Oxford Visual Perception Screen for stroke survivors
At the University of Oxford, I developed a new screening test for visual perception difficulties after stroke, the Oxford Visual Perception Screen or OxVPS.
Visual perception refer to how the brain interprets the information coming from the eyes. Our eyes might be working fine, but after brain injury our brain might not be able to recognise objects or faces anymore, make up words from letters, or direct visual attention. Vision and visual perception problems are common after stroke but are not always picked up in a busy clinical environment. The available tests are too long and some are not suitable for stroke survivors with speech difficulties.
With my research, I want to improve diagnosis of visual perception difficulties after stroke. I have interviewed occupational therapists and orthoptists (or eye movement specialists) about how they screen for visual perceptual difficulties and what their clinical needs are. They told me that they want something that is quick and does not require much training. In a national survey, I asked their colleagues from all over the UK if they agreed. With all that input, I then developed a prototype of a visual perception screen. I made both a paper version and an app. The screen has tests for object recognition, face perception, reading, visuo-motor skills, and more. We have asked opinions of stroke survivors and older volunteers too. They told us how to make the instructions more clear and how to make the app user-friendly. Eighty healthy volunteers completed the screening test to determine what the normal range of scores are for people who did not have a brain injury. In 20 stroke survivors we found very similar results between OxVPS and a well-known visual perception test.
At Durham University, I will be evaluating the diagnostic accuracy of OxVPS. With support of the NIHR, we will ask over 100 stroke survivors around Durham and Oxford to complete OxVPS and a gold standard test of visual perception that takes much longer to complete. We will compare stroke survivor’s results on both test to see if the new quick screening test, OxVPS, gives similar results as the gold standard test. We will also be working on providing clinicians with rehabilitation advice for all the conditions that OxVPS screens for. For this, we will summarise the literature on visual perception rehabilitation and discuss best practice recommendations with a panel of experts.
Stroke Association (2018-2021)
Christ Church Research Centre (2019-2020)
National Institute of Health and Social Care Research (2021-2026)
Prof Nele Demeyere – University of Oxford
Prof Chris Price and Dr Lisa Shaw – Newcastle University
Dr Christine Hazelton – Glasgow Caledonian University
Prof Randi Starrfelt and Dr Ro Julia Robotham – University of Copenhagen
Occupational therapists at Acute Stroke Unit – Oxford University Hospitals
Dr Phil Clathworthy – North Bristol NHS Trust
Moore, M. J., Vancleef, K., Shalev, N., Husain, M., & Demeyere, N. (2019) When Neglect Is Neglected: NIHSS observational measure lacks sensitivity in identifying post-stroke unilateral neglect. Journal of Neurology, Neurosurgery & Psychiatry, 90, 1070-1071. http://dx.doi.org/10.1136/jnnp-2018-319668
Demeyere, N., Sun, S., Milosevich, E., Vancleef, K. (2019). Post-stroke cognition with the Oxford Cognitive Screen vs Montreal Cognitive Assessment: a multi-site randomized controlled study (OCS-CARE). [version 1; peer review: 1 approved, 1 approved with reservations]. AMRC Open Res 2019, 1-12. https://doi.org/10.12688/amrcopenres.12882.1
Vancleef, K., Colwell, M. J., Hewitt, O., Demeyere, N. (2020). Current practice and challenges in screening for visual perception deficits after stroke: a qualitative study. Disability and Rehabilitation. https://doi.org/10.1080/09638288.2020.1824245
Moore, M., Vancleef, K., Riddoch, J., Gillebert, C., Demeyere, N. (2021). Recovery of Visuospatial Neglect Subtypes and Relationship to Functional Outcome Six Months After Stroke. Neurorehabilitation and Neural Repair, 35(9), 823-835. https://doi.org/10.1177/15459683211032977
Colwell, M. J., Demeyere, N., Vancleef, K. (2021). Visual Perceptual Deficit Screening in Stroke Survivors: Evaluation of Current Practice in the United Kingdom and Republic of Ireland. Disability and Rehabilitation, 1–13. https://doi.org/10.1080/09638288.2021.1970246