Neuro-ophthalmology
Manchester Royal Eye Hospital
Neuro-ophthalmology at Manchester Royal Eye Hospital
Manchester Royal Eye Hospital provides a specialist Neuro-ophthalmology and Adult Strabismus service for adults with neurological conditions affecting the eyes, visual pathways and eye movement systems, as well as patients with strabismus and diplopia. The service brings together ophthalmologists, orthoptists, optometrists, imaging practitioners and medical staff to deliver comprehensive assessment, investigation and management of complex visual disorders.
This programme offers observers and fellows structured exposure to NHS subspecialty ophthalmology practice, with a particular focus on neuro-ophthalmology, ocular motility and adult strabismus. Through participation in clinics and multidisciplinary environments, participants will gain insight into the assessment and management of visual pathway disorders, diplopia and eye movement abnormalities, while developing an understanding of patient-centred care, clinical governance and safe NHS practice.
Our programmes provides valuable experience of multidisciplinary working within a high-volume specialist eye hospital and supports future clinical, academic and leadership development in ophthalmology and related specialties.
Fellowships and observerships at Manchester Specialist Health Academy provide international clinicians with structured opportunities to experience high quality healthcare training within a leading NHS environment. Both pathways offer consultant oversight, a clear induction, and access to modern clinical settings that support a strong understanding of advanced patient care. Participants are welcomed into a professional community that encourages learning, collaboration, and engagement with the culture of Manchester.
While fellows take part in more in depth clinical development, gaining exposure to subspecialties, procedures and research, observers focus on shadowing and understanding multidisciplinary practice within NHS services. Both groups benefit from involvement in clinics, team discussions, and wider learning activities such as simulation sessions, CPD opportunities, and quality improvement insight.
Academic contributions and awards
Smith J, Hirst N, Yagan A. A Quality Assurance Audit of an Orthoptic-Led Virtual Neuro-Ophthalmology Clinic. British and Irish Orthoptic Journal. 2023;19(1):7-14.
Academic and service development themes
• Orthoptic-led and consultant-supported neuro-ophthalmology review models.
• Virtual clinic pathways and demand management within neuro-ophthalmology.
• Multidisciplinary working across ophthalmology, orthoptics, imaging and optometry.
• Education, audit and national or international presentations linked to neuro-ophthalmology, ocular motility and strabismus.
Rare and complex cases
Observers and fellows may gain exposure to complex presentations where eye symptoms are linked to neurological disease, ocular motility disorders or adult strabismus.
• Visual symptoms related to disorders affecting the pathways between the brain and the eyes.
• Diplopia and adult strabismus, including misalignment affecting binocular vision and daily function.
• Ocular motility problems associated with general medical or neurological conditions.
• Perceptual difficulties and defects in eye movement control systems.
• Complex assessment pathways using clinical examination, orthoptic assessment, imaging and other relevant tests.
• Specialist management approaches including optical treatments, botulinum toxin injections and surgery where clinically indicated.
Why Manchester?
Manchester is a city of innovation and progress, renowned as the world’s first industrial city and still leading in science, healthcare, and technology. With excellent transport links and a vibrant, multicultural atmosphere, it offers an inclusive environment for learning and professional growth.
Beyond your placement, Manchester offers something for everyone - from watching the iconic Manchester derby to exploring world-class museums and galleries. With vibrant music, sport, and culture, the city truly has it all. Combining heritage and modernity, it creates a unique setting for personal enrichment and memorable experiences whilst you develop professionally.
Meet our expert supervisors
Our team consists of highly qualified and motivated professionals, who are all experts in their field. With many years of experience in the industry, they have the expertise to provide comprehensive, first-rate services to our clients.
Mandagere Vishwanath
FRCSEd, DOMS
Mr Mandagere Vishwanath is a Consultant Ophthalmologist at Manchester Royal Eye Hospital with specialist interests in strabismus (squint), neuro-ophthalmology, ocular ultrasonography, and cataract surgery. Appointed as a Consultant in 2009, he has extensive experience managing complex eye conditions and is actively involved in teaching, training, research, and the development of specialist ophthalmic services.
Ali Yagan
MD. MSc. (Ophth) PGCert (Med Edu.) FRCOphth
Mr Ali Yagan is a Consultant Ophthalmologist at Manchester Royal Eye Hospital with specialist interests in neuro-ophthalmology and adult strabismus surgery. A Consultant since 2015, he specialises in the assessment and management of complex neuro-ophthalmic and ocular motility disorders, alongside squint surgery and botulinum toxin treatment, and is actively involved in teaching and training ophthalmologists.
Revelle Littlewood
MBBS, FRCOphth
Miss Revelle Littlewood is a Consultant Ophthalmologist at Manchester Royal Eye Hospital with specialist interests in neuro-ophthalmology and strabismus (squint). Appointed as a Consultant in 2022, she completed specialist ophthalmic training in South Yorkshire and advanced fellowship training in neuro-ophthalmology and strabismus at Manchester Royal Eye Hospital, where she manages complex neuro-ophthalmic and ocular motility disorders.
Our signature programmes
Observership
Neuro-ophthalmology
Objectives
By the end of the placement, the visiting professional should be able to:
- Describe the scope of neuro-ophthalmology and adult strabismus within a specialist NHS eye hospital.
- Observe how clinicians assess visual symptoms, diplopia, ocular motility disorders and suspected visual pathway conditions.
- Recognise the role of orthoptists, imaging practitioners, optometrists and doctors in multidisciplinary assessment.
- Explain how clinical examination and diagnostic testing contribute to patient-centred management planning.
- Identify key principles of NHS governance, safe practice, communication and multidisciplinary working.
- Reflect on how learning from the observership can support future ophthalmology practice and career development.
Eligibility
- The visiting professional must have sufficient English language skills to engage meaningfully in the observership.
Fellowship
Neuro-ophthalmology
Objectives
By the end of the placement, the visiting professional should be able to:
- Apply advanced clinical reasoning to supervised neuro-ophthalmology and adult strabismus case discussions.
- Interpret how orthoptic assessment, ocular motility examination, visual function testing and imaging contribute to diagnosis and management planning.
- Develop deeper understanding of complex neuro-ophthalmic presentations, adult strabismus, diplopia and visual pathway disorders.
- Gain insight into medical, optical, botulinum toxin and surgical management pathways where appropriate to the fellow’s learning plan.
- Engage with audit, quality improvement, teaching or research-informed practice within local governance arrangements.
- Develop subspecialty capability and professional insight to support future consultant, academic or service leadership roles.
Eligibility
- Postgraduate Qualification: Applicants must hold an overseas-recognised postgraduate medical qualification (MD, MS, Masters) in ophthalmology or a relevant specialty.
- Experience: Minimum of 3 years’ recent experience in ophthalmology or a related specialty within the last 5 years, including at least 12 months of continuous practice before applying.
- Training Level: Equivalent to ST5 or above, or post-CCT clinicians seeking subspecialty exposure.
- Language Proficiency: IELTS Academic with 7.0 in each band and overall 7.5, or OET Medicine with Grade B in all domains, with certificate validity within 24 months.
- Registration: GMC registration is required for fellowship activity. Sponsorship support may be available through approved routes where appropriate.
- Applicants must not have failed PLAB exams previously.
- Visa sponsorship is only available through approved routes; self-funded visas outside agreed schemes are excluded.
- Additional specialty expectation: Prior exposure to neuro-ophthalmology, adult strabismus, ocular motility, optic nerve disease, diplopia assessment or ophthalmic diagnostics is desirable for fellows. Fellows should have sufficient ophthalmology experience to participate in supervised subspecialty case discussion, audit or service-improvement activity