Poster 28: Comparison of hemi-field fresnel prisms versus patching for visual neglect after stroke1

Abstract Objective: To assess the effect of bilateral hemi-field prisms versus patches for treatment of visual neglect after stroke. Design: Randomized, prospective, controlled trial. Setting: Inpatient stroke unit. Participants: 38 patients with stroke, visual neglect defined by the Behavioral Inattention Test (BIT), and visual acuity ≥20/200. Interventions: The prism group received 15 diopter Fresnel prisms over the affected hemi-field bilaterally; patch group received black tape of the unaffected visual hemi-field bilaterally; controls received no visual intervention. The interventions lasted 14 days. Main Outcome Measures: 3 subtests of BIT were recorded at baseline and on days 2, 7, 14, and 16. Results: Admissions demographic were similar for all 3 groups. There were no significant differences in BIT scores while wearing the optical devices. The prism group showed a trend for improvement in all 3 BIT scores 2 days after removal of the optical device. This reached statistical significance for the line bisection scores (prism group ± SEM, 1.5±0.3; patch group, .12±.12; controls, .33±.33; P =.004). Dropouts were highest for prism group (10/16) versus patch group (4/12) and controls (1/10) ( P =0.2). Conclusion: Hemi-field Fresnel prisms showed a beneficial effect on visual neglect 2 days after their removal.