ESO Issues Guideline for Post-Stroke Vision Impairment

A new international clinical guideline led by Professor Fiona Rowe of the University of Liverpool has been released to address the diagnosis and management of visual impairment in stroke survivors. Published by the European Stroke Organization (ESO), this guideline is one of four new documents aimed at standardizing and enhancing post-stroke care across Europe and globally.

High Prevalence of Visual Impairment After Stroke

Visual impairment occurs in approximately 75% of stroke survivors, yet clinical consensus on the best screening methods, timing, and management strategies has long been lacking. The newly developed ESO guideline offers evidence-based recommendations to support clinicians in recognizing and managing a range of visual complications following stroke.

“I co-chaired and led this Vision Guideline from inception to completion,” said Professor Rowe.
“This represents significant work on producing a European international guideline to promote the diagnosis and management of visual problems occurring after stroke.”

Guideline Highlights

Published in the European Stroke Journal, the guideline provides detailed directions on several key aspects of post-stroke visual care:

• Screening Tools: Recommends validated methods for detecting visual impairments in stroke patients.

• Optimal Timing: Offers guidance on when screening and assessments should be conducted to ensure the most effective outcomes.

• Management Strategies: Presents evidence-based approaches for addressing various forms of post-stroke visual impairment, including:

• Visual field loss

• Eye movement disorders

• Visual perceptual difficulties

“Such problems are highly prevalent, so it's crucial to ensure their detection and that appropriate care plans are in place for each patient,” added Professor Rowe.
“We provide recommendations and expert consensus statements for stroke vision care, along with key considerations for future research.”

A Step Forward in Post-Stroke Ophthalmic Care

This new ESO guideline represents a significant advance in stroke rehabilitation and vision care, providing a framework that can improve outcomes for a large population of patients worldwide. It also sets the stage for future research into the effective diagnosis and management of post-stroke visual conditions.

Reference:

Fiona J Rowe et al, European Stroke Organisation (ESO) guideline on visual impairment in stroke, European Stroke Journal (2025). DOI: 10.1177/23969873251314693