The updated guidelines highlight the massive strides made towards cementing the place of orthoptists within the stroke care team.

The guidance is now that people in hospital following a stroke should be offered a specialist orthoptist assessment as soon as possible. If this is not possible before discharge, the person should be offered an urgent outpatient appointment.

This represents a real step forward, in addition to the recommendations in the National Clinical Guideline for Stroke in May, which recommended that vision screening should be completed within 72 hours, but does not specifically mention orthoptists.

Problems with vision and eye movement are common following a stroke or brain injury, affecting about 73% of people. This can have a significant impact on a person’s rehabilitation, as well as negatively affecting their quality of life.

Currently, as highlighted in the evidence review for the new Guidelines, the provision of eye care on stroke units is non-standardised and ad hoc, leading to vision problems being missed. NICE state as the basis for their recommendation that eyesight problems are more likely to be identified during an orthoptist assessment when compared to other forms of assessment.

We are hopeful that the new guidelines will encourage more consistent access to specialist orthoptist assessments, supporting earlier diagnosis of vision and eye movement problems in people who have had a stroke.

Dr Lauren Hepworth, Co-Lead of our Stroke and Neuro Rehabilitation Clinical Advisory Group said “This update of the NICE guidelines on stroke rehabilitation in adults is a positive step forward towards better system of identification and management of visual impairment post-stroke. Implementation of these guidelines will also release other members of the multi-disciplinary team from vision screening to focus on other areas of rehabilitation. There are services which already meet this new recommendation, demonstrating it is possible!”

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