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Visual Neglect – Rehabilitation — SCE Neurology MCQ

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HardNeurorehabilitationVisual Neglect – RehabilitationSCE Neurology

Six weeks after a right-hemisphere stroke, a patient with intact primary visual fields repeatedly begins reading in the middle of each line and omits words to the left. The occupational therapist is targeting this specific reading error. Which exercise most directly implements the NICE visual-inattention strategy?

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Correct answer: D — Scan leftwards from a salient anchor placed at the page boundary

The pattern is visual inattention rather than a primary field defect. NICE describes scanning activities in which a coloured line or another salient stimulus is placed at the edge of the affected side. For this page-based error, the anchor provides a starting point for deliberate leftward exploration before progressing across each line. Rightward pursuit and unaffected-limb movement reinforce the wrong hemispace for the stated task. Occlusion sacrifices binocular vision, while a rightward optical shift does not implement the specified left-boundary scanning exercise.

Reference: NICE NG236, Stroke rehabilitation in adults — recommendations: https://www.nice.org.uk/guidance/ng236/chapter/recommendations