ArticleBMJ open2020
Vision Screening Assessment (VISA) tool: diagnostic accuracy validation of a novel screening tool in detecting visual impairment among stroke survivors.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- European Stroke Organisation (ESO) guideline on visual impairment in stroke.European stroke journal · 2025Guideline
- Health care professional perspectives on vision screening in older adults who attend hospital following a fall: a focus group study.European geriatric medicine · 2026Article
- Validation of the Vision Impairment Screening Assessment in acute stroke care: a prospective diagnostic accuracy study.European stroke journal · 2026Article
- Orthoptic stroke services in the UK and Ireland: how have they evolved?Eye (London, England) · 2026Article
- Vision screening in older adults who attend hospital following a fall: a scoping review.BMC geriatrics · 2025Article
- The importance of assessing vision in falls management: A narrative review.Optometry and vision science : official publication of the American Academy of Optometry · 2025Review
- Development and performance evaluation of a Bengali-adapted mHealth app for early detection of impaired visual acuity.Heliyon · 2024Article
- 'If we don't assess the patient's vision, we risk starting at the wrong end': a qualitative evaluation of a stroke service knowledge translation project.BMC health services research · 2022Article
- Barriers and facilitators to the implementation of a structured visual assessment after stroke in municipal health care services.BMC health services research · 2021Article
- Sensitivity and Specificity of New Visual Field Screening Software for Diagnosing Hemianopia.Eye and brain · 2021Article
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Authors and funding
8 authors.
Funding
Abstract
purposeScreening for visual problems in stroke survivors is not standardised. Visual problems that remain undetected or poorly identified can create unmet needs for stroke survivors. We report the validation of a new Vision Impairment Screening Assessment (VISA) tool intended for use by the stroke team to improve identification of visual impairment in stroke survivors.
methodsWe conducted a prospective case cohort comparative study in four centres to validate the VISA tool against a specialist reference vision assessment. VISA is available in print or as an app (Medicines and Healthcare products Regulatory Agency regulatory approved); these were used equally for two groups. Both VISA and the comprehensive reference vision assessment measured case history, visual acuity, eye alignment, eye movements, visual field and visual inattention. The primary outcome measure was the presence or absence of visual impairment.
resultsTwo hundred and twenty-one stroke survivors were screened. Specialist reference vision assessment was by experienced orthoptists. Full completion of screening and reference vision assessment was achieved for 201 stroke survivors. VISA print was completed for 101 stroke survivors; VISA app was completed for 100. Sensitivity and specificity of VISA print was 97.67% and 66.67%, respectively. Overall agreement was substantial; K=0.648. Sensitivity and specificity of VISA app was 88.31% and 86.96%, respectively. Overall agreement was substantial; K=0.690. Lowest agreement was found for screening of eye movement and near visual acuity.
conclusionsThis validation study indicates acceptability of VISA for screening of potential visual impairment in stroke survivors. Sensitivity and specificity were high indicating the accuracy of this screening tool. VISA is available in print or as an app allowing versatile uptake across multiple stroke settings.
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