Research funded by UK charity, PSPA, highlights the valuable role orthoptists can play in diagnosing a rare neurological condition called Progressive Supranuclear Palsy (PSP).

Recent research, part-funded by the PSP Association (PSPA), has found that specialist eye movement assessments carried out by orthoptists can reliably help clinicians identify PSP earlier and more accurately.

PSP is a rare, degenerative neurological condition which is commonly misdiagnosed. As much as 60% of people diagnosed are initially thought to have other conditions including Parkinson’s, stroke or depression.  Early and accurate diagnosis is vital to affected families accessing appropriate care and being eligible for financial support.

With no definitive diagnostic test available, the team of orthoptic professionals, led by Dominic Burdon, Advanced Orthoptist from the University Hospitals Plymouth NHS Trust, wanted to investigate how oculomotor assessments for identifying signs such as vertical eye movement issues, reduced blink rate, eyelid opening problems, and impaired convergence, could aid the diagnostic process and help differentiate PSP from other atypical Parkinsonian disorders.

The research, published in the British and Irish Orthoptic Journal, reviewed 26 patients referred for orthoptic oculomotor and eye tracker assessment after presenting with atypical Parkinsonian signs. Researchers compared the orthoptic findings with final diagnoses made by neurology and neurosurgery specialists.

Key findings from the research included:

• Orthoptic assessments aligned with final neurological diagnoses in over 80% of cases (21 out of 26 patients).
• Among patients initially flagged as “suspected PSP” by orthoptists, nearly three quarters (73.68%) later received a PSP diagnosis from neurology.
• For patients assessed as “suspected non PSP,” the orthoptic findings were 100% consistent with the final diagnosis.
• Eye tracking technology proved particularly valuable for identifying subtle early signs such as slow velocity vertical saccades, which are highly specific to PSP.

Lead investigator Dominic Burdon, Advanced Orthoptist working at the University Hospitals Plymouth NHS Trust, explained: “Our findings show that orthoptic eye movement assessments are not only clinically useful but highly reliable in supporting early PSP diagnosis. By identifying specific oculomotor patterns, orthoptists can provide valuable diagnostic clarity at a stage when symptoms may still be ambiguous.”

Co-authors Stephen Mullin and Christopher Harris emphasised that early diagnosis allows patients to access essential therapies, including physiotherapy, speech and language therapy, and nutritional support, while they are still able to benefit from them.

James Cusack, CEO at PSPA, said: “We understand the real-life impact delays in diagnosis can create for families living with PSP. Often, that all-important diagnosis not only helps to end years of uncertainty, but it also provides a gateway for accessing specialist care, support, and funding families need to live the best life they can and plan ahead.

“The findings from Dominic and the team’s research, reinforces the importance of specialist eye movement assessment in improving the diagnostic pathway for people with PSP. We are proud to help fund this work that brings us closer to earlier recognition and better care for those living with this devastating condition.”

Read the paper in full at: https://bioj-online.com/articles/505/files/69d8bf7054fb0.pdf

Learn more about how PSPA funds and supports research, here: www.pspassociation.org.uk/research/research-information/research-strategy/

About PSP and CBD

Progressive Supranuclear Palsy (PSP) and Corticobasal Degeneration (CBD) are two rare neuro-degenerative diseases.

They are caused by the loss of neurons in certain parts of the brain. Over time, this leads to difficulties with balance, mobility, speech, vision, swallowing and cognition.

Both conditions are life limiting. There is no treatment and no cure.

Currently, around 60% of people living with either disease, are initially misdiagnosed with other conditions including Parkinson’s, stroke and depression.

PSPA is the only UK charity dedicated to creating a better future for every affected by PSP & CBD.

We will do this by:

• Providing information and support to enable families living with PSP & CBD to live their best possible lives

• Improving the quality of life for people living with the condition via research and awareness raising

• Putting the voice of the PSP & CBD community at the heart of what we do.

For more information please visit www.pspassociation.org.uk

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