Neuro-ophthalmology

Neuro-ophthalmology disorders are vision problems which are related to the nervous system. They can be caused by disorders of the optic nerve - which connects the eye to the brain, bringing visual information to the brain from the eye for processing - as well as the central nervous system (spine and brain), pupil abnormalities and eyeball movement.

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What is Neuro-ophthalmology?

There is a broad range of conditions which are seen by a neuro-ophthalmologist. While some get gradually worse and can lead to vision loss or even be life-threatening, others are no cause for concern. In some cases, neuro-ophthalmology disorders are solely related to the optic nerve, while in others they are related to the nervous system or different medical conditions.

Among the most common optic nerve disorders are; compression, eye movement disorders, injury (trauma), ischaemia (insufficient blood supply), glaucoma (raised pressure level in the eye), and raised pressure level in the brain.

Neuro-ophthalmology disorders causes

The cause of neuro-ophthalmology disorders will depend on the type. Causes can include: inflammation related to diseases affecting different parts of the body; reduced blood supply, which can be caused by smoking, diabetes, hypertension or hyperlipidaemia; and compression that could be caused by a tumour.

Neuro-ophthalmology disorder symptoms

Neuro-ophthalmology disorder symptoms will vary according to the type. For eye movement problems, symptoms can include blurred vision, unstable walk, double vision, weakness, headaches and shaky vision. For compression from a tumour, painless and gradual loss of vision. For inflammation, problems with colours and rapid loss of vision, as well as potentially pain. For ischaemia, painless and rapid loss of vision. For raised pressure in the brain, headache, nausea, vomiting, temporary loss of vision, and loss of balance.

Symptoms from neuro-ophthalmological disorders caused by an injury will depend on the type of injury sustained.

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Neuro-ophthalmology disorder treatments

The treatments given for neuro-ophthalmology disorders will depend on the type. In order to assess neuro-ophthalmology symptoms and determine the best treatment, you would typically undergo a neuro-ophthalmology evaluation. After a neuro-ophthalmologist is sent all the relevant information on your condition - including CT and MRI scan reports and laboratory test results - they will conduct an evaluation which can involve the dilation of pupils - this can make things look blurry and bright.

A comprehensive neuro-ophthalmologic evaluation can take a few hours. You may be asked questions relating to your symptoms, a known condition which you have, your medical history and any allergies to medication.

The examination itself can involve a visual field test, which tests your peripheral vision; a neurologic exam (either complete or partial), in order to assess your sensation, strength and coordination; and a review of the reports and scans from your previous evaluations should they be relevant.

After the neuro-ophthalmologic evaluation has been completed, you will have a discussion about the diagnosis with your neuro-ophthalmologist. Depending on the findings of the neuro-ophthalmologic evaluation, at this stage, you will know whether there is the need for any additional tests to be carried out and the most suitable treatment options.

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