Visual Perceptual Deficit Screening in Stroke Survivors: Evaluation of Current Practice in the United Kingdom and Republic of Ireland
Colwell MJ., Demeyere N., Vancleef K.
PURPOSEVisual perceptual deficits are frequently underdiagnosed in stroke survivors compared to sensory vision deficits or visual neglect. To better understand this imparity, we evaluated current practice for screening post-stroke visual perceptual deficits.METHODSWe conducted a survey targeted at stroke clinicians involved in screening visual perceptual deficits across the United Kingdom and Republic of Ireland.RESULTSForty orthoptists and 174 occupational therapists responded to the survey. Visual perceptual deficit screening was primarily conducted by occupational therapists (94%), with approximately 75-100% of stroke survivors screened per month. Respondents lacked consensus on whether several common post-stroke visual deficits were perceptual or not. During screening, respondents primarily relied on self-reports and observation (94%), while assessment batteries (58%) and screening tools were underutilised (56%) and selected inappropriately (66%). Respondents reported lack of training in visual perception screening (20%) and physical/cognitive condition of stroke survivors (19%) as extremely challenging during screening.CONCLUSIONSVisual perceptual deficits are screened post-stroke at a similar rate to sensory vision or visual neglect. Underdiagnosis of visual perceptual deficits may stem from both reliance on subjective and non-standardised screening approaches, and conflicting definitions of visual perception held among clinicians. We recommend increased training provision and brief performance-based screening tools.