A neuro-ophthalmologist specializes in the diagnosis and treatment of neurological disorders as they affect the eyes and vision. Washington University neuro-ophthalmologists offer world-class care for complex eye disorders. The University is home to the largest neuro-ophthalmic practice between Chicago, Ill., and Columbia, Mo., and one of only a few neuro-ophthalmology practices in St. Louis.
Clinical services are supplemented by ophthalmologic diagnostic laboratories and optometry centers.
Understanding Neuro-ophthalmologic Disorders
Typically, patients are those with conditions such as stroke, brain tumor, multiple sclerosis, and conditions affecting the optic chiasm and/or optic nerve (the nerve that connects the eye to the brain). Damage to the nerve can result from ischemia, trauma, drug toxicity, diabetes, autoimmune disease and infections.
Conditions and disorders include:
- Visual migraine
- Optic atrophy
- Optic neuritis
- Pituitary adenoma
- Ischemic optic neuropathy
- Pseudotumor cerebri
Diagnosis and Treatment
Techniques used to diagnose neuro-ophthalmic disorders look at how each eye works independently, including sight and the ability to distinguish color, fine detail and depth perception. Peripheral vision (seeing out of the corner of the eye) also is an important factor in determining optic health.
One test, called perimetry, measures the visual field by projecting spots of light onto a flat, lighted surface. The patient is asked to fix their gaze on one spot but respond when they detect the presence of another spot approaching the visual field. This is a relatively complex procedure that gives a neuro-ophthalmologist information about the nature and location of disease within the optic nerve or brain.
Treatment depends on the underlying nature of the problem. Whenever possible, we employ conservative techniques such as the use of optical devices or prisms to eliminate double vision, but surgical treatment may be needed if a patient doesn’t respond to other treatments.
Our specialists have extensive experience in injecting botulinum toxin for control of blepharospasm and hemifacial spasm, conditions in which involuntary closure of one or both eyes results in effectively losing total vision when not treated.
During an initial neuro-ophthalmology evaluation, you should expect to spend from three to six hours for thorough testing and medical advice.
For a referral to a Washington University neurologist or neurosurgeon at Barnes-Jewish Hospital, call