Fiona Rowe

• PhD
• Professor: Head of Department at University of Liverpool

Purpose To determine whether we could establish evidence‐based pass/fail criteria for perimetry in the context of the European visual field standards for driving. Methods This two‐centre, cross‐sectional study included participants with binocular visual field loss that had led to revocation of a group‐1 driving licence. The participants underwent...

Background and purpose The impact of bridging thrombolysis prior to endovascular thrombectomy (EVT) compared to EVT alone on intracerebral haemorrhage (ICH), subarachnoid haemorrhage (SAH), and death in anticoagulated atrial fibrillation (AF) patients with acute ischaemic stroke (AIS) is not well defined. Methods A retrospective study was conducte...

Abstract digital poster presentation at SAPC ASM Bristol 3-5 July 2024

Background Enhanced detection of large vessel occlusion (LVO) through machine learning (ML) for acute ischemic stroke appears promising. This systematic review explored the capabilities of ML models compared with prehospital stroke scales for LVO prediction. Methods and Results Six bibliographic databases were searched from inception until October...

Background Visual impairment is a common consequence of neurological impairments, and can impact a person’s ability to undertake everyday tasks, affecting their confidence and mental health. Previous qualitative research in the UK has shown inequalities to exist where patients are accessing vision care after stroke, but little is known around the e...

Purpose The Brain Injury associated Visual Impairment - Impact Questionnaire (BIVI-IQ) was developed to assess the impact of post-stroke visual impairment. The development of the questionnaire used robust methods involving stroke survivors and clinicians. The aim of this study was to assess the validity of the BIVI-IQ in a stroke population. Metho...

The integration of information from different sensory modalities is a fundamental process that enhances perception and performance in real and virtual environments (VR). Understanding these mechanisms, especially during learning tasks that exploit novel multisensory cue combinations provides opportunities for the development of new rehabilitative i...

Purpose: Determine current vision care pathways and practices for stroke survivors in Australia and internationally, focusing on identifying reoccurring gaps in these pathways and unmet care needs. Method: A scoping narrative review was conducted to identify literature related to post-stroke vision care practices and perspectives of patients and...

Introduction Systematic reviews are important to inform decision‐making for evidence‐based health care and patient choice. Deciding which reviews should be prioritized is a key issue for decision‐makers and researchers. Cochrane Eyes and Vision conducted a priority setting exercise for systematic reviews in eye health care. Methods We established...

Background: The use of botulinum toxin as an investigative and treatment modality for strabismus is well reported in the medical literature. However, it is unclear how effective it is in comparison with other treatment options for strabismus. Objectives: The primary objective was to examine the efficacy of botulinum toxin therapy in the treatmen...

Purpose We report results in relation to returning to driving in the UK under the exceptional cases rule for visual field loss. Methods The Hemianopia Adaptation Study is a prospective clinical study recruiting adult stroke survivors with new onset homonymous hemianopia. The mobility assessment course (MAC) was used to measure navigational scannin...

Purpose: To report saccade parameters in participants during adaptation to post-stroke homonymous hemianopia. Methods: In a prospective observational case cohort study, adult stroke survivors with new onset homonymous hemianopia were recruited. Using quantitative measurement, saccade parameters were measured and compared between the hemianopic a...

Purpose: To validate a vision-screening tool for use by nurses and other non-eye care health practitioners (NECHP) to aid identification of visual deficits and ocular conditions in stroke survivors.Material and Methods: Stroke survivors were recruited from two metropolitan Sydney public hospitals who had no access to on-site eye care professionals....

Aim: The aim of this study was to evaluate completed cognitive screens in stroke survivors with and without visual impairment to explore whether the presence of visual impairment impacts on completion of cognitive screening. Materials and methods: Cognitive screening assessment was undertaken using the Oxford Cognitive Screen (OCS). Data from visua...

Objectives Reporting of research for stroke-related visual impairment is inconsistent. The aim of this study was to define three core outcome sets (COS) and related core outcome measurements (COM) for central visual impairment, visual field loss and ocular motility disorders in stroke research. Design The consensus process consisted of an online t...

Background Hemianopia is a complete or partial blindness in the visual fields of both eyes, commonly caused by cerebral infarction. It has been hypothesized that systematic audio-visual (AV) stimulation of the blind hemifield can improve accuracy and search times, probably due to the stimulation of bimodal representations in the superior colliculus...

Aims To provide an overview of how the European visual field standards for driving (specified in Commission Directive 2009/113/EC) are applied and determine whether individuals with visual field defects are treated equally across Europe. Methods One ophthalmic expert from each of 32 European countries was invited to participate in an electronic su...

COVID-19 extended through 2020 with impact on all hospital services. The purpose of this study was to determine the extent of orthoptic service provision during the initial recovery period from July to September 2020 in the UK, Ireland and Channel Islands. We conducted a prospective survey-based cross-sectional study using an online survey aiming f...

Background: Myasthenia gravis (MG) often presents with ocular signs that mimic other forms of ocular defects, such as isolated cranial nerve palsy. Normal velocity or even hyperfast saccadic eye movements in the presence of deficits of smooth pursuit have been well described in the literature in myasthenic patients. The reason for these paradoxica...

Objectives In this study, we sought to evaluate the extent of further visual field that could be assessed when using stimulus size V in standard automated perimetry compared with size III in advanced stage glaucoma and whether cut-off values could be determined for when to switch from size III to size V. Design Prospective cross-sectional study....

Aim The purpose was to explore the reported symptoms of post-stroke visual impairment from a large multi-centre prospective epidemiology study. Methods Visual assessment, including a case history, visual acuity, ocular alignment, ocular motility, visual fields, visual inattention and visual perception, was attempted for all stroke admissions to th...

Introduction Cochrane Eyes and Vision (CEV) is an international network of individuals working to prepare, maintain and promote access to systematic reviews of interventions to treat, prevent or diagnose eye diseases or vision impairment. CEV plans to undertake a priority setting exercise to identify systematically research questions relevant to ou...

Purpose To determine any factors that predict how an individual will adapt to post-stroke hemianopic visual field loss, with close monitoring of the adaptation process from an early stage. Materials and methods The Hemianopia Adaptation Study (HAST) is a prospective observational longitudinal cohort clinical study. Adult stroke survivors (n = 144)...

Objectives Amblyopia, strabismus and ocular motility disorders are common conditions with significant impact on visual function, appearance and quality of life. We aimed to establish a core set of outcomes for each of the three conditions for use in clinical trials and routine clinical practice. Design A comprehensive databank of outcomes was devel...

Background: Hemianopia is a complete or partial blindness in the visual fields of both eyes, commonly caused by cerebral infarction. It has been hypothesized that systematic audio-visual (AV) stimulation of the blind hemifield can improve accuracy and search times in visual exploration, probably due to the stimulation of bimodal representations in...

Background Homonymous visual field defects represent the most frequent type of visual field loss after stroke, affecting nearly 30% of individuals with unilateral post-chiasmal brain damage. This review aimed to gather the available evidence on the biomechanical changes to visual field loss following stroke. Methods A systematic review was conduct...

Background: Reporting generalisable data across stroke populations is important. We aimed to evaluate the Impact of Visual Impairment after Stroke (IVIS) visual assessment protocol in a different UK geographical area. Methods: This was a single-centre acute stroke unit, prospective study (IVIS-extension (IVIS-e) study) with comparison to a multi-...

Aim This study evaluates the spectrum of visual impairment in stroke survivors. Methods The Impact of Visual Impairment after Stroke (IVIS) study is a multi-centre, acute stroke unit, prospective epidemiology study. Comprehensive visual examination was offered to all stroke survivors. Results 1500 stroke admissions were recruited. 1204 stroke sur...

A better understanding of practice-induced functional and structural changes in our brains can help us design more effective learning environments that provide better outcomes. Although there is growing evidence from human neuroimaging that experience-dependent brain plasticity is expressed in measurable brain changes that are correlated with behav...

Background/Objectives Stroke-related visual impairment and atrial fibrillation are both common following stroke. This study explores whether presence of visual impairment following stroke is associated with presence of atrial fibrillation (AF). Subjects/Methods The Impact of Visual Impairment after Stroke (IVIS) study is a multi-centre, acute stro...

Purpose: European visual requirements for driving generally follow the standards of the European Union (EU), but the lack of a uniform perimetry algorithm leads to differing practices in enforcing visual field regulations. The purpose of this study was to develop a perimetry algorithm for group 1 driving licenses (car and motorcycle) that adheres...

Background About two-thirds of stroke survivors experience visual problems and most patients who have a stroke limited to the occipital lobe will have visual impairments only. Aim The V-FAST screening tool, which assesses visual symptoms, eye movements, visual field and visual extinction, and a training package to improve diagnostic accuracy of id...

Introduction Inequalities have been found to exist within the visually impaired stroke population on an individual level, in relation to demographic differences, unequal access to vision services, transport, employment, and financial repercussions. The long‐term impact of living with poststroke visual impairments must be explored, in order to ident...

Purpose: The presence of central visual field loss does not infer the extent of peripheral visual field loss. In advanced stage glaucoma, we evaluated whether automated kinetic perimetry provided additional visual field information to that of central static perimetry. Materials and Methods: We undertook a prospective cross sectional study of advanc...

Aim: COVID-19 has widely impacted hospital services. The purpose of this study was to determine the impact of COVID-19 on Orthoptists and their clinical practice in the UK, Ireland, and Channel Islands. Methods: We conducted a prospective survey-based cross-sectional study using an online survey aiming for coverage of orthoptic departments acros...

Purpose Screening for visual problems in stroke survivors is not standardised. Visual problems that remain undetected or poorly identified can create unmet needs for stroke survivors. We report the validation of a new Vision Impairment Screening Assessment (VISA) tool intended for use by the stroke team to improve identification of visual impairmen...

Purpose: We aimed to develop a stroke-vision care pathway for stroke survivors with visual impairment. Methods: A literature review searched key electronic bibliographic databases for care pathways related to stroke/vision. Two focus group meetings using semi-structured/nominal group technique reached consensus on items relevant for inclusion in a...

Background: Neurological conditions frequently cause visual field loss, commonly resulting in perimetry requests for suspected or known conditions. Currently there are no national guidelines for perimetry in neurological conditions. A wide choice of perimetry programs exists. An inappropriate program choice could fail to detect visual field loss....

Objectives Visual impairment following stroke is common with a reported incidence of visual impairment in 60% of stroke survivors. Screening for visual impairment is neither routine nor standardised. This results in a health inequality where some stroke survivors receive comprehensive vision assessment to identify any existent visual problems while...

Aim: To compare kinetic perimetry on the Humphrey 850 and Octopus 900 perimeters for assessment of visual fields, uniocular rotations and fields of binocular single vision. Methods: Prospective cross section study comparing Humphrey 850 kinetic perimetry to kinetic perimetry using the Octopus 900. Results were compared for both perimeters for th...

Aim: New methods of measurement require testing to evaluate test validity. This study compares stereoacuity results of the Lang Stereopad to other common clinical stereoacuity assessments in a normal vision population. Methods: A prospective cross-sectional study was conducted comparing the Lang Stereopad stereoacuity results to results from the La...

Aim: New methods of measurement require testing to evaluate test validity. This study compares stereoacuity results of the Lang Stereopad to other common clinical stereoacuity assessments in a normal vision population. Methods: A prospective cross-sectional study was conducted comparing the Lang Stereopad stereoacuity results to results from the La...

Aim: Orthoptists are perhaps the only allied health profession without a standard home visits service in the UK, although it could arguably be of benefit to many orthoptic patients. The aim of this survey was to identify whether home visits are being offered, or have the potential to be offered, within the orthoptic profession. Method: A survey...

Background: Among the available patient-reported outcome measures (PROMs) there is an absence of a PROM with a specific focus on the impact of the wide variety of visual impairments following stroke. Our aim was to develop a patient reported quality of life outcome measure for stroke survivors with visual impairment. Methods: Potential items wer...

Background: Visual field defects are estimated to affect 20% to 57% of people who have had a stroke. Visual field defects can affect functional ability in activities of daily living (commonly affecting mobility, reading and driving), quality of life, ability to participate in rehabilitation, and depression and anxiety following stroke. There are m...

Aim: In 2007 a national orthoptic survey identified poor provision of vision assessment for stroke survivors. The purpose of this study is to report a 10-year update of this survey to identify changes in clinical practice over recent years. Methods: An online practice survey of registered orthoptists (British and Irish Orthoptic Society, BIOS) w...

Background: We conduct supplementary analyses of the NEI VFQ-25 data to evaluate where changes occurred within subscales of the NEI VFQ-25 leading to change in the composite scores between the three treatment arms, and evaluate the NEI VFQ-25 with and without the Neuro 10 supplement. Methods: A prospective, multicentre, parallel, single-blind, t...

Purpose: To review the evidence on the impact of visual field loss on skills required for driving. Methods: A literature search was undertaken using a systematic approach. Papers within scope were identified by two independent reviewers, and papers were grouped into similar themes for discussion. Key findings: Evidence suggests that both binocula...

Peripheral vision loss results in the inability to detect objects in the peripheral visual field which affects the ability to evaluate and avoid potential hazards. A different number of assistive navigation systems have been developed to help people with vision impairments using wearable and portable devices. Most of these systems are designed to s...

Aim: To conduct a feasibility study using vertical reading for stroke survivors with homonymous hemianopia. Feasibility objectives included assessing the appropriateness of testing methods, outcomes and amount of recruitment possible. Vertical reading has yet no empirical evidence for its use in homonymous hemianopia. Method: A cross-over design...

Background Visual problems are an under-reported sequela following stroke. The aim of this study is to report annual incidence and point prevalence of visual problems in an acute adult stroke population and to explore feasibility of early timing of visual assessment. Methods and findings Multi-centre acute stroke unit, prospective, epidemiology st...

IVIS database.sav Minimum anonymised data set. (SAV)

Peripheral vision loss is the lack of ability to recognise objects and shapes in the outer area of the visual field. This condition can affect people's daily activities and reduces their quality of life. In this work, a smart technology that implements computer vision algorithms in real-time to detect and track moving hazards around people with per...

Background: Fusional amplitudes are important for clinical practice in diagnosing and managing binocular vision anomalies. Several measurement methods can be used to assess fusional amplitudes. However, those methods are not interchangeable, and measurement repeatability has been questioned. Objectives: To compare the normative values of tests for...

Background Core Outcome Sets (COS) are defined as the minimum sets of outcomes that should be measured and reported in all randomised controlled trials to facilitate combination and comparability of research. The aim of this review is to produce an item bank of previously reported outcome measures from published studies in amblyopia, strabismus and...

Background: Visual field loss occurs frequently in neurological conditions and perimetry is commonly requested for patients with suspected or known conditions. There are currently no guidelines for how visual fields in neurological conditions should be assessed. There is a wide range of visual field programs available and the wrong choice of progr...

Aim To provide a systematic overview of the factors that influence how a person adapts to visual field loss following stroke. Method A systematic review was undertaken (data search period 1861–2016) inclusive of systematic reviews, randomized controlled trials, controlled trials, cohort studies, observational studies, and case controlled studies....

The efficient use of image sensors has been one of the top challenges for computer vision researchers for several years. Detecting and tracking objects, video surveillance, navigation, and many other real-time applications depend on motion estimation for moving camera. In this paper, a real-time method for the detection and classification of the mo...

Peripheral vision loss is the lack of ability to recognise objects and shapes in the outer area of the visual field. In this study, we propose a smart technology that implements computer vision algorithms in real-time to detect and track moving hazards around people with peripheral vision loss. Using smart glasses, our system produces warning notif...

Background: Acquired brain injury can cause eye movement disorders which may include: strabismus, gaze deficits and nystagmus, causing visual symptoms of double, blurred or 'juddery' vision and reading difficulties. A wide range of interventions exist that have potential to alleviate or ameliorate these symptoms. There is a need to evaluate the ef...

Objective To report and evaluate a new Vision Impairment Screening Assessment (VISA) tool intended for use by the stroke team to improve identification of visual impairment in stroke survivors. Design Prospective case cohort comparative study. Setting Stroke units at two secondary care hospitals and one tertiary centre. Participants 116 stroke s...

Introduction The aim of this study was to ascertain what items stroke survivors and stroke care professionals think are important when assessing quality of life for stroke survivors with visual impairment for inclusion in the new patient‐reported outcome measure. Methods A reactive Delphi process was used in a three‐round electronic‐based survey....

Aim To profile the full range of visual disorders from a large prospective observation study of stroke survivors referred by stroke multidisciplinary teams to orthoptic services with suspected visual problems. Methods Multicenter prospective study undertaken in 20 acute Trust hospitals. Standardized screening/referral forms and investigation forms...

Objectives In the United Kingdom, when an individual's sight falls to and remains at a certain threshold, they may be offered registration as sight impaired. Recent analysis of causes of registrable sight impairment in England/Wales indicated that visual impairment due to stroke had increased as a proportionate cause of sight loss. We aim to assess...

Objectives We sought to determine stroke survivors’ views on impact of stroke‐related visual impairment to quality of life. Materials and Methods Stroke survivors with visual impairment, more than 1 year post stroke onset, were recruited. Semistructured biographical narrative interviews were audio‐recorded and transcribed verbatim. A thematic appr...

Purpose: This study sought to explore the practice of orthoptists internationally in care provision for poststroke visual impairment. Methods: Survey questions were developed and piloted with clinicians, academics, and users. Questions addressed types of visual problems, how these were identified, treated, and followed up, care pathways in use,...

The aim of this study was to identify which treatments for post-stroke visual impairment have a supportive evidence base, and which are being used in practice without supportive evidence. A systematic review of the literature reporting on the available treatment options was compared against the visual treatments used in the Vision In Stroke (VIS) s...

The aim of this study was to report on the health inequalities facing stroke survivors with visual impairments as described in the current literature. A systemic review of the literature was conducted to investigate the potential health inequalities facing stroke survivors with subsequent visual impairments. A quality-of-evidence and risk-of-bias a...

Aim: To present an overview of the range of systematic reviews on intervention trials pertinent to orthoptic practice, produced by the Cochrane Eyes and Vision group (CEV). Methods: We searched the 2016 Cochrane Library database (31.03.2016) to identify completed reviews and protocols of direct relevance to orthoptic practice. These reviews are cur...

Background: The use of botulinum toxin as an investigative and treatment modality for strabismus is well reported in the medical literature. However, it is unclear how effective it is in comparison to other treatment options for strabismus. Objectives: The primary objective was to examine the efficacy of botulinum toxin therapy in the treatment...

Aim To provide a systematic overview of interventions for stroke related visual impairments. Method A systematic review of the literature was conducted including randomized controlled trials, controlled trials, cohort studies, observational studies, systematic reviews, and retrospective medical note reviews. All languages were included and transla...

Objective: Pilot trial comparing prism therapy and visual search training, for homonymous hemianopia, to standard care (information only). Methods: Prospective, multicentre, parallel, single-blind, three-arm RCT across fifteen UK acute stroke units. Participants: Stroke survivors with homonymous hemianopia. Interventions: Arm a (Fresnel prisms) for...

Purpose: To evaluate the role of neural integrators (NI) in the oculomotor system. Methods: A literature search was carried out using several electronic databases during the months of June 2014 to March 2015. The following keywords were used to generate focused results: 'neural integrators', 'gaze-holding', 'oculomotor integration', 'impaired ga...

Purpose: To provide a systematic overview of the various tools available to screen for post-stroke visual impairment. Methods: A review of the literature was conducted including randomised controlled trials, controlled trials, cohort studies, observational studies, systematic reviews and retrospective medical note reviews. All languages were includ...