Services
Neuro-Ophthalmology
Specialist assessment and management of visual disturbances arising from the optic nerve, visual pathways, and the brain.
What is Neuro-Ophthalmology?
Neuro-ophthalmology sits at the interface between ophthalmology and neurology. It encompasses conditions where the visual symptoms arise not from the eye itself, but from the optic nerve, the visual pathways through the brain, or the neurological control of eye movements.
Many neuro-ophthalmic conditions are serious and require prompt investigation and treatment. They may be the presenting feature of significant neurological or systemic disease — including multiple sclerosis, brain tumours, giant cell arteritis, and raised intracranial pressure. Early referral can be critical.
Conditions We Assess and Treat
Optic Neuritis
Inflammation of the optic nerve causing acute visual loss, pain on eye movement, and reduced colour vision. Often associated with multiple sclerosis. Requires urgent evaluation and may require treatment with intravenous steroids.
Papilloedema & Raised Intracranial Pressure
Swelling of the optic disc due to raised intracranial pressure. Causes include idiopathic intracranial hypertension (pseudotumour cerebri) and space-occupying lesions. Requires urgent investigation with brain imaging and lumbar puncture.
Diplopia (Double Vision)
New-onset double vision may indicate cranial nerve palsy (third, fourth, or sixth nerve), myasthenia gravis, thyroid eye disease, or orbital pathology. Careful assessment is required to determine the cause and appropriate management.
Visual Field Defects
Patterns of visual field loss can localise the site of damage within the visual pathway — from the optic nerve to the occipital cortex. May be caused by stroke, tumour, glaucoma, or other neurological conditions.
Unexplained Visual Loss
When visual loss cannot be explained by standard eye examination, neuro-ophthalmic assessment is required to identify optic nerve or intracranial causes.
Giant Cell Arteritis (Temporal Arteritis)
A medical emergency in patients over 50 presenting with new headache, jaw claudication, and visual symptoms. Without urgent treatment, permanent blindness can result. Requires immediate steroid treatment and biopsy.
When to Refer Urgently
- Acute painful visual loss
- New painless monocular visual loss
- Sudden onset diplopia
- Swollen optic discs on fundoscopy
- Headache with visual symptoms in patients >50
- Asymmetric or unexplained visual field loss
- Ptosis with dilated or small pupil
Urgent referrals welcome
For urgent neuro-ophthalmic presentations, please call us directly.
Call 03 9466 8822Make an AppointmentAlso Assessed & Managed
Thyroid Eye Disease
Orbital inflammation and proptosis associated with thyroid dysfunction, managed in conjunction with endocrinology.
Myasthenia Gravis
Neuromuscular junction disorder causing variable ptosis and diplopia. Managed in collaboration with neurology.
Nystagmus
Involuntary rhythmic eye movements. Assessment helps determine whether the cause is congenital, neurological, or vestibular.
Functional Visual Loss
Visual symptoms without an organic cause. Careful examination and appropriate investigations are required to exclude serious pathology.
Our Neuro-Ophthalmology Specialist
Dr Rogan Fraser is a consultant in the Neuro-Ophthalmology Unit at the Royal Victorian Eye and Ear Hospital, and a visiting lecturer at Monash and Deakin universities.
Dr Rogan Fraser
FRANZCO
Neuro-Ophthalmology
General Ophthalmology
Dr Rogan Fraser practices comprehensive, general ophthalmology with an interest in neuro-ophthalmology. He graduated from the University of Melbourne with a Doctor of Medicine in 2015 where he was on the Dean's Honours list. Prior to that, he practised as an optometrist in regional Victoria for a number of years, which is where his passion for personalised compassionate and full scope eyecare was developed and honed. Dr Fraser undertook his ophthalmology training through the Royal Victorian Eye and Ear Hospital, and in his final year was appointed the Chief Registrar. He currently works as a consultant in the Neuro-ophthalmology unit at the Eye and Ear, as well as in that hospital's emergency department. In this capacity he supervises and teaches both ophthalmology and neurology trainees. He is a visiting lecturer for Monash and Deakin universities, and has been a faculty member of surgical, and neuro-ophthalmology conferences throughout Australia. He is a Fellow of the Royal Australian and New Zealand College of Ophthalmologists, and a member of both the Neuro-Ophthalmology Society of Australia, and the UK Neuro-Ophthalmology Society.
Qualifications
- —FRANZCO
Academic
- —Visiting Lecturer, Monash University
- —Visiting Lecturer, Deakin University
Professional Memberships
- —Neuro-Ophthalmology Society of Australia
- —UK Neuro-Ophthalmology Society
Public Appointments
- —Neuro-ophthalmology Unit, Royal Victorian Eye and Ear Hospital
- —Emergency Department, Royal Victorian Eye and Ear Hospital
Refer a Patient to Neuro-Ophthalmology
Dr Rogan Fraser welcomes referrals for neuro-ophthalmic conditions. For urgent presentations, please call us directly on 03 9466 8822.