Neuro-ophthalmology

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Neuro-ophthalmology is the sub-specialty of ophthalmic research that deals with neuronal relations of visual defects. In simple terms, It can be explained as it is the specialty that deals with ophthalmic diseases with neurological problems and various optic nerve disorders.

Major neuro-ophthalmological disorders include mainly optic neuritis, optic neuropathy, monocular blindness, migraine and visual symptoms etc. Neuro-ophthalmic disease conditions occur due to optic nerve dysfunctions as well as eye movement disorders.

Neuro-ophthalmological testing is can be performed to detect the spectrum of neuro-ophthalmic diseases in the earliest stage. The testing involves sensory testing, visual acuity, color-vision testing, Amsler grid etc.

Neuro-ophthalmology studies help to give a proper understanding of complex systemic diseases and their visual effects. Glaucoma is one of the major neuro-ophthalmic diseases that affect visual pathways of the brain.

Patients with the neuro-ophthalmological disease often report symptoms that relate to the eyes like unexplained loss of vision, loss of peripheral vision, abnormalities in the pupil, double vision, and twitching of facial and eyelid muscles. Because of the difficulty in diagnosing these symptoms patients often end up visiting several physicians before receiving a clear-cut diagnosis.

Types of Neuro-Ophthalmological Conditions

  • Eye movement disorders
  • Unexplained visual loss
  • Double vision
  • Facial movement disorders, Blepharospasm, Hemi Facial Spasm
  • Abnormalities of the pupil
  • Myasthenia gravis
  • Thyroid eye disease
  • Orbital Tumor

Some specific examples of these include

Eye Movement Abnormalities:

  • Thyroid Eye Disease
  • Myasthenia Gravis
  • Ocular motor nerve disorders
  • Gaze Palsies and Nystagmus
  • Double vision

Visual Disorders:

  • Post Traumatic Visual Disorders
  • Papilledema (including Pseudotumor Cerebri)
  • Ischemic Optic Neuropathy (including Temporal Arteritis)
  • Compressive Optic Neuropathy
  • Pituitary and other brain tumors
  • Optic Neuritis (including Multiple Sclerosis and Devic’s Disease)

Neuro-Ophthalmic Diagnostic Procedures

Diagnosis and treatment of neuro-ophthalmic disorders which may be conducted through a series of tests mentioned below. Diagnostic evaluation services often include the following:

  • MRI
  • CT scan
  • Ultrasound
  • Cerebral angiography
  • Optical coherence tomography

A neuro-ophthalmologic evaluation is a detailed and comprehensive examination that might last for hours. A complete medical history is taken and a doctor needs to examine the visual field and eye movement or any required procedure.

Treatment Options

Treatment plans depend on the case and stage for each patient. Treatment of a neuro-ophthalmic disorder depends on the specific type of disorder that has been diagnosed.

Mostly it may include Vision Restoration Therapy (VRT). VRT is a non-invasive treatment that helps to restore vision that has been lost as a result of a traumatic brain injury, such as a stroke or any other trauma. It is completed using a specially-designed computer device, VRT encourages visual stimulation to enhance activity in the brain relating to vision. It has proven to help some patients regain lost to sight.

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