Neuro-ophthalmology

What is neuro-ophthalmology?

Neuro-ophthalmology is an area in which a disease can manifest itself by both ophthalmological and neurological signs and they often intersect each other.
Neuro-ophthalmology encompasses the optic nerve diseases (papillary edema, optic neuritis, ischemic optic neuropathies), the pupillary anomalies, the abnormalities of the visual field and / or visual acuity loss secondary to a cerebral illnesses (of vascular, compressive, inflammatory origin …), the diplopias (double vision) of central (brain) or peripheral (e.g. muscular) origin and the of multiple-etiology pathologies (vascular, metabolic, compressive …).

Diagnosis and management

The diagnosis is based on a complete ophthalmic examination, assisted by imaging techniques. The neurological examination is essential to look for associated signs that can guide to the exact anatomical area of the primary abnormality. Moreover, the brain imaging can localize the anomaly more accurately.
For these reasons the management of these pathologies is multidisciplinary and requires a close collaboration between the ophthalmologist, the neurologist, the neurosurgeon and the neuro-radiologist. The imaging (visual field, colors vision test, visual evoked potentials to name but a few) and oculomotor assessment are carried out by orthoptists.

Electrode placement for visual evoked potentials examination
Electrode placement for visual evoked potentials examination

Treatment

The treatment depends on the cause, and can be either medical or surgical.