It seems to me that both do surgeries and both have to work with nerves.
Somewhere I have seen that working with nerve and eye is one of the hardest surgeries so I wonder why Neurosurgical average pay range from 350 to 500k pa and neuro opht are average 180 to 220k pa
I recently started med school so I do not have so broad knowledge so I might be missing something, but as it is now I just wonder.
Neuro-ophthalmologists come to their sub-specialty by one of two ways: as neurologists first who do a neurology residency then a neuro-ophthalmology fellowship, or as ophthalmologists first who do an ophthalmlogy residency then a fellowship in neuro-ophthalmology.
Both are different from neurosurgeons, who do neurosurgery residencies (with or without additional fellowship).
Neurology-first neuro-ophthamologists seldom do any surgery. Ophthalmology-first neuro-ophthalmologists may do surgery in general ophthamology or their subspecialty or in combination with a related subspecialty, oculoplastic surgery or strabismus surgery, for example. Which they may do will depend on their particular training experience and desire.
Neuro-ophthalmology is typically a lower patient volume practice. The exams take longer than average ophthalmology exams, may require additional exam methods and more time with the patient. Throughput--patients seen per day, and procedural income by surgery and ancillary services determine earning, directly in private practice and indirectly in institutional practice. In a fairer and more reasonable system, there would be some way to value the services better, but the general RVU x multiplier method applied to ophthalmology in the USA generally disadvantages the subspecialties that cannot responsibly see 40 patients per day or afford the level of staff support that rate of activity requires and can afford.
Neurosurgeons earn a great deal of their income from performing surgery and less from office services. The surgeries they perform are commonly very complex and entail risk and are reimbursed relatively well (although some might point out how dermatologists turn that principle on its head.)
