Seeing Stars, Stones and Snow

A/Prof Clare L. Fraser

Meeting:  2022 RANZCO


Date:      -


Session Time:      -

Synopsis: Sometimes in neuro-ophthalmology it is the patient who is not quite sure what they are seeing and sometimes it is the doctor.
My neuro-ophthalmic research has always been driven by the curiosities and patient vignettes, particularly those rare conditions that have been overlooked by past research efforts. This lecture will explore recent advances in three areas of neuro-ophthalmology from my own research.
A concussion is often colloquially referred to as “seeing
stars” after a head injury. The visual pathways make up 30-50% of the brain substance, and therefore a diffuse brain injury like a concussion will often result in visual symptoms. These can be persistent and difficult for the patient to explain. Research is expanding on the diagnosis and management of acute concussion, post-concussion syndrome and chronic traumatic encephalopathy.
Drusen is the German word for a geode or stone. Optic disc drusen are calcified areas in front of the lamina cribrosa within the disc substance. Drusen can cause dif- ficulty for the ophthalmologist who needs to decide if the patient has papilloedema or true disc swelling. New diag- nostic guidelines have been published and there is increasing research into the nature of disc drusen, how they progress and the risks to a patient’s vision.
Finally, Visual Snow Syndrome is an increasingly recognised visual phenomenon which now has its own set of diagnostic criteria. While not being dangerous or progressive, it can cause very disabling symptoms for the patient. New research is providing insights into the neu- rological substrate of this phenomenon and will hope- fully lead to better treatment options.