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Progressive Supranuclear Palsy (PSP): An Orthoptic Assessment.

Dominic Burdon¹, Stephen Mullin², Christopher Harris¹

¹Royal Eye Infirmary, University Hospitals Plymouth, UK.

The British and Irish Orthoptic Journal

|April 13, 2026

Summary

This summary is machine-generated.

Orthoptic assessments, including eye-tracker evaluations, effectively differentiate Progressive Supranuclear Palsy (PSP) from other atypical Parkinsonian disorders. This aids clinicians in early diagnosis and management of these complex neurological conditions.

Keywords:

Atypical Parkinsonian disorder neurology orthoptic assessment progressive supranuclear palsy (PSP)vertical supranuclear gaze palsy

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Area of Science:

Neurology
Ophthalmology
Diagnostic Imaging

Background:

Progressive Supranuclear Palsy (PSP) presents with overlapping motor and oculomotor signs with other atypical Parkinsonian disorders, complicating early clinical diagnosis.
Accurate differentiation is crucial for timely and appropriate patient management.

Purpose of the Study:

To audit the diagnostic utility of orthoptic oculomotor and eye-tracker assessments in patients with atypical Parkinsonian signs.
To evaluate the consistency of orthoptic diagnoses with final neurology/neurosurgery diagnoses.

Main Methods:

Retrospective analysis of 26 patients with atypical Parkinsonian signs undergoing orthoptic oculomotor assessment.
Orthoptic evaluation included assessment of oculomotor range, doll's head manoeuvre, saccadic velocity, vergence, eyelid signs, and fixation.
Comparison of orthoptic diagnoses with final neurology/neurosurgery diagnoses.

Main Results:

Orthoptic assessment correctly identified 'suspected PSP' in 73.68% of cases later confirmed by neurology/neurosurgery.
In 26.32% of 'suspected PSP' cases, orthoptic findings suggested PSP, but alternative diagnoses were ultimately made.
Orthoptic diagnoses for 'suspected non-PSP' cases were consistent with final diagnoses in all instances.

Conclusions:

Orthoptic oculomotor and eye-tracker assessments demonstrate high consistency with final diagnoses, achieving 80.77% concordance.
Early orthoptic assessment is clinically effective in ruling Progressive Supranuclear Palsy (PSP) in or out, aiding differential diagnosis in atypical Parkinsonian patients.