Stroke and Vision Defects Study: Phase 1 Validation of a Vision Screening Tool

Aim

To validate the effectiveness of the Tool developed for use by stroke clinicians, in detecting the presence of vision defects in patients diagnosed with stroke.

Benefits

The Vision Screening Tool will facilitate rehabilitation and recovery for patients with stroke by detecting both acquired and long standing vision defects.

Summary

The study will be undertaken over twelve months involving 100 patients who have had a stroke and are capable of responding to an assessment using the Tool. Two stroke patient cohorts (each numbering 50) will be recruited from two metropolitan hospitals that currently do not have access to on site eye services and assessed to validate the effectiveness of the Tool.

Two groups of examiners will be required, one the research orthoptist and the other, available clinicians working with patients who have suffered a stroke. The assessment undertaken for the two different cohorts is outlined below.

  • The first cohort of 50 patients will initially be examined by non-orthoptic stroke clinicians using the Tool then a full eye examination will be conducted by the research orthoptist.  The purpose is to compare the Tool used by a non-orthoptist with a criterion-based orthoptist examination.
  • The second cohort of 50 patients will be examined separately by both the stroke clinician and the research orthoptist, each using the Tool on different occasions. This second assessment will enable an evaluation of the effectiveness of the Tool when used by a non-orthoptist compared to use by an orthoptist who is a trained ophthalmic clinician.

The Study Lead, a senior lecturer in the Discipline of Orthoptics at the University of Sydney, will coordinate the study and supervise the research orthoptist’s master’s program.

A steering committee will provide governance for the study and will include internal ACI and external stakeholders including the University of Sydney.

Funding of $5500 provided for Phase 1.

Background

The ‘Stroke & Vision defects: A pilot study to compare the existing models of care’ 2008 reported that an orthoptist on site was best practice for the management of eye conditions for stroke patients. In order to improve eye care for patients recovering from stroke the study recommended that:

  • Increased attention is paid to the detection of ocular conditions - both pre-existing and acquired - as part of the acute stroke management process
  • Ocular findings are managed with treatment or onward referral
  • Documentation is provided for each patient of ocular conditions that arise from either an ophthalmic or neurological cause
  • Communication of ocular status to staff, patients and relatives is undertaken

One strategy recommended to achieve this was the development of ‘standard eye assessment tools for inclusion in the Acute Stroke Care Clinical Guidelines, use in the stroke unit and in the patient medical record’.

The Tool, developed and tested by the ACI Orthoptic Standing Committee is being validated in this study.

Partnerships

  • Discipline of Orthoptics, Faculty of Health Sciences, University of Sydney
  • Agency for Clinical Innovation, Ophthalmology Network
  • Northern Sydney Local Health District

Key Dates

March 2014

Statewide Forms Committee approval of endorsed Tool 

July 2014

National and site specific ethics approval for Manly and Hornsby Ku-ring-gai Hospitals

August 2014

Commence patient recruitment

December 2014

Complete patient recruitment

March 2015

Complete data analysis

June 2015

Complete Phase 1 Study Report for Master’s program and ACI

December 2015

Study written and paper to be published

Pilot Sites

Northern Sydney Local Health DistrictManly Hospital
Hornsby Ku-ring-gai Hospital

Implementation Sites

Evaluation

Related Initiatives

Further Details

For further information about the study, contact:

Neryla Jolly
Hon. Senior Lecturer, Discipline of Orthoptics
02 93519251
Neryla.jolly@sydney.edu.au

Contact

Sarah-Jane Waller
Ophthalmology Network Manager
sarahjane.waller@health.nsw.gov.au
02 9464 4645

Donald MacLellan
Director, Surgery, Anaesthesia and Critical Care
donald.maclellan@health.nsw.gov.au
02 9464 4604

Page Top | Added: 2 July 2014 | Last modified: 3 July 2014

ACI
Status:
Contact:
Sarah-Jane Waller
Ophthalmology Network Manager
Email
02 9464 4645
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