Ocular disorders in stroke patients in a tertiary hospital in Nigeria

Abstract

Background: Stroke is a medical emergency of public health importance which affects the physical, mental, and emotional well‑being of its victims. Management and rehabilitation are cumbersome for patients and caregivers. Ocular involvement and visual loss could further increase the burden of care.

Aim: To determine the prevalence of ocular disorders in patients with stroke in a Tertiary Hospital in Nigeria.

Materials and Methods: A descriptive hospital‑based study was performed on all consenting and conscious adult patients aged 18 years and above with a diagnosis of stroke made within 1‑year who were admitted to the stroke ward or attended the stroke clinic of the Neurology Unit in the Department of Medicine, University of Benin Teaching Hospital, Benin City from October 2013 to December 2013.

Results: A total of 170 eyes of 85 patients were studied with a mean age of 66.08 years ± 10.99; range 43–88 years. There was a male: female ratio of 2.6:1. Ocular abnormalities were documented in 95.5% of the patients. A presenting visual acuity of ≥6/18 was found in 66.7%. Mild ptosis and exotropia were seen in 2.9% and 0.6% of the eyes respectively. Intraocular pressure was between 10–21 mmHg in 87.7% eyes while 11.8% eyes had afferent pupillary defects. Cataract was seen in 71.8% eyes and optic nerve head changes in 48.8% eyes which includes temporal disc pallor and glaucomatous optic neuropathy in 29.4% and 14.2% eyes, respectively. Abnormalities found in the retina include retinal hemorrhages in 10.6% eyes, cotton wool spots in 2.4% eyes, and hard exudates in 7.8% eyes. Retinal vascular abnormalities were documented in 32.4% eyes. Visual complaints following stroke were documented in 9.6% of the patients.

Conclusion: Ocular abnormalities are present in patients with stroke, mostly due to predisposing risk factors for stroke, and age‑related changes. Routine ophthalmic evaluation is suggested in the management of patients with cerebrovascular accident in our environment for better quality of care.

Keywords: Cerebrovascular accident, ocular disorders, stroke