The Current Provision of Post-Stroke Vision Care in Malaysia: A Qualitative Interview Among Stroke-Care Professionals

Abstract

Background: The inequality in care provision for stroke survivors who have visual problems has been reported globally. It revealed that many stroke survivors continue to experience unmet needs concerning their visual problems. Qualitative interviews were conducted with stroke care professionals to explore gaps and loopholes in vision care provisions. Methods: A semi-structured interview study using purposive sampling and inductive qualitative content analysis was conducted. A total of 8 stroke-care professionals with more than 10 years of experience from university teaching Hospitals in Malaysia were recruited for the interview from January 2021 to January 2022. A criterion-based sample of healthcare professionals involved in post-stroke care was recruited. Data collection continued until thematic saturation was reached. Ethical approval has been obtained from the IIUM Research Ethics Committee following the principles of the Declaration of Helsinki. Results: The central theme is current provision, and there are five main themes identified: indefinite vision care pathways, incomplete eye examination, insufficient referrals, absence of visual rehabilitation, and lack of eye care professionals. All respondents reported that the most common visual impairments seen in their practice were homonymous visual field loss and visual neglect. However, the care pathway for assessing visual impairment remained unclear and varied among professionals. In outpatient services, rehabilitation mainly focuses on improving bodily function and activities of daily living. There is also a need to include optometrists and ophthalmologists specializing in neuro-vision care in the rehabilitation team. Conclusion: This study shows that there are gaps and loopholes in the current provision of post-stroke vision care in Malaysia. A standardized protocol in the country should be developed to give a clear pathway for managing vision after a stroke.