Hemianopia Add-on for Firefox!

Believe it or not, there's a hemianopia add-on for Mozilla's excellent Firefox web browser. Hemianopia can sometimes cause problems finding the beginning of a line of text, so this add-on draws a vertical line on your Firefox web browser. By clicking and dragging, you can position it wherever is most helpful for your web page.  By double-clicking you can change it's colour or switch it off.  I'd be very interested to know how whether it's helpful.

The link is here: Firefox Hemianopia Add-on.
To get the Firefox browser, click This Link.

The add-on is produced by the Yahoo! Accessibility Lab.

UK Stroke Forum - Vision and Stroke Workshop

The provisional programme for the UK Stroke Forum has now been released.
A "Vision and Stroke Workshop", organised by the British and Irish Orthoptic Society is being held at 9-10:30 in the Alsh Room on 1st December. Talks to include:

09.00-09.20 Visual perception defects following stroke Deborah Parkinson (Teaching Lead and Stroke Specialist Orthoptist, Sheffield Teaching Hospitals NHS Foundation Trust)

09.20-09.50 Visual Problems and Driving Professor Chris Dickinson (Professor of Clinical Optometry, University of Manchester)

09.50-10.20 Recovery from Post-Stroke Visual Impairment: Evidence from a Clinical Trials Resource Dr Myzoon Ali (CSO Post-Doctoral Research Fellow, Glasgow Caledonian University)

10.20-10.30 Panel Questions

For the full programme, Follow This Link.

Review of Transcranial Direct Durrent Stimulation in Chronic Stroke

Transcranial direct current stimulation (tDCS) is a simple way of directly electrically stimluating the surface of the brain, which seems to be able to increase or reduce how "excitable" (how easily activated by nerve cell inputs) the brain's cortex is.  The hope is that if done in the right way this might help recovery from or rehabilitation of stroke.  It makes a good alternative to transcranial magnetic stimulation, because it's cheaper and more comfortable, so it's being increasingly used.  We don't know for certain how it works yet, but GABA (the main chemical in the brain that is released by nerve cells and inhibits other nerve cells) and glutamate (the main chemical that is released by nerve cells and stimulates other nerve cells) seem to be involved.


This review by Charlotte Stagg in Oxford explains a bit about the use of tDCS in chronic stroke (that is, stroke that happened some time ago).  I'm afraid it's a bit "tech-y", but it's easier than reading the research articles!

Visuomotor Imagery for Neglect Rehabilitation

A group based in Heidelberg, Germany, has performed a pilot study using imagery of the neglected arm to treat visuospatial neglect.  They trained 15 patients for an hour a day for 3 weeks, and found that imagining using the neglected arm improved copying/ drawing tasks and enhanced sensation in the arm.

Follow this link to the PubMed abstract.

Citation: Disabil Rehabil. 2011;33(21-22):2033-2043. Epub 2011 Feb 24.

UK Stroke Forum 2011

The UK Stroke Forum runs from 29 November to 1 December 2011 (see www.ukstrokeforum.org).  Look out for the following session on vision after stroke:

1 December
09.00 – 10.30 Parallel session 3(e)
Alsh Room
Vision and Stroke Workshop
Chairs: Tracey Shipman (Royal Hallamshire Hospital) and Dr Fiona Rowe (Senior Lecturer, University of Liverpool).
Visual perception defects following stroke
Deborah Parkinson (Teaching Lead and Stroke Specialist Orthoptist, Sheffield Teaching Hospitals NHS Foundation Trust).
Visual Problems and Driving
Professor Christine Dickinson (Faculty of Life Sciences, University of Manchester).
Recovery from Post-Stroke Visual Impairment: Evidence from a Clinical Trials Resource
Dr Myzoon Ali (CSO Post-Doctoral Research Fellow, Glasgow Caledonian University).

Amercian Heart Association "Million Hearts Initiative"

The AHA has just published its intention to prevent a million strokes and heart attacks over the next 5 years. They say "Effective community CVD prevention interventions have been underutilized due to a lack of a coordinated national effort". This initiative is aimed at changing that. Click Here to visit the related AHA Science News page.

Prisms for hemianopia

Here is a video posted on YouTube by Chadwick Optical, makers of prisms stuck onto glasses to treat hemianopia. These prisms bring part of the blind visual field into the seeing field. They were developed by Eli Peli, Professor of Ophthalmology at Harvard Medical School. He describes how it works in this paper. Like most hemianopia rehabilitation strategies this method has not been clearly proven in a clinical trial, but there is some supporting scientific evidence.

There are a couple more videos on Chadwick Optical's YouTube channel here.

Interact Reading Service

A short video about the UK Guardian Charity Award winning reading service for stroke patients, Interact Reading Service.

Guardian Charity Award 2009-InterAct Reading Service from InterAct Reading Service on Vimeo.

Self-help for one-side neglect

This short article from the American Stroke Association gives advice about how to help people with neglect following stroke to adapt to their difficulties.

Click here to read the article

ReadRight rehabilitation for hemianopic alexia

Click for a 3 minute YouTube video about ReadRight web-based rehabilitation for hemianopic alexia (from University College London and the UK Stroke Association).

New Studies on Hemianopia and Driving

2 studies about driving with hemianopia / quadrantanopia have just been published by Cynthia Owsley's group in Birmingham, Alabama.

The first, "Self-reported driving difficulty by persons with hemianopia and quadrantanopia", published in Current Eye Research (Link to PubMed) found that people with hemianopia / quadrantanopia who were unsafe to drive didn't report any more difficulty driving than those rated safe (both reported more difficulty than people with normal visual fields).

The second, "Hemianopic and quadrantanopic field loss, eye and head movements, and driving", published in Investigative Ophthalmology and Vision Science (Link to PubMed) found that people with hemianopia / quadrantanopia rated as safe to drive made more head movements into their blind field, with more stable lane keeping and less sudden braking. The authors suggest clinical trials training these characteristics. Perhaps they'll run one. Watch this space!

Visual impairment is more than just vision

2 interesting studies published recently show that limitations experienced by visually impaired adults are not all about visual ability.

The first, by Alma and others (Quality of Life Research, June 2011) found that social participation in visually impaired older adults was not determined by visual ability, but rather by age, physical fitness, helplessness, social network size, and how important people viewed participation in particular activities.

The second, by Tabrett and Lathem (Investigative Ophthalmology and Vision Science, May 2011) looked at limitation in daily activities relying on vision. They found that self-reported limitation was affected by visual acuity, but also significantly by depression and adjustment to vision loss.

For people working with visually impaired adults this is a helpful reminder that we need to look at more than how good their vision is!

National Stroke Awareness Month

May is National Stroke Awareness Month in the USA. They've released the Faces of Stroke in a bid to raise stroke awareness. See the the National Stroke Association web site.

Also, the FAST campaign to raise stroke awareness has been re-released in the UK. Follow this link.

Krystel Huxlin (University of Rochester) on rehabilitating visual motion perception

European Stroke Conference, Hamburg 2011

The European Stroke Conference will take place in Hamburg this year, 24-27 May.

For details, see this web site.

For those with an interest in vision, see teaching course 6, Tuesday 24 May, 15:30-17:30:
 "Stroke syndromes of the posterior circulation"
Includes talks:
Brain-stem ischemic stroke eponyms – an update
J.S. Kim, South Korea
Oculomotor presentations of brain-stem ischemia
D. Kömpf, Germany
Ischemic stroke patterns in the posterior cerebral artery territory
R. Kern, Germany

RNIB Stroke and Vision

Web page from the RNIB (Royal National Institute of the Blind, UK) describing visual problems due to stroke.  Follow this link.

Tuebingen visual search / saccade training programme (VISIOcoach)

The University of Tuebingen Low Vision Clinic produces a saccadic training programme for patients with hemianopia, VISIOcoach.  It encourages saccdes into the blind hemifield.  It's based on this 2009 publication in the journal Neurology.  It costs around 300 Euros + tax.  The authors don't have any financial interest (which is reassuring).

Vycor Medical buys NovaVision

NovaVision, the US company producing a controversial visual rehabilitation programme, has been bought by Vycor Medical, producers of neurosurgical retraction devices.  The NovaVision method has been around for some years since their original trial was published in Nature Medicine.  Unfortunately this trial was very significantly flawed, and the method has been the subject of controversy ever since.

News article on completion of Vycor acquisition (12 January 2011)


News article on commencement of Vycor acquisition (11 November 2010)

Cochrane Review of Interventions for Visual Field Loss after Stroke

The provisional findings of the recent Cochrane Review of Interventions for Visual Field Loss after Stroke were presented at the UK Stroke Forum 2010. Click this link to download the poster (PDF format).  The recommendations are currently under peer review.

Reading impairment in Stroke - UK Stroke Forum podcast

Dr Fiona Rowe, Liverpool University, describes a study of reading impairment in stroke, part of the VIS (Vision in Stroke) study, in this UK Stroke Forum Podcast