Neuro-ophthalmic disorders are very common (giant cell arteritis, stroke related visual field loss, vascular cranial nerve palsies etc.) and, if mild or long standing, may be dealt with in primary care, primary care ophthalmology, screening services and general ophthalmic services.
Neuro-ophthalmic disease standards in this document apply to care of the common conditions at the severe or acute end of the spectrum, those requiring invasive procedures and more serious or unusual conditions such as posterior uveitis or unusual retinal vasculopathies, which are more appropriately managed in a dedicated neuro MR service. Some conditions are appropriately managed within the neuro-ophthalmic eye clinics such as ocular motility disorders, eyelid disorders, chronic optic neuropathies including selected genetic disorders, posterior uveitis or retinal vasculopathies. Others require targeted co-management with neurology, neurosurgery, diagnostic and interventional radiology, clinical neurophysiology, and neuro-rehabilitation: these services are located within a Clinical Neurosciences Centre where ready access and consultant-led cross –specialty liaison is required.
Any hospital based dedicated neuro-ophthalmic service, and neuro-ophthalmology within neuroscience centres and neuro-rehab services are currently defined as specialised services.