Neuro-ophthalmology

Neuro-ophthalmology is devoted to disorders of the nervous system that affect the visual pathway.

Neuro-ophthalmology is a field concerned with diagnosis and treatment of neurological and systemic disorders that affect vision. These disorders can involve any part of the visual pathway, from the eye and optic nerve to the visual centers in the brain. Neuro-ophthalmology disorders also may affect the oculomotor system – including the eye muscles and the parts of the brain controlling eye movements and eye alignment as well as the nerves that connect them.

Neuro-ophthalmology disorders

Our neuro-ophthalmologists work in conjunction with other Henry Ford specialists in ophthalmology, neurology, neurosurgery and neuroradiology to provide multidisciplinary, coordinated care for a wide range of neuro-ophthalmology conditions and disorders, including:

• Decreased vision or visual field defects in one or both eyes due to diseases of the optic nerve and visual centers of the brain or to the pathways between them
• Eye movement disorders, including strabismus (misaligned eyes)
• Double vision (diplopia)
• Abnormal eye movements, such as nystagmus (“jumpy” eyes), impaired tracking or refixation
• Eyelid abnormalities (e.g., droopiness or lid retraction)
• Pupillary abnormalities, such as anisocoria (unequal pupils)
• Blepharospasm and other involuntary facial movements
• Pseudotumor cerebri (increase in intracranial pressure not caused by a tumor)
• Giant cell arteritis (inflammation in the linings of the arteries in the neck, upper body and arms that carry blood to the head)
• Other unexplained visual disturbances

Causes of neuro-ophthalmology diseases and conditions

These disorders and problems are caused by a variety of conditions:

• Optic nerve disease, including optic neuritis (inflammation of the optic nerve), ischemic optic neuropathy, compressive optic neuropathies and Leber optic neuropathy
• Papilledema, which is a swelling of the optic disc (the head of the optic nerve) from high pressure inside the skull
• Brain tumors that affect vision or eye movements, including tumors of the pituitary gland, intrinsic tumors of the brain (meningioma, glioma) and tumors that metastasize to the brain from elsewhere in the body
• Ocular motor nerve palsies and other cranial neuropathies
• Graves disease (thyroid eye disease)
• Myasthenia gravis (an autoimmune neuromuscular disease that weakens eye muscles)
• Multiple sclerosis
• Stroke and aneurysm
• Orbital tumors

Referral to a Henry Ford neuro-ophthalmologist

To request an appointment to see a Henry Ford neuro-ophthalmologist, you will need a referral from your primary care physician, ophthalmologist, optometrist, neurologist or neurosurgeon.

Neuro-ophthalmology assessment

Once referred to a Henry Ford neuro-ophthalmologist for assessment, you will receive a complete evaluation, including:

• Visual acuity testing
• Color vision testing
• Evaluation of eye movements and alignment
• Visual field testing using kinetic perimetry, static perimetry or both.
• Dilated examination of the optic disc (nerve head) and the retina at the back of the eye

Selected patients may also undergo other diagnostic tests, including a CT scan, MRI or ultrasound.

Neuro-ophthalmology treatment

After completing the evaluation, your Henry Ford neuro-ophthalmologist may recommend further tests and therapy and will report findings to your referring doctor. Generally, specific neuro-ophthalmology treatment depends on the underlying cause of the neuro-ophthalmological disorder. With some conditions, such as double vision and optic neuritis, treatment may be provided and monitored by your neuro-ophthalmologist.

At Henry Ford, patients come first.

The Henry Ford Department of Ophthalmology is committed to providing our patients with compassionate, personalized care. We feature the most advanced treatments in eye care and are dedicated to vision research – always staying at the forefront of innovation. A leader in Michigan, as well as one of the largest ophthalmology practices in the United States, we treat more than 55,000 patients per year at 12 locations throughout southeast Michigan. In addition, our team works closely with Henry Ford Medical Group physicians in other departments, providing multidisciplinary, coordinated care for those patients who need it.