Introduction: Visual impairment is a debilitating consequence of stroke hindering successful rehabilitation. Australian research in vision care pathways for stroke survivors is limited. Utilising surveys care pathways were investigated to determine if adequate to meet vision care needs.
Methods: A Health Professional Survey (HPS) and Stroke Survivor Survey (SSS) were developed following CHERRIES guidelines for web-based surveys. Questions focused on screening/assessment, management and referral, and education of stroke survivors. Stroke survivors with vision impairment three months to five years post-stroke were invited to participate in the SSS. Various health professionals involved in stroke care were invited to participate in the HPS.
Results: 27 health professionals from various specialties and care settings completed the HPS. 89% reported no workplace protocol for post-stroke vision problems. Majority of vision assessments were performed by non-eyecare practitioners. Protocol and access shortages were identified as primary barriers to timely referral and management post-stroke vision problems.
43 stroke survivors (mean age = 60) completed the SSS. 28% reported no vision assessment within six months of their stroke. 88% reported no inpatient treatment for vision problems. Many noted daily life impacts and unmet vision care needs in care plans or referrals. Key barriers to vision care were insufficient information, professional attention, and access to vision rehabilitation.
Conclusions: Most non-eyecare stroke healthcare professionals in NSW provide vision care without guidelines or protocols, leading to unstandardised post-stroke vision care and unmet needs for stroke survivors.
Relevance to clinical practice or patient experience: Clear comprehensive, evidence-based post-stroke vision care pathways appropriate for the Australian healthcare context are needed. Areas of improvement relate to increased specialised eyecare access and vision-specific training for stroke health professionals.