Neuro-ophthalmology

Neuro-ophthalmology is a subspecialty that merges the fields of neurology and ophthalmology, often dealing with complex systemic diseases that have manifestations in the visual system. Neuro-ophthalmologists initially complete a residency in either neurology or ophthalmology, then do a fellowship in the complementary field. Since diagnostic studies can be normal in patients with significant neuro-ophthalmic disease, a detailed medical history is essential. Neuro-ophthalmology focuses on diseases of the nervous system that affect vision, control of eye movements, or pupillary reflexes.

History

Neuro-ophthalmology as a recognized discipline in medicine largely began in the early 20th century. However, elements of the field extend back to ancient times. The first known documentation of neuro-ophthalmologic disease can be found in the Ebers Papyrus, one of the oldest preserved medical documents dating from 1550 BC, Egypt.

Clinical Issues

Neuro-ophthalmologists are often active teachers in their academic institution, and the first four years of postgraduate specialty training in both neurology and ophthalmology require a three-month course in neuro-ophthalmology.

Diseases and Symptoms

Neuro-ophthalmology encompasses a wide range of diseases. Some of the most commonly encountered conditions include optic neuritis, ischemic optic neuropathy, optic disc edema, pituitary tumors, giant cell arteritis, brain tumors or strokes affecting vision, idiopathic intracranial hypertension, unexplained visual loss, blepharospasm, hemifacial spasm, nystagmus, and double vision.

Diagnostic Tests

Neuro-ophthalmologists may use a wide variety of diagnostic tests, including magnetic resonance imaging (MRI), computed tomography (CT), and angiography to help diagnose and treat their patients.

Treatment

Treatment in neuro-ophthalmology is a rapidly evolving field. The advent of new therapies for many neuro-ophthalmologic conditions has made it an exciting area of medicine.

See Also

• Ophthalmology
• Neurology
• Optic neuritis
• Ischemic optic neuropathy
• Optic disc edema
• Pituitary tumors
• Giant cell arteritis
• Brain tumors
• Strokes
• Idiopathic intracranial hypertension
• Unexplained visual loss
• Blepharospasm
• Hemifacial spasm
• Nystagmus
• Double vision

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