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Ocular manifestations in patients with cerebrovascular accidents in India: a cross-sectional observational study

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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.

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Authors and Affiliations

  1. Lokmanya Tilak Municipal Medical College and Hospital, Mumbai, India

    Suchit Dadia, Chhaya Shinde & Roshani Desai

  2. Bharti Eye Foundation and Hospitals, New Delhi, India

    Suchit Dadia, Archana Gupta Mahajan, Sourabh Sharma, Bhupesh Singh & Sudhank Bharti

  3. Roshani-I Care, Jogeshwari West, Mumbai, India

    Roshani Desai

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  1. Suchit Dadia
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  2. Chhaya Shinde
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  3. Roshani Desai
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  4. Archana Gupta Mahajan
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  5. Sourabh Sharma
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  6. Bhupesh Singh
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  7. Sudhank Bharti
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Correspondence to Suchit Dadia.

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The authors declare that they have no conflict of interest.

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All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Dadia, S., Shinde, C., Desai, R. et al. Ocular manifestations in patients with cerebrovascular accidents in India: a cross-sectional observational study. Int Ophthalmol 39, 2843–2849 (2019). https://doi.org/10.1007/s10792-019-01131-7

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  • DOI: https://doi.org/10.1007/s10792-019-01131-7

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