Neuro-Ophthalmology

Vision problems are common among a large portion of today’s society. Recognising the signs and symptoms of some of the most common eye conditions can go a long way in preventing them from occurring. Many of us are not proactive when it comes to our eye health. Dr. Dory Neu-Ner is an ophthalmologist that believes in taking care of our eyes to protect our vision. This will make performing everyday tasks much easier.

We need to practice preventative care by having routine eye exams done by Dr. Neu-Ner in order to diagnose any vision problems early. Good eyesight improves the overall quality of life. It contributes to a huge part of our non-verbal communication, improves our learning and comprehension, and is an important part of our health in general.

Your eyes, like many other organs in the body, can lose their full potential if not taken care of properly. They are subject to injuries and stress that can bring on eye diseases such as glaucoma, macular degeneration, cataracts and more. The good news is that many of these eye disorders or diseases can be effectively treated with early diagnosis and specialist input from an ophthalmologist.

What is a neuro ophthalmologist?

Neuro-ophthalmologists are trained to diagnose and manage vision problems that arise from conditions affecting the brain, the optic nerve, or the nerves controlling eye movement. These can include visual disturbances caused by stroke, trauma, inflammatory conditions such as optic neuritis, or growths affecting the visual pathways.

As an ophthalmologist, Dr Neu-Ner assesses these visual symptoms and examines the eye for signs that point to an underlying neurological cause, such as swelling of the optic nerve, abnormal eye movements, or changes in the visual field. Where a neurological or systemic condition is suspected, he coordinates care with neurologists and other specialists to help ensure you receive a full and accurate diagnosis.

A number of neurological, vascular and structural conditions can affect the control of your eye movements or your brain’s ability to process visual information. Dr Neu-Ner assesses the following conditions where they affect your eyes or vision, working alongside your GP, neurologist or other specialists where needed:

  • Multiple sclerosis (MS) – an autoimmune condition in which the immune system attacks the central nervous system, which can affect the optic nerve and eye movements.
  • Ischemic optic neuropathy (ION) – a sudden loss of vision caused by a disruption in blood supply to the optic nerve.
  • Migraine with aura – an aura is a temporary sensory disturbance that can occur before or during a migraine, such as blind spots, flashing lights, zigzag lines, or tingling in the face.
  • Optic neuritis (ON) – inflammation of the optic nerve, which often causes eye pain (especially with eye movement) alongside vision loss, and is frequently linked to conditions such as multiple sclerosis or infection.
  • Idiopathic intracranial hypertension (IIH) – a condition in which the pressure inside the skull is raised without an identifiable cause such as a tumour. It most commonly affects women of childbearing age and is associated with excess body weight. Symptoms include headaches, pulsing ringing in the ears, brief episodes of greyed-out or blurred vision, and sometimes double vision. IIH can cause swelling of the optic nerve that, if left untreated, may lead to permanent vision loss, so ongoing monitoring is important
  • Giant cell arteritis (GCA) – inflammation of the arteries, particularly around the head and temples, most common in people over 50. Symptoms may include a new headache, scalp tenderness, jaw pain when chewing, and vision disturbance. GCA is a medical emergency: left untreated, it can cause sudden and permanent vision loss, so same-day assessment is essential if it’s suspected.

Since much of how you see depends on how your brain and nervous system process visual signals, an eye examination can often reveal signs of an underlying neurological condition. Dr Neu-Ner assesses the parts of your neurological system connected to vision — including the optic nerve, pupils, eye movements and visual fields — using tools such as imaging of the optic nerve and retina, and, where indicated, by referring you for MRI brain or orbital imaging. As an ophthalmologist, he will perform a thorough eye examination that may include the following:

  • Slit lamp examination – a bright light and microscope are used to get a close look at the structures inside your eye, which is effective in detecting a wide range of eye diseases.
  • Visual acuity and eye movement testing – you will be asked to read letters on a chart to check the clarity of your vision, and to follow a target as it moves side to side and up and down to check that your eye muscles are working correctly together.
  • Visual field and colour vision testing – a visual field test measures how far you can see in each direction without moving your eyes, while a colour vision test involves identifying patterns on a series of coloured test cards.
  • A focused neurological examination – this combines ophthalmic and neurological techniques to assess the aspects of your nervous system connected to vision, including pupil responses, eyelid and eye movements, and the appearance of your optic nerve. Where a broader neurological problem is suspected, Dr Neu-Ner will refer you for a full neurological assessment.
  • Review of any previous scans or results you bring with you – this can save time and give an overview of your history, helping to inform your assessment.
  • Eye pressure measurement (tonometry) – this quick test is performed at most eye examinations and typically involves gently touching an instrument to the surface of the eye after numbing drops are applied.

Neuro-ophthalmology FAQs

Ophthalmologists are medical professionals specialized in diagnosing and treating all eye and vision problems. Their expertise includes providing vision services such as prescribing glasses and contact lenses, as well as managing and preventing ocular medical conditions, which may involve performing surgery.

Ophthalmology provides comprehensive eye care, including disease prevention, refractive and optical services, diagnosis and management of eye conditions, as well as medical, surgical, and rehabilitative treatments.

Ophthalmologists are qualified to diagnose and treat a range of eye conditions, including cataracts, glaucoma, eye injuries and trauma, dry eyes, age-related macular degeneration (AMD), retinal disorders, uveitis, strabismus, and others.

Surgical ophthalmology involves ophthalmologists performing microsurgical procedures within the eye, such as cataract extraction and retinal detachment repair. Most surgical ophthalmologists perform cataract surgeries and usually specialize in one of several surgical subspecialties.

If your primary care physician or optometrist is unable to address your eye condition, you will be referred to an ophthalmologist. An ophthalmologist can provide a detailed evaluation and offer a more precise diagnosis.

Ophthalmologists are experts in diagnosing and treating eye injuries, infections, diseases, and disorders. They assess for early signs of conditions like cataracts or glaucoma and conduct comprehensive examinations of the retina and optic nerve.

Cataract surgery is the most frequently performed eye surgery. It is commonly done due to the widespread occurrence of cataracts, which cause clouding of the eye’s natural lens, particularly in the aging population.

A standard ophthalmic exam is a comprehensive series of assessments performed by an ophthalmologist or optometrist, both of whom specialize in eye health. These tests assess vision and overall eye health and are also known as a comprehensive eye exam or routine eye exam.

Eye emergencies, including sudden vision loss, corneal laceration, retinal detachment, foreign objects or chemicals in the eye, orbital cellulitis, acute glaucoma, and scleritis, necessitate immediate referral to an ophthalmologist for urgent medical care.

Visual acuity measurement includes preliminary tests to evaluate visual function and eye health. These tests assess depth perception, color vision, peripheral vision, and pupil response to light. Additionally, refractive status is assessed to identify conditions such as nearsightedness, farsightedness, or astigmatism.

Some common eye diseases include glaucoma cataracts, diabetic retinopathy, and age-related macular degeneration

It is generally advised to undergo an eye exam every 1 to 2 years, based on age, risk factors, and whether you currently use corrective lenses.

An ophthalmologist is a medical and surgical specialist providing the highest level of eye care. Their advanced training allows them to diagnose and treat a broader range of eye conditions compared to optometrists and opticians.

Before your eye test, bring notes on any questions you have, a list of all current medications and treatments, any glasses you use, and details about distances for specific tasks like using a computer. Also, include any medical documents related to previous eye treatments. Inform your eye specialist if you have diabetes or if there are any special needs, such as learning disabilities, autism, or physical disabilities, that may affect the examination.

Vision screening is a basic test designed to identify potential vision issues early. An eye exam, on the other hand, provides a comprehensive evaluation of your eyes and overall eye health.