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Published on: October 18, 2018
Reading difficulty after stroke: ocular and non ocular causes
Fiona Rowe1, David Wright, Darren Brand
1Orthoptics and vision science, University of Liverpool, Liverpool, UK. rowef@liverpool.ac.uk
Summary
Reading difficulties after stroke are often due to visual impairments like field loss or eye movement issues. A smaller percentage have non-visual causes, but all patients with visual impairment can receive targeted advice or treatment.
Area of Science:
- Ophthalmology
- Neurology
- Rehabilitation Medicine
Background:
- Reading impairment post-stroke can stem from ocular issues such as visual field loss, eye movement abnormalities, and reduced central vision.
- Non-ocular factors contributing to reading difficulties include cognitive deficits and language impairments like aphasia.
Purpose of the Study:
- To determine the prevalence of ocular and non-ocular causes of reading difficulty in patients referred for suspected visual impairment after stroke.
- To identify specific visual and non-visual factors contributing to reading impairment in a post-stroke population.
Main Methods:
- A prospective, multicenter observational study involving 21 sites with standardized referral and assessment protocols.
- Comprehensive visual assessments included visual acuity, visual fields, ocular alignment, eye movements, and visual inattention.
- Ethical approval and informed patient consent were obtained for all participants.
Main Results:
- Out of 915 recruited patients, 19.3% (177) reported reading difficulties.
- Ocular causes were prevalent, including visual field loss (109 patients), eye movement abnormalities (85), low vision (27), and visual perceptual impairment (39).
- Aphasia (15 patients) and alexia (8 patients) were identified as non-ocular causes; 87 patients had multiple ocular diagnoses.
Conclusions:
- The majority of reading difficulties in stroke patients are attributable to visual impairments, primarily low vision, eye movement disorders, and visual field deficits.
- Non-ocular factors, such as aphasia and alexia, account for a smaller proportion of reading impairments.
- All identified visual impairments were amenable to targeted treatments or management strategies.
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