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Neuro-Ophthalmology

Neuro-ophthalmology is a specialized branch of medicine that focuses on eye conditions caused by health issues that affect the nervous system. This includes loss of sight due to brain or optic nerve injury. Trauma, inflammation, tumors, toxicities, strokes, and infections can also cause these injuries.

A neuro-ophthalmologist will also see patients that have trouble with eye movements and coordination. This may result in a patient’s eyes looking different ways, or double vision due to misalignment. These conditions relate to the brain as well as the muscles that control the eye.

Why Choose SightMD

Our specialists can provide compassionate care to control your symptoms and if possible they can cure your eye condition. SightMD is a trusted practice that has helped thousands of patients with the help from our doctors neuro-ophthalmic patients gain control of their vision.

When to See a Neuro-Ophthalmologist

Symptoms of neuro-ophthalmic conditions vary as each condition depends on their exact cause and the specific nerves they affect. Some of the most common symptoms include:

Double vision

There are two types of double vision. Monocular diplopia occurs when the eye does not refract light properly. This type is not actually caused by a neurological condition. Binocular diplopia occurs when the nerves do not allow the eyes to move at the same time. This causes each eye to focus on a slightly different point.

Sudden vision loss

Sudden vision loss can result from optic neuritis, ischemic optic neuropathy, macular degeneration, closed-angle glaucoma, and other disorders. The degree of severity will depend on the cause as it can range from a partial loss of vision to complete vision loss. In all cases patients should seek immediate help and treat it as a medical emergency.

Unequal pupils

Unequal pupils can result from neurological and systemic conditions. Such conditions include cranial nerve palsy, Horner syndrome, glaucoma, or Adie’s tonic pupil. Sometimes, uneven pupils may indicate a life-threatening condition so it is important for patients experiencing this symptom to contact a doctor as soon as possible.

Nystagmus

Rapid uncontrolled eye movement can be present at birth and it may also be a symptom of a condition such as cataracts, optic nerve hypoplasia, multiple sclerosis, stroke, and medication toxicity. Nystagmus can cause blurred vision and in severe cases, patients may experience jumping images and an inability to focus their eyes.

Drooping of the eyelids

Also called ptosis, drooping eyelids is a common condition. It typically occurs as the facial skin and muscles lose elasticity with age. Yet, in some cases, ptosis can indicate a neurological condition. Conditions could include Horner syndrome, myasthenia gravis, cranial nerve palsy, or an aneurysm. By itself, ptosis does not actually threaten a patient’s ocular health, although a drooping eyelid may obstruct vision.

Bulging of the eye

In a healthy eye, the white part of the eye should not be visible above the iris and if this area does show, it could indicate a serious condition. Conditions could include Graves’ disease, pseudotumor cerebri, or a tumor around the eye. Bulging eyes occur gradually and some patients may not even notice the symptom for several months.

Neurological Vision Disorders We Treat

Our specialists can treat a variety of neuro-ophthalmology disorders, including:

  • Pseudotumor cerebri: Mimicking the symptoms of a brain tumor. A buildup of pressure in the skull causes this condition. It can result in blurred vision and double vision.
  • Myasthenia gravis: This condition is characterized by intermittent weakness of voluntary muscles. It can cause severe muscle weakness all over the body. Eyelids are especially affecting by this condition.
  • Multiple sclerosis: MS is a chronic disease of the central nervous system. It causes a degeneration of myelin, the protective coating that surrounds the nerves. It can result in difficulties with mobility, overwhelming fatigue, and other symptoms. It can also affect the optic nerve, resulting in compromised vision, or loss of vision. MS can also result in compromised eye movement.
  • Giant cell arteritis: Inflammation of the arteries can lead to pain, inflammation, and loss of vision.
  • Ischemic optic neuropathy: Sometimes called “a stroke of the optic nerve,” this condition can lead to sudden vision loss.
  • Optic neuritis: Inflammation of the optic nerve is often a result of MS. It can lead to sudden, though reversible, vision loss.
  • Cranial nerve palsy: The third, fourth and sixth cranial nerves, which emanate from the brain stem, help control eye movement. Malfunction of these nerves can result in limited eye movement and drooping eyelids.
  • Toxic optic neuropathy: Certain poisonous substances, medical overdoses, or nutritional deficits can lead to progressive vision degeneration.
  • Horner syndrome: When the sympathetic nerves of the head and neck are disrupted, patients may suffer from ptosis, small pupil, and reduced sweating of the face.
neuro-ophthalmology brain view

Diagnostic Services

Because neuro-ophthalmic disorders range in cause and origin, there is no one method of diagnosis. Neuro-ophthalmic conditions are often overlooked as the symptoms so this can sometimes make it hard to piece together. Neuro-ophthalmic disorders can often manifest symptoms in the eyes alone so a disease affecting the brain or optic nerve is not always initially suspected. That is why it is important to see an experienced neuro-ophthalmic specialist as they will be able to correlate symptoms and make a diagnosis. In some cases, a quick diagnosis is key to give patients their best prognosis.

Finding a correlation between all the symptoms helps to diagnose these disorders. Your doctor will check the structures inside of your eyes as well as the muscles around the eyes. They will then test your visual acuity and color vision. If your doctor finds anything concerning, they will call for more detailed testing.

This can be very alarming to most patients so if you feel that you may have one of the neuro-ophthalmic disorders listed above, contact your eye doctor right away. Our vision experts here will be able to refer you to our very own neuro-ophthalmologists. Contact one of our many Sight MD locations today to schedule your appointment

Treatments

At SightMD, we treat neuro-ophthalmic conditions in a variety of ways. Treatment depends upon the specific disease and symptoms. Treatment steps include:

  • Diagnosis: Many neuro-ophthalmic conditions present similar symptoms. Thorough analysis and diagnosis is the vital first step in any treatment. Visual acuity tests, MRIs, and analysis of other clinical symptoms are all important diagnostic methods.
  • Medication: Many neuro-ophthalmic conditions are treatable with medication. For instance, we often prescribe corticosteroids to treat MS and giant cell arteritis.
  • Lifestyle changes: Dietary and sleep adjustments are important factors to consider. They can sometimes help cure or control neurological conditions. Pseudotumor cerebri, for example, often affects overweight women. So here doctors may suggest weight loss as a good treatment option.
  • Treating underlying conditions: Often, treating the underlying cause of a neuro-ophthalmic condition is the best way to restore or maintain vision. We work with patients’ care primary physicians to identify these conditions. Together we determine an appropriate treatment plan.
  • Surgery: We use conservative treatments whenever possible. Yet, when medication or other options are ineffective, surgery may be recommended. Surgery can successfully treat severe pseudotumor cerebri.

Contact SightMD today to schedule an appointment with one of our doctors to discuss your vision health at one of our convenient locations!