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The material has been prepared by

Dr. Elena Belikova, Ph.D.

Neuroophthalmology examines the visual disturbances associated with the nervous system. That is, those cases where the cause of the disturbance is not in the eyeball, but in the optic nerve and neural connections of the eye with the brain. To diagnose such diseases, knowledge is needed not only about the organs of vision, but also the brain, nerves and muscles.

What is neuroophthalmology?

Neuroophthalmology is involved in the diagnosis and treatment of neurological diseases that affect the level of vision - pathologies of the optic nerve (for example, atrophy), neural pathways of the visual stimulus (a complex system that is consistent with each other, nerve cells that allow a person to see) and the neuromuscular system.

Among the common complaints of our patients, there are:

  • Blurred vision, flashes, sparks, "flicker" in the eyes, etc.
  • Complete or partial loss of vision, decrease in visual fields
  • Disorders of eye movement - sudden strabismus PTZ of the eyelids (drooping eyelids)
  • Exophthalmos (bulging of the eyeball) or enophthalmos (sagging of the eyeball)
  • Headaches, dizziness, fainting
  • General vision impairment, pain when moving the eyes, decrease in visual fields
  • Disorder of color perception (decrease in contrast sensitivity)
  • Different pupil size
  • Duality in the eyes. 

Some neuroophthalmological diseases reduce the patient’s quality of life, while others may result in irreversible loss of vision or even endanger the patient’s life. Sometimes the problem is limited only to the optic nerve or nervous system, but it happens that is associated with the general state of health. Neuroophthalmologists have the knowledge to assess the condition of the patient in terms of neurology, ophthalmology and medicine in general.

What diseases does a neuroophthalmologist treat?

The most relevant of them:

  • Vascular diseases of the optic nerves at various levels of the optic pathway (acute and chronic optic neuropathy, circulatory disorders in the optic nerve, etc.)
  • Inflammatory diseases of the optic nerves
  • Atrophy of the optic nerves
  • Congestion disks of the optic nerves (brain formation, inflammatory diseases brain, etc.)
  • Diseases of the oculomotor apparatus - strabismus, double vision, etc.
  • Pupillary disorders.

We will talk about the most common diseases that are treated by a neuroophthalmologist

Inflammation of the optic nerve 

Inflammation of the optic nerve is a common cause of sudden loss of vision at a young age. Most often, this pathology is found in women and can be accompanied by pain during eye movements, a sharp drop in visual acuity, deterioration in color perception, and a decrease in visual fields. If the doctor finds that the patient suspects acute inflammation of the optic nerve, a magnetic tomography of the brain is performed to exclude the possibility of inflammatory lesions of the central nervous system. Treatment is effective in most cases - leads to improved vision in 2-3 weeks and a full recovery in 6 months.

Congestion of the optic nerve

Congestion of the optic nerve is its edema, which was formed due to increased intracranial pressure or for another reason non-inflammatory in nature. In normal condition, the disc is flat, with edema, the boundaries of the disc are blurred, nerve fibers rise and swell. They lose their natural luster and become less transparent, veins accumulate around, and bleeding around the disc may also appear.

Edema occurs due to inflammation, infection, swelling, circulatory disorders or increased intracranial pressure. Nystagmus Nystagmus is a quick involuntary eye movement. It is congenital - due to loss of visual acuity or acquired - with violations of the central nervous system. To diagnose nystagmus and identify the causes that caused this condition, a comprehensive ophthalmological and neuropathological examination is necessary.

Diplopia (double vision)

Diplopia is a double vision. Usually this is a temporary phenomenon and it passes by itself. However, double vision for a long time is a rather serious symptom of visual impairment. This phenomenon can occur due to a nervous disorder, a violation of neuromuscular transmission, or damage to the muscles that move the eyeball. For example, with diseases of the thyroid gland or muscle pathology.

Anisocoria (pupils of different sizes)

The difference in the size of the pupils can be benign (physiological feature or consequences of the use of drops) or pathological. In pathological this phenomenon requires careful clarification and search for disorders in the nervous system. 

Neuroophthalmology in Moscow

An examination by a neuroophthalmologist is one of the most comprehensive and comprehensive examinations, which sometimes takes about two hours. The doctor will ask you to describe the existing problem and tell the full history of the disease - about previous hospitalizations, operations, previous serious illnesses, diseases of relatives and allergies to medications.

What pathologies do you need to consult a neurophthalmologist with:

  • Thyroid diseases
  • Demyelinating diseases (multiple sclerosis)
  • Diabetes mellitus
  • Brain formations (meningioma, sclerosis, cysts, pituitary adenomas)
  • Neurological diseases (myasthenia, injuries of the cranial red nerves)
  • Cerebrovascular accidents background (stroke, cerebral infarction).

Early diagnosis can successfully control most eye diseases. An annual examination helps prevent diseases that could lead to irreversible consequences in the future. You can undergo a neuroophthalmological examination in Moscow in the Eye Clinic of Dr. Belikova. Only high-experienced specialists who are ready to help cope with diseases of varying degrees of complexity conduct our appointment.