Suchit Dadia1,2, Chhaya Shinde3, Roshani Desai3,4, Archana Gupta Mahajan5, Sourabh Sharma5, Bhupesh Singh5, Sudhank Bharti5. 1. Lokmanya Tilak Municipal Medical College and Hospital, Mumbai, India. drsuchit.dadia@gmail.com. 2. Bharti Eye Foundation and Hospitals, New Delhi, India. drsuchit.dadia@gmail.com. 3. Lokmanya Tilak Municipal Medical College and Hospital, Mumbai, India. 4. Roshani-I Care, Jogeshwari West, Mumbai, India. 5. Bharti Eye Foundation and Hospitals, New Delhi, India.
Abstract
PURPOSE: To assess ophthalmic manifestations in patients with stroke and emphasize the importance of a formal screening for visual problems in stroke patients in hospital and rehabilitation settings. METHODS: This was a cross-sectional study of 50 newly diagnosed patients with stroke with Glasgow Coma Scale (GCS) > 8 examined within 3 days of onset. A detailed ophthalmic examination was performed for each patient including visual acuity, fields, ocular motility, slit lamp and fundus examination, line bisection tests and cranial nerve assessment. Radiological investigations were reviewed and anatomically correlated. RESULTS: A total of 50 patients (41 male and nine female) were included in the study. Mean age of the stroke cohort was 51.36 years. Twenty-nine patients (58%) had a subcortical stroke, while 42% (n = 21) patients had a cortical stroke. Nineteen patients (38%) demonstrated visual field defects. Twenty-one patients (42%) had a gaze palsy. Vertical gaze palsy (n = 8) was more common in cortical stroke, while internuclear ophthalmoplegia (n = 2), horizontal gaze palsies (n = 4) and Parinaud's syndrome (n = 1) were seen more commonly in those with subcortical stroke. Twenty-four percent (n = 12) patients had nystagmus. Twelve percent (n = 6) patients had diplopia. Thirty-eight percent (n = 19) patients had convergence insufficiency. Sixteen patients (32%) complained of visual impairment. Retinal abnormalities were seen in 58% (n = 29) of patients. CONCLUSIONS: Ophthalmic manifestations were seen in 90% of stroke survivors. Their presence in majority of the patients in our cohort suggests that earliest routine ophthalmic examination should be mandatory in all patients with acute stroke.
PURPOSE: To assess ophthalmic manifestations in patients with stroke and emphasize the importance of a formal screening for visual problems in strokepatients in hospital and rehabilitation settings. METHODS: This was a cross-sectional study of 50 newly diagnosed patients with stroke with Glasgow Coma Scale (GCS) > 8 examined within 3 days of onset. A detailed ophthalmic examination was performed for each patient including visual acuity, fields, ocular motility, slit lamp and fundus examination, line bisection tests and cranial nerve assessment. Radiological investigations were reviewed and anatomically correlated. RESULTS: A total of 50 patients (41 male and nine female) were included in the study. Mean age of the stroke cohort was 51.36 years. Twenty-nine patients (58%) had a subcortical stroke, while 42% (n = 21) patients had a cortical stroke. Nineteen patients (38%) demonstrated visual field defects. Twenty-one patients (42%) had a gaze palsy. Vertical gaze palsy (n = 8) was more common in cortical stroke, while internuclear ophthalmoplegia (n = 2), horizontal gaze palsies (n = 4) and Parinaud's syndrome (n = 1) were seen more commonly in those with subcortical stroke. Twenty-four percent (n = 12) patients had nystagmus. Twelve percent (n = 6) patients had diplopia. Thirty-eight percent (n = 19) patients had convergence insufficiency. Sixteen patients (32%) complained of visual impairment. Retinal abnormalities were seen in 58% (n = 29) of patients. CONCLUSIONS: Ophthalmic manifestations were seen in 90% of stroke survivors. Their presence in majority of the patients in our cohort suggests that earliest routine ophthalmic examination should be mandatory in all patients with acute stroke.
Authors: Argye E Hillis; Melissa Newhart; Jennifer Heidler; Peter B Barker; Edward H Herskovits; Mahaveer Degaonkar Journal: J Neurosci Date: 2005-03-23 Impact factor: 6.167
Authors: Sapna E Sridharan; J P Unnikrishnan; Sajith Sukumaran; P N Sylaja; S Dinesh Nayak; P Sankara Sarma; Kurupath Radhakrishnan Journal: Stroke Date: 2009-02-19 Impact factor: 7.914