Clinical Practice Patterns of Orthoptists in Post-Stroke Vision Care in Australia

Introduction: Vision impairment is common after stroke and whilst orthoptists are well placed to assess and manage post-stroke visual deficits, their role within Australian stroke care pathways is poorly understood. This study examined orthoptic practice patterns and perceived barriers to post-stroke vision care in Australia. Methods: A cross-sectional online survey of practising Australian orthoptists working in stroke care was conducted, collecting data on demographics, practice settings, referral pathways, assessment and management practices, and perceived barriers. Quantitative data were analysed descriptively, and open-ended responses thematically. Results: Twenty-nine orthoptists completed the survey, representing an estimated 22% of the orthoptic workforce engaged in stroke care. Respondents were mainly experienced clinicians working in private ophthalmology or hospital outpatient eye clinics, with limited involvement in stroke units or rehabilitation settings. Orthoptists reported managing a broad range of post-stroke visual deficits, reflected in comprehensive visual assessments and rehabilitation strategies. Orthoptic involvement most often commenced months post-stroke and key barriers to orthoptic services included limited awareness of orthoptic roles, exclusion from multidisciplinary stroke teams, funding and lack of guideline inclusion. Conclusion: Post-stroke vision care in Australia broadly aligns with international practice, but survey findings suggest that the timing and context of orthoptic involvement may be influenced by structural and organisational factors.