Identifying Visual Impairment After Acquired Brain Injury-Current Practice, Referrals, and Barriers

Purpose: Visual impairment (VI) is still underdiagnosed in patients with acquired brain injury despite the large impact on dailylife activities and rehabilitation. The aim of this study was to explore the current practice of identification of VI, managementplans, referrals, and experienced barriers in Norwegian hospital settings.Materials and Methods: An online survey was sent out to leaders (n = 62) in hospitals treating patients with acquired brain injury.Data from 22 items covering routines, interdisciplinary collaboration, assessment tools, protocols, barriers, referral practice, andbackground information were collected.Results: Respondents (n = 108) comprised various professions from mainly acute or subacute settings. Visual field deficits,oculomotor dysfunction, and neglect were most commonly but not routinely assessed (53%–57%). Besides medical examination,patient interviews, and observations rather than standardized tests or questionnaires (82% vs.25%) were used. Few workplacesseemed to have interdisciplinary vision teams (13%). Barriers were patient characteristics such as cognitive and languageimpairment and limited resources. Below half (45%) felt competent in assessing VI or had attended courses on the topic (44%).Conclusions: The study highlights the need to implement standardized assessment, improve interdisciplinary collaboration, andfacilitate training courses to enable hospital staff to assess VI after brain injury. These steps could contribute to improvedassessment and management of VI and contribute to overcome the indicated barriers leading to better patient care and outcome.