Neuro-ophthalmic Disorders

Side view of smiling middle aged couple on beach looking off into the distance together.Neurological vision disorders are caused by conditions affecting the nervous system, such as multiple sclerosis and pseudotumor cerebri. These disorders can involve malfunction of the eyelids and muscles that control eye movement, or they may affect the optic nerve itself, resulting in partial or full vision loss. With early diagnosis and treatment, our doctors can help control your symptoms and restore lost vision. Depending on your unique condition, treatment may involve lifestyle changes (such as exercise and weight loss), medication, or surgery. We use advanced diagnostic tools and techniques to determine the cause of your vision issues, and if necessary, we can work with your primary care physician to determine the best solution for you.



Common Conditions

At SightMD, we treat vision conditions caused by neurological disorders such as:

  • Pseudotumor cerebri: Also called intracranial hypertension, the symptoms of this disorder mimic those of a brain tumor. However, instead of a tumor, patients are actually suffering from an unexplained buildup of fluid inside their skulls. Indications of this condition include flickering vision (especially when bending over), gradual vision loss, headaches, and a rushing sound the patient hears corresponding with his heartbeat. The exact causes of this condition are unknown.
  • Myasthenia gravis: Myasthenia gravis occurs when nerve impulses are blocked, leading to severe muscle weakness. This condition can affect the eyelids and the muscles that control eye movement. Symptoms include drooping eyelids, double vision, difficulty breathing and swallowing, and fatigue that worsens as the day progresses.
  • Multiple sclerosis (MS): Healthy nerves are covered in a protective sheath called myelin. In patients who suffer from MS, their immune system damages the myelin, leading to widespread nerve malfunction. Specific, related ocular symptoms include double vision and vision loss.
  • Giant cell arteritis: This condition occurs when the medium-sized arteries become inflamed, blocking the flow of blood to a particular organ. Giant cell arteritis, also known as temporal arteritis, can compromise function of the eyes, scalp, and jaw, and symptoms include vision loss, double vision, headache, scalp tenderness, and pain, especially in the temples. Giant cell arteritis most frequently affects patients over age 55.
  • Ischemic optic neuropathy: Non-arteritic anterior ischemic optic neuropathy (NAION) is believed to be caused by what is often described as “a stroke of the optic nerve.” The condition can cause sudden vision loss, especially early in the morning, just after waking up. NAION patients are usually over the age of 55 and have other underlying health conditions such as high cholesterol, high blood pressure, diabetes, and coronary artery disease.
  • Optic neuritis: Optic neuritis is caused by inflammation of the optic nerve. The condition is often associated with MS, although it can also be caused by other conditions such as autoimmune disease or optic nerve injury. Optic neuritis causes sudden or rapidly progressing vision loss, which can range from total blindness to loss of vision in small areas. With proper care, the loss of vision is usually temporary.
  • Cranial nerve palsy: The cranial nerves allow the sense organs in the head to operate properly. When one of these nerve sets malfunctions, it can cause a range of symptoms, depending on which nerves are affected. Cranial nerve palsy can prevent certain eye or eyelid movements, leading to double vision, a dilated pupil, or a drooping eyelid. This disease is frequently caused by high blood pressure, diabetes, and head trauma.
  • Toxic optic neuropathy: This condition is caused by ingesting a poisonous substance, such as lead, mercury, or ethanol. It can also result from an overdose of certain medications, or from the lack of vitamin B in a patient’s diet. The primary symptom is slow, progressive vision loss, ranging from changes in color perception to total blindness.
  • Horner syndrome: his condition affects the sympathetic nerves of the head and neck and the symptoms include drooping of the eyelid (ptosis), small pupil, and decreased sweating of the face. The condition may be caused by a mild nerve dysfunction or by a more serious underlying condition such as a stroke or brain tumor.

Treatment

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

  • Diagnosis: Many neuro-ophthalmic conditions present similar symptoms, so a thorough analysis and diagnosis is the vital first step before moving forward with any treatment. Visual acuity tests, MRIs, and analysis of other clinical symptoms are all important diagnostic methods.
  • Medication: Fortunately, 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 can sometimes help cure or control neurological conditions. Pseudotumor cerebri, for example, often affects overweight women, so weight loss may be 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 closely with patients’ care primary physicians to identify these conditions and determine an appropriate treatment plan.
  • Surgery: At SightMD, we use conservative treatments whenever possible. However, when medication or other options are ineffective, surgery may be recommended. Surgery can successfully treat severe pseudotumor cerebri.

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