Stroke & Neurological Deficit

Orthoptic assessment and management for patients following a stroke or neurological deficit

Information for healthcare commissioners and other health professionals on orthoptic assessment and management for patients following a stroke or neurological deficit

Incidence of visual impairment

Visual impairment is a common finding after stroke and / or neurological deficit. It has been estimated that 60-70% of stroke survivors have some degree of visual impairment immediately post stroke, with a similar incidence likely following other types of brain injury. Visual impairment may include impaired central vision, impaired peripheral vision (visual field), eye movement disorders, reading difficulties and visual perception disorders including visual inattention.

Impact of visual impairment

Visual impairment can have negative implications on quality of life and activities of daily living causing loss of confidence, diminished enjoyment of reading and watching television, reduced mobility and increased risk of falls. When patients are undergoing rehabilitation following a neurological problem, a visual impairment is associated with a reduced prognosis for successful rehabilitation, meaning poorer outcomes and a longer hospital stay.

Expertise of orthoptists

Orthoptists have specific expertise in the specialist assessment and management of these visual deficits. The British and Irish Orthoptic Society (BIOS) has developed standardised care pathways, referral forms, patient leaflets and position statements for orthoptic services in this specialist area.  These recommendations are evidence-based and provide a standardising approach to orthoptic services for these patients.

It is essential that commissioners consult with Orthoptists in their area in the tendering process for stroke and neurological rehabilitation services, to ensure patients’ needs are met with dedicated and specialist services.



For more information contact BIOS Stroke and Neurological Rehab Special Interest Group Lead:

Mrs Claire Howard  (