awareness Training And Resources) has been created by NHS Education for Scotland to improve knowledge about stroke.  They have a module on "Vision after Stroke".  To take a look, follow THIS LINK.

Todd Rose: Myth of the Average - Variability Matters

I saw this and thought it was well worth sharing.  It talks about educational theory, but the argument works just as well for rehabilitation.

EyeSearch paper published

Results of a study using the free web-based therapy EyeSearch (www.eyesearch.ucl.ac.uk) have recently been published in the journal "Annals of Clinical and Translational Neurology", a bit of an obscure journal admittedly.  The researchers found that the method improved the time taken to find objects on a visual search task.


Participants were self-screened online and those with neglect were excluded.  Hemianopia was demonstrated using an online visual field test designed by the researchers.

The results are made more convincing by the fact that patients reported improvements on some activities in their daily lives but not others.  Those that improved were those that perhaps involve more visual search: shopping, collision avoidance and finding things.

The paper can be found by following this link.

The graph below shows how search time reduced over time (3 time points) during the study:

The graph below shows how patient-reported tasks improved over time (3 time points as above).  Those in red improved, those in blue didn't:


The "proof-of-principle" paper that initially tested the "Ramp-Step" method of visual search training was published in Cortex in 2013.  Follow this link to the paper (abstract free, login required for full text).