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Neuro-Ophthalmology
  • What is neuro-opthalmology ?

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  • Common nerve related diseases for the eye

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Neuro-Ophthalmology

Neuro-Ophthalmology is a speciality born when the branches of ophthalmology and neurology merge. This field deals with vision-related problems caused by any diseases or disorder of the nervous system. Since we use a significant portion of our brain for activities related to our sense of sight, not all optic problems come from the eyes. These problems affect not only the vision but also eye movement, alignment and pupil reflexes.

The need for a neuro-ophthalmologist can be considered after a full eye examination where no fault of the eye itself is found. The symptoms for such cases often indicate to optic nerve disease or damage, which is causing an issue in the visual pathway. There can be many other symptoms that can be flagged and referred to a neuro-ophthalmologist.

While ailments related to neuro-ophthalmology are not always very serious, they have the potential to be permanently damaging or even fatal if not treated in time. Sometimes these problems limit themselves to the nervous system through the optic nerve, other times, relate to general medical conditions. Whatever the causes may be, all these manifest as some problem regarding the sense of sight.

The most common of these symptoms that could point towards a neuro-ophthalmological problem are:

  • A sudden diminishing of sight and in worse cases, even total loss of sight
  • A sudden eye stroke (loss of vision called transient ischemic attack)
  • Visual hallucinations, where patients see things, shapes or silhouettes where there are none
  • Diplopia (Double vision)
  • Intractable headaches without any seeming cause or plausible reason
  • Abnormalities of the pupil (slow reaction, the difference in size of the pupils)
  • Difficulties in identifying colours or differentiating between them
  • Inability to tolerate bright light and often getting momentary blindness or headaches because of it
  • Defects in the field of vision
  • Adult life onset of squint or strabismus

To identify the above symptoms and subsequently treat the cause of them can only be done by someone specially trained for it, a neuro-ophthalmologist. Centre For Sight is in possession of an excellent team of experts to diagnose and treat such diseases and disorders. The most commonly occurring of these type which needs a neuro-ophthalmologist to treat them are :

Optic Neuritis

It is an inflammation of the optic nerve which causes damage to it and hinders proper functioning, thus resulting in temporary vision loss in the eye that is connected to the damaged nerve. It also leads to constant pain in that eye. Optic neuritis causes vision loss as it blocks the sensory data that flows between eyes and the brain. In a more severe case, the symptoms may also include loss of visual field, colours and even sensation of flashing lights.

Optic Neuropathy

Any damage to the optic nerve that causes the death of neurons or nerve cells in it comes under the category of optic neuropathy. The most noticeable symptom is sudden onset of loss of vision. Accompanying it is the gradual fading out of colours from vision. As more cells die, it becomes even more damaging and ultimately results in total loss of sight.

Optic Disc Edema

Also known as Papilledema, is actually swelling of the optic disc due to mounting intracranial pressure. The cause of the rise in pressure, whether unilateral or bilateral, can be many and may not always be identified at once. Too much swelling without timely treatment can lead to permanent blindness or even prove to be life-threatening.

Ocular Myasthenia Gravis

In simple terms, this means that the ocular muscles or muscles that regulate the movement of eyes and control the eyelids get tired easily and are not up to the task at all times. This causes a physical barrier in the form of the eyelid itself in the patient’s vision. The other symptoms include double vision, muscle ache and overall poor vision.

A brain tumour affecting vision

A tumour in the general area of the optic nerve can have quite adverse effects on vision. Similarly, a brain tumour affects many of brains parts from where the motor and sensory functions of the body are performed. Since this is the control unit of the body, all symptoms of neuro-ophthalmological problems can be caused due to an unfortunate tumour in the brain; double vision, reduced field of vision, headaches, abnormal eye or pupil movements etc.

Pseudotumor Cerebri

As the name suggests, it is the sensation and symptoms of a tumour without there actually being a real brain tumour present. Excessive pressure on the brain can cause this and similar to the ill effects of a brain tumour on vision, in this case, vision suffers too. Sometimes it can be difficult to differentiate a false tumour from a real one in the initial diagnosis but further screening and testing are helpful.

Other Common Disorders

Some other common problems are due to eye movement disorders, pupil disorders and even Thyroid Eye Disease. Out of these, the Thyroid Eye Disease is an autoimmune disease this can result in bulging eyes, retraction of eyelids, double vision, reduced sight, and irritation around/in the eye.

Outside of these well-known causes of visual difficulties of neuro-ophthalmologic nature, unexplained loss of vision and headaches can also be a cause of concern that deserves the proper attention of expert doctors. At Centre For Sight, the neuro-ophthalmologists often work in tandem with expert neurosurgeons, neurologists and radiologists to provide the best care and state of the art treatment to the patients.

This department is outfitted with the most advanced and modern infrastructure which helps in the diagnosis of many complicated neuro-ophthalmic conditions. Some of these facilities are listed here:

  • Optical coherence tomography
  • Electrodiagnostics – VEP, ERG, MFERG, MFVEP
  • Humphrey visual field analyzer
  • Fundus photography and autofluorescence
  • Evaluation of the eye movements and ocular alignment
  • Neuro-optometry clinic

This department is also known for its active participation in the publishing of papers, research for the same and is an authority in the subject.

Treatment for all the above-stated neuro-ophthalmology problems can be sought at the Delhi, Gurgaon, Hyderabad, Indore, Jaipur, Ahmedabad, Vadodara, Agra, Meerut and Moradabad branch of Centre for Sight.

FAQs

What is the job of a Neuro-Ophthalmologist?

A Neuro-ophthalmologist treats patients with a number of symptoms ranging from vision loss, double vision, drooping eyelids, visual field defects, headache, eyelid and facial disorders. They also diagnose and treat patients with ophthalmic symptoms of other neurological diseases.

What is the meaning of neuro-ophthalmology?

It is the ophthalmic subspecialty or sub-branch that deals with eye-related conditions caused by neurological diseases that may include various optic nerve disorders. This field is a combination of other different primary specialities like Neurology, Neurosurgery and Radiology with Ophthalmology as its parent speciality.

What are the most common disorders or issues affecting the eyes?

Some of the common disorders include Traumatic optic neuropathy, Optic neuritis (inflammation and swelling of the optic nerve), Ischemic Optic neuropathies (Decreased blood supply to the optic nerve), Papilledema, Pituitary tumours and Cranial nerve palsies.

What are the main tests regarding neuro-ophthalmologic problems?

Here, the department holds most advanced equipment to help in the diagnosis of many neuro-ophthalmic diseases.

  • Humphrey visual field analyzer
  • Evaluation of the eye movements and ocular alignment
  • Optical coherence tomography
  • Fundus photography and autofluorescence
  • Electrodiagnostics – VEP, ERG, MFERG, MFVEP
  • Neuro-optometry clinic

What are the symptoms of optic nerve damage?

The most noticeable signs and symptoms of optic nerve damage are unequal pupils, abnormal pupillary reactions and abnormal eye movements.

How can optic neuritis be diagnosed?

Diagnosis of optic neuritis can generally be made on clinical grounds alone. However, some blood investigations and an MRI may be necessary because inflammation is often related to diseases that can affect other parts of the body.