EYE. BRAIN. NERVES. MUSCLES.
Neuro-ophthalmology, a subspecialty of both neurology and ophthalmology, is the treatment of visual problems that are related to the nervous system; that is, visual problems that do not come from the eyes themselves. We use almost half of the brain for vision-related activities.
Neuro-ophthalmologists undergo specialized training and expertise in problems of the eye, brain, nerves and muscles. These physicians complete at least five years of clinical training after medical school and are usually board-certified in neurology, ophthalmology, or both. Neuro-ophthalmologists have unique abilities to evaluate patients from the neurologic, ophthalmologic, and medical standpoints to diagnose and treat a wide variety of problems. Costly medical testing is often avoided by seeing a neuro-ophthalmologist.
Common Problems Evaluated by Neuro-ophthalmologists
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-ophthalmology symptoms and conditions:
- Abnormal eye movements
- Double vision
- Eyelid abnormalities
- Myasthenia gravis
- Optic nerve problems (such as optic neuritis and ischemic optic neuropathy)
- Thyroid eye disease
- Transient visual loss
- Unequal pupil size
- Unexplained visual loss
- Visual disturbances
- Visual field loss
Preparing for Your Neuro-ophthalmology Evaluation
- Request that your treating physicians send all relevant information to the neuro-ophthalmologist prior to your appointment, including office notes, results of laboratory tests and reports of CT and MRI scans.
- If you have had a CT or MRI scan performed, arrange to pick up the actual films and bring them with you, or have the facility mail them to the neuro-ophthalmologist in advance or your appointment.
- You will probably have your pupils dilated during the visit. The eye drops last about four hours and will make things look bright and blurry up close. Have someone else drive you to the appointment, and bring your sunglasses.
- In order for the physician to get a good look at your eyelids and to avoid ruining your appearance when the eye drops are administered, do not wear eye makeup.
- Bring a complete list of medications with you, including the name and dosage of prescription and over-the-counter medications.
What to Expect During the Evaluation
The neuro-ophthalmologic evaluation is one of the most comprehensive examinations you will experience. It may take a few hours to complete. You will be asked to give an account of your current problem and relate your entire medical history and medication allergies.
- You will have a complete eye examination. This may include testing of your peripheral vision (visual field test).
- You 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.