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Orthoptic stroke services in the UK and Ireland: how have they evolved?
Lauren R Hepworth1, Fiona J Rowe2
1Institute of Population Health, University of Liverpool, Liverpool, UK. lauren.hepworth@liverpool.ac.uk.
Eye (London, England)
|January 17, 2026
Summary
Despite increased stroke vision screening, funded orthoptic services have decreased, leading to persistent health inequalities in post-stroke vision care across the UK. This study establishes a baseline for future guideline impact assessment.
Area of Science:
- Ophthalmology
- Neurology
- Public Health
Background:
- ~100,000 UK strokes annually result in visual impairment for 60% of survivors.
- Orthoptic stroke services were previously surveyed in 2007 and 2017.
- New post-stroke vision guidelines (2023-2025) and national audits were implemented.
Purpose of the Study:
- To assess current provision of orthoptic stroke services.
- To evaluate changes since the 2016 National Clinical Guideline update through 2023.
Main Methods:
- An online survey was distributed to registered orthoptists in the UK and Ireland.
- Data were collected from 206 respondents across 125 orthoptic departments (67% response rate).
Main Results:
- 66.1% of departments with stroke units provided vision services, but only 27.6% were funded.
- Most services relied on stroke team screening (84.2%) with orthoptic referral (65.8%), often without validated tools (50%).
- Mean staffing was 0.43 FTE per 42.5 beds, with only 0.27 FTE funded.
Conclusions:
- Stroke unit vision screening has increased, but funded services have declined since 2017.
- Persistent health inequalities exist regarding post-stroke vision service provision.
- This study provides a baseline for assessing future guideline and audit impacts on vision care.
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