Visual impairment is surprisingly common in the UK, with the NHS stating that over two million people live with some form of sight loss. In most cases, those conditions are connected to your eyes alone. However, you may find that your vision problems are the result of a problem with your nervous system, not just your eyes.
That’s where neuro-ophthalmology specialists become important to your medical future. Combining the neurology and ophthalmology specialities, a neuro-ophthalmologist helps you to confront issues such as optic nerve disorders and visual challenges related to your eye muscles and visual processing pathways. Common conditions that fall under the neuro-ophthalmology banner include papilledema, ocular myasthenia gravis, and optic neuritis – all conditions that are linked to your nervous system in some capacity.
Here, we explore the work of our neuro-ophthalmology specialists in more detail, explaining some of the most common conditions that fall under their remit.
We’ve touched on the answer to this question when noting that neuro-ophthalmology bridges the gap between neurology and ophthalmology. It serves as a sub-speciality of both, with those working within the speciality typically focusing on vision problems caused by issues with your brain or nervous system. For example, if you have become visually impaired as a result of a stroke or head trauma, you’ll likely visit a neuro-ophthalmologist for treatment.
As a result of these neurological connections, this sub-speciality often involves dealing with very complex cases. Your specialist has to look beyond your eyes to discover the nervous system-related issues that may cause your vision problems. Early diagnosis of these neurological issues is essential to ensure you’re swiftly provided with a relevant treatment, which could extend from the prescription of corrective lenses up to surgical procedures.
To emphasise the complex nature of the neuro-ophthalmology speciality, numerous conditions fall under its banner. Each will have something to do both with your eyes and nervous system, though each can also impact you in different ways. A selection of the most common neuro-ophthalmological conditions we help you to confront at Clinica London include the following:
Affecting both the eye itself and your overall vision, optic neuritis syndrome occurs when your optic nerve becomes inflamed, causing it to swell considerably larger than its normal size. Beyond vision problems, the condition can cause pain around the eye. It’s most common in patients who have multiple sclerosis, though you may also contract this condition as a result of an infection if you have an autoimmune disorder.
Speaking of autoimmune disorders, having one may also make you vulnerable to ocular myasthenia gravis. This condition causes your body to incorrectly identify your eye muscle receptors as “threats” to your body, causing your immune system to interfere with the muscles’ production of acetylcholine. The result is that your eye muscles feel weak and become increasingly weaker as the day progresses. Look for double vision and drooping eyelids as symptoms of ocular myasthenia gravis.
Unexplained pressure inside your skull is the main symptom that suggests you may have pseudotumor cerebri. The condition mimics the feeling you might experience if you have a brain tumour – hence the “pseudo” part of its name – and can cause both optical never swelling and problems with your vision. Thankfully, you don’t actually have a tumour with this condition. But it’s one that can’t be left untreated as it can lead to permanent changes to your vision and papilledema, a swelling of the optic disc.
We use the term “papilledema” to explain any sort of swelling of your optic disc caused by some form of intracranial pressure. The previously mentioned pseudotumor cerebri can cause this type of swelling, though it’s far from the only potential cause. Legitimate brain tumours, high blood pressure, and infections can also lead to this condition. As such, papilledema treatment varies depending on the root cause of your condition. Antibiotics, weight loss, and surgical procedures are all potential treatments, with Clinica London offering all three.
Think of optic neuropathy as a catch-all term for any damage that occurs to your optic nerve. As such, optic neuropathy causes can range from trauma and infection to ischemia – a condition that causes a less-than-normal flow of blood to your optic nerve. Vision impairment is common with optic neuropathy, with that impairment ranging from seeing strange flashes and flickers through to complete loss of vision. Some patients also experience pain that feels like it’s coming from inside their eyes.
As you can gather from the various conditions that neuro-ophthalmology covers, symptoms can vary widely from patient to patient. Many of these symptoms can also be indicative of other ophthalmological conditions, making diagnosis more complex. The following are symptoms we recommend you keep in mind:
Though we could describe these symptoms as somewhat general, or at least potentially related to a range of conditions, the neuro-ophthalmology specialists conduct a range of tests on you as part of our diagnostic approach. These include visual field tests, which examine your range of vision as well as the quality of your eyesight. MRI exams allow our specialists to get a better sense of what’s happening with the soft tissues in your body around the brain and eye. We may also use optical coherence tomography (OCT) scans to generate detailed images of your eye. Typically, a combination of the three allows Clinica London to diagnose your condition.
As with symptom recognition and diagnosis, the sheer number of conditions that neuro-ophthalmology covers can mean your treatment options vary significantly from other patients. Clinica London offers several treatments, including all of the following:
Your recovery, including time taken and the extent of said recovery, will vary depending on your condition and its severity. For instance, treatments designed to ease inflammation of your optic nerve can result in the near-total return of your visual field. Vision loss caused by optic neuritis syndrome may be reversed within three months. However, some neuro-ophthalmological conditions are chronic, with the effects you experience being long-lasting enough to require ongoing therapy and lifestyle changes.
We recommend visiting Clinica London to discuss your condition as soon as you recognise any of the symptoms described earlier. Sudden visual changes – including the loss of your peripheral vision and blurriness – are immediate signs to consult a specialist. The same goes for persistent double-vision, pressure felt around your eye in your head, and consistent fatigue felt in your eye muscles. Standard treatments may resolve these issues, though we will run the appropriate tests to ensure you’re working with the correct specialist.
Any condition where issues with your eyes can be linked to your brain and/or nervous system. Papilledema, optic neuritis, and ocular myasthenia gravis are all examples, as we have discussed above.
Clinica London specialists use a range of tests to diagnose neuro-ophthalmological issues. These include field of vision tests, along with MRI and OCT exams – all designed to determine the exact neurological cause of your vision issues.
This isn’t a “yes” or “no” question, though early diagnosis and treatment for your condition usually leads to better outcomes. Some neuro-ophthalmological conditions are manageable rather than 100% curable.
You’ll likely notice blurring of your vision, sometimes accompanied by sudden vision loss in more extreme cases. Optic neuritis can also make moving your eyes painful due to the inflammation of your optic nerve.
The simple answer comes from the neurological component, as neuro-ophthalmology focuses on vision issues caused by neurological conditions or issues with your nervous system.
Before your consultation with a Clinica London neuro-ophthalmology specialist, we recommend that you prepare by listing any symptoms you’re experiencing. This list, along with the tests our specialist conducts, will allow us to narrow down the specific condition you have. We also recommend avoiding taking any form of unprescribed medication – and informing us of any medication you do take – before your neuro-ophthalmological exams.
Post-treatment is one of the most vital periods in your recovery process. Follow all prescribed medication recommendations your Clinica London specialist makes, along with any lifestyle changes suggested to you. Follow-up appointments are essential as they allow us (and you) to track the progress of your treatment. We may also ask you to monitor any changes to your vision, both positive and negative, so we can ensure your ongoing care post-treatment is what you require.
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