What is Neuro-Ophthalmology?

Neuro-ophthalmology is a complex medical specialty that treats vision problems originating in the brain or nerves instead of the eye. Brain injuries, stroke, problems with the optic nerve, and even spasms in the muscles surrounding the eye can all interfere with sight. A neuro-ophthalmologist provides specialized care for the eyes, brain, nerves that support vision, and muscles surrounding the eyes.

Often, a patient is referred to a neuro-ophthalmologist when vision problems can't be explained by standard eye exams. Even if the eyes are working correctly, there are a surprising number of issues that can cause vision loss. Some of the problems that neuro-ophthalmologists treat include:
  • Optic nerve disorders, including optic neuritis and ischemic optic neuropathy
  • Visual field loss, including blind spots or loss of peripheral vision
  • Unexplained blindness
  • Visual disturbances, 'seeing spots' or halos
  • Double vision
  • Abnormal eye movements
  • Fixed or uneven pupils
  • Eye issues related to a larger illness, such as thyroid disease, multiple sclerosis, or myasthenia gravis

Neuro-ophthalmologists need to examine the function of the brain and nervous system as well as the eyes in order to care for patients. They may order specialized tests that can provide more information about what's going on inside the body. It's common for a visit to begin with an eye exam, but neuro-ophthalmologists often order CT scans or MRIs as well. In addition, they may perform:
  • Neurological exams to check brain function
  • Visual field tests, also known as perimetry, to gauge vision
  • Pupillography to test the reactions of the pupil
  • Critical flicker fusion testing, to check how well the optic nerve transmits information
  • Electroretinography to examine the function of rods and cones in the eye
  • Optical coherence tomography to examine the retina and optic nerve

Sudden problems with your vision can be very frightening. A neuro-ophthalmologist can provide you with information about why your vision has changed, as well as make recommendations for treatment.
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