May 2012 - Pennine Acute Hospitals NHS Trust

News - Trust stories
Vision screening at bedside
PATIENTS who have had a stroke can
now have their vision assessed on
their rehabilitation ward, without
having to wait for an outpatient
appointment .
The service offers early identification
of the nature of visual loss that may
be experienced following a stroke,
and provides vital information which
can contribute towards the coordination
of multi-disciplinary care
for the individual patient .
Set up to provide an ocular
assessment to be performed at the
bedside, with the minimum
disruption for both the patient and
the ward, the specialist vision screening
service is provided to patients of Dr
Ahmed at North Manchester General
Hospital, Dr Namushi at Fairfield
General Hospital, and Drs Vasallo
and Ahmed at The Royal Oldham
Hospital .
Angela Costello, Kay Jackson and
Kayley Curtis specialise in ocular stroke
work and their role includes assessment,
treatment, advice, counselling, liaison
with other members of the multidisciplinary
team, and the provision
of information which helps in the
management of the implications of visual
loss within the hospital, plus when the
patients are discharged .
Orthoptist Angela, said: “Many patients
will experience visual difficulties following
a stroke . The symptoms can vary from
visual loss (total or partial), double vision,
blurred vision, focussing difficulties,
misjudging distances and direction, a
constantly moving image, unsteadiness,
hallucinations, changed eye position,
altered position of the head for viewing,
and eye movement difficulties to name
but a few .
“These problems may interfere with
the patient’s ability to read, limit
mobility, affect the ability to
perform tasks for other
therapeutic hospital
assessments, and also
cause distress, confusion
and a loss of confidence .
Some patients may
have to have a change
of lifestyle, and often
will be very anxious
about how visual loss
will affect them in the
long-term, or whether
the visual loss will
progress further .
“One patient said that
initially the loss of
vision did not seem too
important when she was
very ill . However, as she
started to recover medically,
the visual loss became a major cause of
distress, and the permanency of this was
very difficult to come to terms with .”
Although not all patients who have a
stroke will suffer vision loss, for those that
do, it is important that their visual status
is established so that their rehabilitation
goals can be planned accordingly . Patients
may also have existing ocular problems
when they come onto the ward, and so
the orthoptists need to plan for their goals
and potential regarding rehabilitation .
As communication can be hindered in
stroke patients, the orthoptists have to
use widely variable and modified testing
techniques to maximise the amount of
information which they can obtain from
the patients .
These can include matching letters rather
than naming them, use of a picture chart
if letter recognition has been affected,
taking time and presenting small
amounts of visual information
to avoid confusion, giving
cues to help patients
achieve ocular motility,
and more animated
explanations/
demonstration of how
to perform the tests .
An audit of the first
six months of the
service revealed
a very varied
caseload with many
interesting clinical
presentations . 330
assessments were
undertaken, 212 of
these demonstrated
visual problems,
and 85 patients were
younger than 65 years
of age .
Thought for
the month
by Rev Jane Vost
Why worry?
15
There is such a lot of uncertainty
around these days . Whether it is
about our jobs, our health or even
what the weather is going to be like
today, we will always know or speak
to someone who is worrying about
something .
But why do we worry? Why do we
allow these things to constantly go
over and over in our mind, feeding
on them until they become huge
inside us?
Well even those who work in the
spiritual care team are not immune to
it and an answer I have given to that
question and I guess many of you
would give is “I just can’t help it .”
As humans we are conditioned to
be self-sufficient, to be in control of
our situations and we are not happy
unless we know what is going to
happen, how, when and to whom!
A wise friend gave me a good tip .
Every time you start to worry think of
something to be thankful for . It is
surprising how thinking of something
good in our lives can help us to
forget to worry about the things that
are not so good . In fact it can help
us to see that sometimes the things
we are worrying about are not worth
worrying about at all .
Just think of all the time we waste
worrying, the hours of sleep that are
lost, the opportunities missed . There
are so many more good things to
think about . The flowers in your
garden, that smile on your son’s
face as he sees you come home from
work . The joy of times shared with a
loved one . Knowing your team have
just won the match!
We will always face troubles, people
always have . It is how we handle
them that counts .
Jesus said: “Who of you by worrying
can add a single hour to your life?”
life is precious; let’s make the most
of it . Don’t miss out on the joys of
today by worrying about tomorrow .