'I didn't know stroke affected eyes'

By Jane Elliott
Health reporter, BBC News

Alan had vision problems shortly before stroke

When Alan Jones had a stroke he lost the use of the right side of his body.

He also lost part of his sight in both eyes.

But while his body slowly recovered over the months his sight never did, meaning he had to give up his job as a heavy goods vehicle driver.

Alan's sight problems were quickly identified, and he was taught special exercises to allow his eyes to compensate for the loss of vision.

But the Stroke Association warn that many others are slipping through the net.

At their UK Stroke Forum conference they called for all patients to have a visual assessment from an eye specialist.

Over half of all stroke survivors have visual problems, yet experts say just a quarter of these are referred to specialists for treatments which could improve their condition.

My message to people now is that if you have a stroke go and get your sight tested Alan Jones

The most common condition, affecting 30% of stroke survivors is 'homonymous hemianopia' (loss of half a field of vision).

This can be helped by prisms on the glasses.

Prisms can also assist in treating double vision (diplopia).

Sonia MacDiarmid, deputy head orthoptist (an expert in vision disorder) from the British and Irish Orthoptic Society, said the effects of the visual impairments can be devastating.

"It can limit the quality of life for the patient because all aspects of self care can potentially be affected such as preparing meals, walking independently and reading or watching television.

Many problems are not picked up

"It can restrict opportunities for leisure pursuits or access to public services and can also increase depression which is a common symptom of stroke.

"Yet many of these problems can be treated or reduced by seeing an orthoptist or other eye specialists.

"In my experience just 25% of stroke survivors currently get referred."

Alan said problems with his sight and balance pre-stroke had been the first indication that he was ill.

"My eyes were blurred and when I was driving I used to get dizzy spells and I would get wavy lines in front of my eyes.

"I did not know that stroke could affect your sight. But my message to people now is that if you have a stroke go and get your sight tested."

'Adapted well'

Alan's wife Pauline said the loss of sight had been so devastating that it had left him almost isolated, but she said that because he looks well many who do not know him are unaware of his problems.

"Because his eyes look focussed many people do not think he has a problem and it is like it is invisible.

"But it has left him quite isolated, because he can not go out alone for a walk. He can no longer drive. This has been life changing because he still had about 10 years work time left."

Alan had prisms fitted to his glasses, but these did not work for him and Sonia said he had to be taught how to retrain his eyes.

"He has adapted quite well," she said.

She added that they were also able to get Alan quickly registered partially sighted, which entitles him to certain benefits.

Jon Barrick, chief executive at the Stroke Association, said supporting stroke survivors like Alan to regain independence would save cash as well as help patients.

Stoke currently cost the economy £7 billion a year.

"This evidence shows the significance of a referral to an eye specialist as part of a successful rehabilitation following a stroke.

"More action must be taken by hospitals and local authorities to ensure that the resources are available and managed effectively to provide all stroke survivors with visual assessments and an informed care plan a result."