Overview:
Neuro-ophthalmology is an ophthalmic subspecialty that addresses the relationship between the eye and the brain, specifically disorders of the optic nerve (nerve that connects the eye to the brain), orbit (eye socket), and brain. Neuro-ophthalmologists take care of visual problems that are related to the nervous system; that is, visual problems that do not come from the eyes themselves
Our Ophthalmologists provide comprehensive clinical care to a broad spectrum of patients with vision problems due to inherited retinal diseases, optic nerve diseases, central nervous system disorders, ocular motility dysfunction (abnormal eye alignment or problems controlling eye movements), and pupillary abnormalities. Although some problems seen by neuro-ophthalmologists are not worrisome, other conditions can worsen and cause permanent visual loss, or become life threatening. Sometimes the problem is confined to the optic nerve or the nervous system and other times it is related to a general medical condition. Neuro-ophthalmologists have unique abilities to evaluate patients from the neurologic, ophthalmologic, and medical standpoints to diagnose and treat a wide variety of problems.
Some of the most common signs of Optic Nerve Dysfunction include:
- Reduced visual activity all of a sudden
- Double vision and headaches
- A less reactive pupil (pupil is the central part of eyeball that allows light to pass through)
- Impairment of colour vision (especially inability to identify red & green colours)
- Difficulty in seeing light (Photophobia)
- Visual Field Defects (visibility coverage)
Neuro Ophthalmic Conditions
- Optic Neuritis:This is a condition that involves inflammation of the optic nerve. An inflammation could occur due to various reasons – starting from an infection to an autoimmune disorder.
- Papilloedema:In this case, the optic disc (the circular area where the optic nerve connects to the retina, at the back of the eye) swells up due to an excessive pressure from inside the skull may be due to a tumor for instance.
- Nutritional Optic Neuropathy: Here the damage to the optic nerve is caused by certain toxic substances found in tobacco & alcohol. This could also occur due to lack of nutrients and deficiency of vitamin B-complex and folic acid.
- Diabetic Neuropathy:In this, the optic nerve is damaged due to the excessive blood sugar or diabetes. As the disease progresses, the blood supply to the retina gets cut-off, leading to vision loss.
Preparing for the Neuro-Ophthalmology Evaluation
- Physicians send all relevant information to the neuro-ophthalmologist prior to the appointment, including office notes, results of laboratory tests and reports of CT and MRI scans.
- If the patient has had a CT or MRI scan performed, arrange to pick up the actual films and bring them with them,
- Patient will probably have his/her pupils dilated during the visit. The eye drops last about 4 hours and will make things look bright and blurry up close.
- In order for the physician to get a good look at eyelids, and to avoid ruining appearance when the eye drops are administered, do not wear eye makeup.
- Bring a complete list of medications along with, including the name and dosage of prescription and over-the-counter medications.
Happens During the Evaluation
- The neuro-ophthalmologic evaluation is one of the most comprehensive examinations a patient will experience. It may take a few hours to complete. Patient will be asked to give an account of current problem and relate the entire medical history, including previous hospitalizations, operations, serious illnesses, medical problems in family members, and medication allergies.
- Patient will have a complete eye examination. This may include peripheral vision testing (visual field test) and other ancillary tests.
- Patient may have a partial or complete neurologic exam to test your strength, sensation, and coordination.
- The neuro-ophthalmologist will review the records and scans from previous evaluations, if applicable.
- After the examination, the neuro-ophthalmologist will discuss the diagnosis (or possible diagnoses), the need for any additional testing and possible treatment.
Neuro-Ophthalmology Treatment Team
An adult or pediatric neuro-ophthalmologist sees patients with neuro-ophthalmic conditions.
Many other subspecialists, such as neurosurgeons, medical oncologists, and radiation oncologists, work with neuro-ophthalmologists. They also work with ophthalmic specialists like ocular oncologists, retina specialists, pediatric ophthalmologists, cornea specialists, and oculoplastic surgeons.
Our specialty group provides cutting-edge ocular imaging and neuroimaging. We hold a monthly imaging conference with neuro-radiology colleagues to evaluate patients with complex conditions. So you have a team of experts looking at your situation from every angle.