Neuro-Ophthalmology is a specialization concentrating on neurological complications connected to the eye. We all have studied in our school how the human eye captures the visuals it sees. Transmitting to the brain to be resolved as images via the optic nerve. And any dysfunction of this nerve may lead to visual deterioration and could even lead to irreparable damage.
This field is an amalgamation of the fields of Neurology and Ophthalmology.
Under the super-specialty field of Neuro-Ophthalmology comes the diagnosis and administration of complex systemic ailment of the nervous system that damage vision, eye movements, and positioning, as well as pupillary reflexes.
Neuro-Ophthalmology – When to visit your eye doctor?
In case you need special care, your eye doctor Delhi will usually suggest you visit an expert in Neuro-Ophthalmology after a comprehensive eye examination.
Often, reasons could be the diseases affecting the pupils of the eye, and certain kinds of squint (especially paralytic).
Other than that the symptoms that prompt such a referral include those associated with optic nerve disease or diseases of the visual pathway (the nervous system component that connects the eyes to the brain).
If you do not get Neuro-Ophthalmology Treatment in time, it could result in Optic Nerve atrophy (death of the optic nerve). Therefore, these issues become quite a concern for doctors. Some of the most common symptoms of Optic Nerve Dysfunction are:
- Sudden reduction in vision and visual activity,
- Sudden temporary loss of vision (called a transient ischemic attack or eye stroke),
- Double vision (Diplopia),
- Visual hallucinations,
- Intractable Headaches,
- Pupillary abnormalities, (The pupil being slow to react, the difference in the size of the pupils – a pupil is the central part of the eyeball that allows light to pass through),
- Partial or complete color blindness suddenly (especially failure to identify red & green colors),
- Inability to bear bright light,
- Difficulty in seeing light (Photophobia),
- Squint or Strabismus (especially if the onset is in adult age),
- Visual Field Defects (peripheral vision – visibility coverage).
Types of Neuro-Ophthalmology Diseases & their Treatment
Given below are a few common conditions about neuro-ophthalmology:
Optic Neuritis Neuro-Ophthalmology
This is a disease that involves swelling of the optic nerve, a bundle of nerve fibers that transmits visual data from your eye to your brain. This inflammation could occur due to various reasons. Ranging from an infection to an autoimmune disorder. There is a sudden onset loss or decrease in vision due to the inflammation. Optic neuritis is often linked with Multiple Sclerosis(MS). The common symptoms of optic neuritis are pain and temporary vision loss in one eye.
Signs of Optic Neuritis Neuro-Ophthalmology can be the first indication of MS, or they can occur later in the course of MS. Besides MS, Optic Neuritis can occur with other infections or immune diseases, for example, Lupus.
Most people who go through a single episode of Optic Neuritis are usually able to recover their vision. Treatment with steroids may speed up the recovery after Optic Neuritis.
Treatment for Optic Neuritis
As mentioned above, the condition often goes away on its own. To help you heal faster, your doctor may prescribe you some high-dose steroid drugs through an IV. This treatment also helps lower your risk of other MS problems or delay its start if it’s the cause. But while these drugs help the swelling go down, they don’t improve your vision.
In that, your doctor would suggest other treatments, such as:
- Intravenous Immune Globulin (IVIG): It is also called Plasma Exchange. This is a medicine made from blood. You get it through a vein in your arm. It is expensive. And some doctors do not coincide with the opinion that it works. But it may be an option if you have severe symptoms, and can’t use steroids, or they haven’t helped bring any improvement. If your brain MRI shows you have lesions, you can get this Neuro-Ophthalmology Treatment for the long-term.
- Vitamin B12 shots. It’s rare but may be prescribed when its deficiency is a cause of Optic Neuritis.
If your optic neuritis results from a disease, your doctor will treat that condition.
Papilloedema Neuro-Ophthalmology
Papilledema is a severe medical ailment where the optic nerve becomes inflamed. Some of the signs may involve visual disturbances, headaches, and nausea.
In Papilledema, the optic disc (the circular area where the optic nerve joins the retina, at the back of the eye) swells up due to excessive constraint from inside the skull. That may be because of a brain tumor, head trauma, bleeding in the brain, infections like meningitis, encephalitis, etc., for instance.
This inflammation of the optic nerve head (the part of the optic nerve which can directly be seen by your eye doctor Delhi, during a retinal evaluation).
It is critical to identify the cause of Papilledema Neuro-Ophthalmology because some of them can be life-threatening. It can occur in one or both eyes.
Treatment of Papilledema will vary according to the cause.
Treatment when Papilledema is caused by IIH
In the case of IIH, Idiopathic Intracranial hypertension, which is a rare condition where the body may give rise to, too much cerebrospinal fluid. This leads to increased constraints in the brain. It may be treated by weight loss, a low-salt diet, and medications, such as acetazolamide, furosemide, or topiramate.
Surgery is usually only considered when lifestyle changes and medications fail to help.
Treatment when Papilledema is caused by tumors, head injury, or infection
Such underlying conditions will demand more serious treatment. For example, a brain tumor, bleeding within the brain, a blood clot, or some other brain conditions would require surgery.
What type of surgical procedures that will be used will depend on the conditions they need to rectify.
On the other side, infections are usually treated with antibiotics or antiviral medications.
Treatment when Papilledema is caused by high blood pressure
In some rare cases, papilledema is caused by extremely high blood pressure, for example, more than 180/120.
When a person’s blood pressure has reached this high, it is known as a hypertensive crisis and requires critical emergency medical care. Here the blood pressure must be lowered to avoid further harm. This means medical treatment in the emergency room and intensive care unit of a good hospital.
Treatment for other causes
As there are a wide variety of other medical problems and conditions that can drive the increase in pressure inside the brain. Therefore, brain and eye specialists can help determine the best treatment options based on that specific cause that is diagnosed.
Nutritional Optic Neuropathy
Here the damage to the optic nerve begins because of specific toxic substances contained in tobacco & alcohol. Therefore, you can say that the optic nerve may also have got damaged due to the lack of certain supplements and lack of vitamin B-complex and folic acid. These ailments may also present as decreased vision.
Treatment
There is no single established treatment for patients who have nutritional optic neuropathy. Different causes may require different modes.
However, it is clear from the causes that the intake of the toxic elements has to be stopped or at least cut-down. And nutrition to be enhanced.Because that is the essential factor in all these patients. A well-balanced diet, which is high in protein, and well-supplemented with B-complex vitamins is recommended.
Diabetic Neuropathy or Diabetic Retinopathy
In this, the optic nerve is injured due to the unrestricted presence of sugar in the blood or diabetes. As the ailment moves along, the blood supply to the retina gets blocked, causing vision loss.
Diabetic effects on the eyes usually can be prevented with early detection, proper management of your diabetes and getting regular eye tests performed by your eye doctor Delhi.
Diabetes damages the blood vessels within the retinal tissue, causing them to leak fluid and distort vision. The retina is the membrane at the back of the eye. Its function is to convert any light that hits the eye into signals that can be translated by the brain. This is how visual images are produced, and it is how the sight functions in the human eye.
Treating this Diabetic Neuropathy depends on several factors, including the severity and type of diabetes, and how the patient has responded to previous treatments.
Also Read:
Diet and Nutrition for Healthy Eyes
Photocoagulation or Focal laser treatment
Under this treatment, targeted laser burns seal the leaks from abnormal blood vessels. Photocoagulation can either stop or reduce the leakage of blood and buildup of fluid in the eye.
People usually experience blurred vision for 24 hours after undergoing focal laser treatment. Tiny specks may appear in the visual field for a few weeks after the procedure.
Pan-Retinal Photocoagulation or Scatter laser treatment
Scattered laser beams burn the areas of the retina away from the macula, normally in two or three sessions. The macula is the area at the center of the retina where the vision is the strongest.
The laser rays cause abnormal new blood vessels to shrink and scar. Patients may have blurred vision for 24 hours after the session. And there may be some loss of night vision or peripheral vision.
Vitrectomy
This involves the removal of some of the vitreous from inside the eyeball. The ophthalmologist replaces the clouded gel with a clear liquid or gas. The body will eventually absorb the gas or liquid. This will create new vitreous to replace the clouded gel that has been removed.
Any blood in the vitreous and scar tissue that may be pulling on the retina is removed. This procedure is typically performed in a good eye hospital Delhi under local anesthetic.
The retina may also be strengthened and held in position with tiny clamps.
After the surgery, the patient may be prescribed to wear an eye patch to gradually regain the use of their eye, which can be fatigued after a vitrectomy.If gas was used to replace the removed gel, the patient should not travel by air until all gas has been absorbed into the body. Your ophthalmologist will tell you how long this should take. Most patients will have blurred vision for a few weeks after the surgery. It can take a few months for the normal vision to return.