Characteristics of neuro-ophthalmic visual disturbances post-cataract surgery
Reviewed by Lauren Hepworth

The authors present a retrospective case review of adult patients seen by neuro-ophthalmology over a nine-year period. The aim of the study was to identify the cause of neuro-ophthalmic referrals within six months of cataract surgery. Individuals already known to neuro-ophthalmology, had received combined intraocular procedure with cataract surgery, or were lost to follow-up, were excluded. The following data were extracted from medical records: medical history, full neuro-ophthalmic assessment and any diagnostic tests received. The primary study outcome was the neuro-ophthalmic aetiology causing the visual disturbance. A total of 173 cases met the inclusion criteria. Blurred vision was the most commonly reported symptom of the new onset visual disturbance. Other common symptoms reported were diplopia, photophobia and visual field loss. Of those included 61% received a neuro-ophthalmic diagnosis. The most common diagnosis was decompensating strabismus (30.6%), of which 58% had no pre-surgery complaint of diplopia. The prevalence of neuro-ophthalmic disorders post-cataract surgery was calculated as 0.15%. The authors acknowledge the limitations of their retrospective methodology. This study highlights the importance to investigate the history of strabismus, diplopia or prescription of prisms prior to cataract surgery. This investigation should include ocular alignment and ocular motility to allow management of cataract surgery expectations and prevent / reduce anxiety if diplopia does occur postoperatively.

Frequency and etiologies of visual disturbance after cataract surgery identified in neuro-ophthalmology clinics.
Lin S-C, Giang A, Liu GT, et al.
JOURNAL OF NEURO-OPHTHALMOLOGY
2023;43:359–63.