This document is the fourth edition of the BIOS position statement for vision services in stroke practice. It provides a brief overview of orthoptic practice for individuals who have had a stroke, their carers and health care practitioners. It also includes recommendations for the staffing input required from Orthoptists for acute stroke units. It has been updated using a combination of current research evidence from the medical literature and Cochrane systematic reviews, expert consensus from the Orthoptic Clinical Advisory Group (CAG) in Stroke and neuro-rehabilitation and models of best practice