A neuro-ophthalmologist is a physician who specializes in disorders of the nervous system as they relate to the eyes or vision. They have completed medical training and have done specialty training in either neurology or ophthalmology with an extra focus on neuro-ophthalmology. This involves disorders ranging from the nerves that control pupil size, eye muscles and eye movements, to the optic nerve and the vision processing part of the brain known as the occipital lobe. Vision loss can be caused by injury to the brain itself or to the optic nerves which act like a cable to carry information from the eye to the brain, or any location in between. These conditions can be caused by trauma, inflammation, strokes, tumors, toxicities or infections.

Also seen by neuro-ophthalmology are patients who have problems controlling eye movements, such as shaking of the eyes, known as nystagmus, to difficulty moving the eyes or double vision from ocular mis-alignment, called strabismus. This can also be caused by a variety of disorders and can often be corrected by prism lenses or sometimes, with a surgical procedure.

Horizon Eye Specialists offers comprehensive neuro-ophthalmological services using up to date diagnostic equipment and extensive eye exams to help arrive at a diagnosis and unique treatment plan for each patient. Because of this the clinical visit may take 1-3 hours depending on each patient’s needs. Our office and staff recognize that patients with neuro-ophthalmological problems require communication and counseling along with our comprehensive clinical services.

Typical Disorders:

  • Optic nerve inflammation or swelling/Papilledema
  • Intracranial hypertension
  • Optic atrophy
  • Vision loss
  • Stroke
  • Multiple Sclerosis
  • Nystagmus
  • Brain tumors/Pituitary tumors
  • Myasthenia gravis
  • Giant cell arteritis/Temporal arteritis
  • Unequal pupils
  • Double vision
  • Blepharospasm/Hemifacial spasm



What takes place during a neuro-ophthalmology examination?

The neuro-ophthalmology exam begins with a careful history of the patient’s problem including time of onset and the progression of symptoms over time. The full medical history and surgical history is reviewed with the patient as well as the medications and any recent changes to medication or environment. This is then followed by a complete eye examination including visual acuity, color vision, visual field testing and eye movements. In most cases, dilating drops will be administered to allow viewing of the inner structures of the eye, including the optic nerve and retina. After all necessary testing is complete, the neuro-ophthalmologist will review all of the information and neuroimaging available and will discuss their condition and any treatment or management options available to the patient.

What should you bring to your neuro-ophthalmological examination?

  • 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
  • All notes from previous eye exams including photographs, scans, and visual field testing
  • Any relevant prior medical records including radiology reports
  • A CD or films of any MRI or CT of the brain or eyes that was done previously so we can personally review the images

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