What is neuro-ophthalmology?

Neuro-ophthalmology involves the assessment and management of conditions affecting vision that arise outside the eye. A neuro-ophthalmologist deals with diseases of the brain, the nerves that connect the eyes to the brain, the control of eye movement, the regulation of the size of the pupils, and disorders of the eye sockets. In some instances, an eye doctor may ask a patient to see a neuro-ophthalmologist if the cause of a vision problem is unclear.

What is different about a neuro-ophthalmology exam compared to a regular eye exam?

Many times patients will have a test called a visual field analysis before they see the neuro-ophthalmologist. This analysis measures just how well patients can see lights in the center and edges of their vision. The history-taking part of the examination is much longer than usual because the neuro-ophthalmologist will be very concerned about just how the problem came on and has affected the patient's ability to function. The examination of the eyes is more detailed than usual. The examination may be expanded to include testing of the central nervous system related to other parts of the body. Some patients may require additional tests based upon the results of their examinations. Almost all patients require dilating drops unless they have a medical condition that would make dilation dangerous to their eyes.

How should I prepare before the exam and how long will things take?

Make sure that the doctor who set up your examination has provided the neuro-ophthalmologist with any medical records or past diagnostic test results before you arrive for your examination. Alternatively, you may bring this information with you to the exam. Wear eyeglasses rather than contact lenses if you have them to help the exam go smoothly. You will have paperwork to fill out for medical history and insurance purposes so expect to arrive 20 to 30 minutes ahead of your scheduled appointment time. This will assist the doctor in seeing you on schedule so you will not have to wait inappropriately. Expect the exam by the doctor to take between 45 minutes and an hour from when he starts to when you leave; this does not include the time required for special testing. Because you most likely will be dilated, you will want to have someone come with you to drive you home. If you come alone, remember to wear sunglasses and take extra care if you drove yourself. If people come with you, they are welcome to participate in any discussions and observe the examination.

Information about common neuro-ophthalmic diseases