Title
Survey of vision screening services provided for stroke patients in Wales.

Lead researcher
Professor Rachel North, School of Optometry & Vision Science, Cardiff University

Aim
Despite visual impairment occurring to 70% of stroke patients, vision screening is not included in the majority of stroke services in the UK. The aim of this pilot study is to assess the vision screening services available for stroke patients in Wales. It will investigate the extent and accessibility of vision screening services, and also review who carries out the screening and the vision tests that are included. This information is essential if visual impairment is to be detected and appropriate treatment/ rehabilitation is to be provided to maximise the quality of life for the patient. The results of this pathway study may also open up opportunities for a larger UK wide portfolio scale study.

Background
Stroke affects approximately 11,000 people in Wales per year and mostly the elderly. It is the 3rd commonest cause of death (3,000) and the major cause of severe disability. The effects can be devastating and life changing and costs the economy an estimated £8 billion per year in England. Therefore, it is a priority for health and social services and in 2006 the NSF for Older People in Wales set out the standards for stroke services in Wales, including maximising post stroke independent living and quality of life. Some form of visual impairment occurs to the majority of stroke survivors (70-92%). The risk factors for falls include increasing age, dependency in activities of daily living, visual impairment (1.7 times), neurological and cardiovascular disease and postural stability. Therefore, stroke patients are also at increased risk of falls and hip fractures, which can have serious consequences as less than half return to their own home resulting in considerable financial costs for health and social services. The Welsh assembly Government “ Together for Health “ plan (2011) whilst including a plan for stroke services does not currently include routine vision screening and this should be reviewed.

Study design summary
To assess the current provision of vision screening for stroke patients a questionnaire will be sent to each Health Board Executive Lead for Stroke and orthoptists, physiotherapists, occupational therapists, community nurses for the elderly and community based services, eg Stroke Association, in Wales.

Total awarded
£8,395