Raised pressure inside the skull (intracranial hypertension) is a serious condition that can occur after brain injuries, strokes, brain tumours, bleeding, or disorders affecting the circulation of cerebrospinal fluid. If not detected and treated promptly, it can lead to permanent visual loss, neurological disability, and, in severe cases, death. Currently, the most accurate way to measure intracranial pressure (ICP) requires inserting a pressure-monitoring device into the brain through a surgical procedure. Although this method provides valuable information, it is invasive, carries risks, and cannot be used routinely for all patients who may be at risk.

This research aims to develop safer, non-invasive ways to identify and monitor raised intracranial pressure by studying changes in the eye. The eye provides a unique window into the brain because the optic nerve connects to the brain and is surrounded by the same protective fluid. Changes caused by increased pressure can therefore be reflected in the structures and blood vessels of the eye.

The project will investigate several eye-based measurements, including spontaneous retinal venous pulsations (tiny natural movements of retinal veins), retinal imaging using optical coherence tomography (OCT), measurements of the optic nerve sheath, and pupil responses. These markers will be compared with direct ICP measurements collected from patients who already require monitoring as part of their clinical care.

The study will combine these different eye measurements using advanced data analysis methods to determine whether they can accurately predict intracranial pressure. It will also explore whether these markers can detect changes earlier than current clinical signs and whether they can be used to monitor patients after treatment.

The long-term goal is to develop a reliable, accessible, and non-invasive method for assessing intracranial pressure. This could transform care for patients with neurological conditions, allowing earlier diagnosis, reducing the need for invasive procedures, and enabling faster treatment to prevent complications such as blindness and permanent brain injury.