Development of a Best Practice Statement for Screening, Assessment and Management of Vision Problems in the First 30 days After an Acute Stroke

Background: Every year, 15 million people worldwide suffer a stroke (World Heart Federation 2013). Stroke can affect the visual system causing problems with visual perception, eye movement disorders, low vision and visual field loss (Rowe et al 2009). UK guidelines for stroke recommend that everyone who has a stroke should be screened for vision problems. However, the guidelines conclude that there is insufficient quality research to make recommendations about how best to assess, and rehabilitate adults who experience visual problems as a consequence of their stroke. Aim: This project aimed to develop a best practice statement for the Identification and management of visual problems following stroke in the acute phase (first 30 days). Method: A Rapid Evidence Assessment method (Bevan et al 2010.) was used to scope the literature. Of 9,032 references identified, 234, met the review inclusion criteria. These were systematically and critically appraised by a multi-disciplinary team of clinicians, health professionals and academics with expertise in stroke and related vision problems. Data from 118 of the articles reviewed, and contributions from lay representatives, provided the evidence base for the Best Practice Statement. Results: Best Practice guidelines for initial screening, assessment and management of visual field deficit, eye movement disorders, and visual neglect/inattention in the first 30 days following stroke have been published and areas for future research identified. Discussion Conclusion: Not all areas of patient care have the research available to inform a clinical guideline. Using a Best Practice approach allows experts in the field to combine their clinical expertise and develop recommendations for best practice when traditional methods are unable to do so. Randomised controlled trials (RCTs) are urgently required to determine the effects of clinically relevant rehabilitation interventions. This presentation will describe the method used to develop the statement and present the results.