Why is this research needed?
Immediately after their stroke around 30% of people have a vision problem called hemianopia – loss of vision on one side of the visual field. This leaves them with a ‘blind side’ to their right or left. Hemianopia is caused when damage to the brain affects how it processes what the eyes see – it's not due to a problem with a person’s eyes. Only around 15% of stroke survivors with hemianopia will recover their vision in the weeks after their stroke – roughly 180,000 stroke survivors live with hemianopia.
Hemianopia affects things like reading, driving and how people are able to avoid objects as they move around. This can have a major impact on a stroke survivor’s recovery, their day-to-day life, their ability to be independent and whether they’re able to return to work.
We don’t know what the best treatment options are to help stroke survivors with visual field loss. This lack of evidence means that there’s a variety of treatment being offered by the NHS across the country, causing unfair and unnecessary differences in the care that stroke survivors receive. The lack of support and treatment options led to stroke survivors, their families, and healthcare professionals naming ‘treatment for vision problems after stroke’ as one of the most important areas for research to focus on.
A treatment called ‘visual scanning training’ could help stroke survivors to manage hemianopia. It involves a patient repeatedly locating different targets in both the ‘seeing’ and ‘blind’ sides of their visual field. It can increase awareness of the ‘blind side’ as it encourages the patient to look into this area of their vision. Visual scanning training can be paper-based or may use computers. Paper-based visual scanning training is available to all patients; computer training is not.
What is the research aiming to achieve?
An earlier study by this team of researchers, funded by the Stroke Association, tested paper-based visual scanning training and found promising results. They now want to test this treatment in a larger study to find out whether paper-based visual scanning training:
- Is an effective treatment for stroke survivors with hemianopia to help them adapt to and manage their vision problems.
- Improves stroke survivor’s quality of life and independence.
- Is an acceptable treatment to stroke survivors and healthcare professionals.
How will they do this?
The researchers will test if their new, paper-based visual scanning training can be used as a treatment to improve stroke survivors’ lives in a Randomised Controlled Trial (RCT). In the RCT, participants are split randomly into two groups, where only one group has the new paper-based visual scanning training.
The researchers will test participant’s visual reactions and independence in daily activities in both groups. They’ll compare the two groups to see if the group who received the new treatment do better than the group that didn’t.
The participants will receive visual scanning training for 30 minutes every day, seven days per week for six weeks. The researchers will also follow both groups for six months after this six-week period, to see whether any beneficial effects of the new treatment last beyond the end of the training programme.
What benefits could this have for people affected by stroke?
There’s a lack of evidence for treatments that can help stroke survivors to adapt to and manage visual problems after stroke. The researchers hope that this study will provide some much-needed evidence that visual scanning training can help stroke survivors and will lead to the new treatment being recommended for stroke survivors with hemianopia in clinical guidelines.
If the researchers find that visual scanning treatment can help stroke survivors live more independently, this could save money in the NHS and social care as these stroke survivors will require less support in their daily lives.