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Neuro-Ophthalmology Diseases

Neuro-ophthalmology focuses on diseases of the nervous system that affect vision, control of eye movements, or pupillary reflexes. Neuro-ophthalmologists often see patients with complex multi-system disease. Patients often have co-existing disease in other fields (rheumatology, endocrinology, oncology, cardiology, etc.), thus the neuro-ophthalmologist is usually a liaison between ophthalmology and other specialties.

Typical Disorders We Treat:

  • Optic Nerve Disease
  • Visual Field Loss due to Tumor or Stroke
  • Intracranial Hypertension
  • Disorders of the Lids and Pupils
  • Thyroid Eye Disease
  • Multiple Sclerosis & Associated Optic Neuritis
  • Vision Loss
  • Double Vision
  • Papilledema

Managing Neuro-Ophthalmology Diseases

The eye professionals at Bucks-Mont Eye Associates can offer diagnostic modalities and treatment options to detect and manage various neuro-ophthalmic conditions. After making the diagnosis and understanding the possible causes, we can offer treatment for patients with blurred vision, transient or permanent loss of vision, unusual visual phenomena, or double vision. Additionally, Botulinum toxin therapy (BOTOX®) is available for patients diagnosed with blepharospasm or hemifacial spasm.

  • Patients who have any loss of visual acuity, visual field, or color vision due to a problem with the brain or optic nerves.
  • Patients who have or are suspected to have high intracranial pressure (pressure in the head) because this increased pressure can cause optic nerve swelling and loss of vision.
  • Patients who have problems moving their eyes or double vision due to misalignment. Such a problem may result from injury to the brain centers, nerves, or muscles that control eye movements or from a nerve transmission problem called myasthenia gravis.
  • Patients who have tumors of the pituitary gland or other tumors that may compress the vision pathways to make sure there is no loss of visual fields, even when they are not aware of any vision problems. This is particularly important prior to and after operations to remove these tumors.
  • Patients who have unequal pupils are evaluated by neuro-ophthalmology. A sudden change in pupil size may reflect a serious underlying condition and should be seen emergently.
  • Patients with involuntary shaking of the eyes (nystagmus).
  • Botulinum toxin therapy (Botox®) is available for patients diagnosed with blepharospasm or hemifacial spasm.
The neuro-ophthalmology exam begins with a careful history of the patient’s problem and a review of any neurological or medical problems that could be relevant. This is followed by an evaluation of the patient’s vision and eye movements and typically includes testing of the visual acuity, color vision, and visual fields. The eye will be examined under the microscope (slit lamp) with special attention paid to the optic nerve and retina in the back of the eye. In most cases, dilating drops will be administered to allow easy viewing of these important structures. The pressure and size of each eye may be checked as well. Eye movements will be evaluated, which may include the use of prism lenses and special charts. In cases of unequal pupils, certain drops may be administered which help identify the cause of the problem. Visual field testing is conducted at a machine, which displays lights in various parts of the visual world while the patient presses a button to acknowledge each light. In this way, patterns of visual field loss may emerge that can help lead to a diagnosis.

Finally, the neuro-ophthalmologist will sit down with the patient and discuss their condition and any treatments or management strategies that may be offered.

  • Your glasses and a copy of your prescription, if you have it
  • A referral from your referring physician with the specific reason for the visit
  • Any relevant prior medical records including radiology and laboratory reports
  • A CD and report of any MRI or CT of the brain or eyes that have been performed