TY - JOUR
T1 - Neuro-ophthalmic manifestations of cerebrovascular accidents
AU - Ghannam, Alaa S.Bou
AU - Subramanian, Prem S.
N1 - Funding Information:
This work was supported in part by a challenge grant from Research to Prevent Blindness to the Department of Ophthalmology, University of Colorado School of Medicine.
Publisher Copyright:
Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Purpose of review Ocular functions can be affected in almost any type of cerebrovascular accident (CVA) creating a burden on the patient and family and limiting functionality. The present review summarizes the different ocular outcomes after stroke, divided into three categories: vision, ocular motility, and visual perception. We also discuss interventions that have been proposed to help restore vision and perception after CVA. Recent findings Interventions that might help expand or compensate for visual field loss and visuospatial neglect include explorative saccade training, prisms, visual restoration therapy (VRT), and transcranial direct current stimulation (tDCS). VRT makes use of neuroplasticity, which has shown efficacy in animal models but remains controversial in human studies. Summary CVAs can lead to decreased visual acuity, visual field loss, ocular motility abnormalities, and visuospatial perception deficits. Although ocular motility problems can be corrected with surgery, vision, and perception deficits are more difficult to overcome. Interventions to restore or compensate for visual field deficits are controversial despite theoretical underpinnings, animal model evidence, and case reports of their efficacies.
AB - Purpose of review Ocular functions can be affected in almost any type of cerebrovascular accident (CVA) creating a burden on the patient and family and limiting functionality. The present review summarizes the different ocular outcomes after stroke, divided into three categories: vision, ocular motility, and visual perception. We also discuss interventions that have been proposed to help restore vision and perception after CVA. Recent findings Interventions that might help expand or compensate for visual field loss and visuospatial neglect include explorative saccade training, prisms, visual restoration therapy (VRT), and transcranial direct current stimulation (tDCS). VRT makes use of neuroplasticity, which has shown efficacy in animal models but remains controversial in human studies. Summary CVAs can lead to decreased visual acuity, visual field loss, ocular motility abnormalities, and visuospatial perception deficits. Although ocular motility problems can be corrected with surgery, vision, and perception deficits are more difficult to overcome. Interventions to restore or compensate for visual field deficits are controversial despite theoretical underpinnings, animal model evidence, and case reports of their efficacies.
KW - homonymous hemianopia
KW - ocular motor dysfunction
KW - stroke
KW - visual rehabilitation
KW - visual restoration therapy
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U2 - 10.1097/ICU.0000000000000414
DO - 10.1097/ICU.0000000000000414
M3 - Review article
C2 - 28984724
AN - SCOPUS:85030758053
SN - 1040-8738
VL - 28
SP - 564
EP - 572
JO - Current opinion in ophthalmology
JF - Current opinion in ophthalmology
IS - 6
ER -