Clinical and Basic Aspects of Neuro-Ophthalmology

Neuro-ophthalmology is a rapidly-evolving field of medicine combining expertise from both neurology and ophthalmology to diagnose and manage diseases of the eyes and optic nerve. By coordinating the efforts of both ophthalmologists and neurologists, neuro-ophthalmologists are able to provide optimal care for eye diseases that are best managed in an integrated approach. Clinical neuro-ophthalmology involves the diagnosis and management of patients with consideration of both ophthalmic and neurological symptoms and signs. These include headaches, visual disturbances like diplopia (double vision) or decreased vision, eye movement disturbances, pupillary abnormalities, eyelid disorders, orbital disorders, tumors, and oculomotor nerve palsies. In addition, neuro-ophthalmologists provide clinical diagnosis and management for optic neuropathies such as glaucoma and multiple sclerosis, aneurysms, and tumors or masses of the optic nerve. Basic neuro-ophthalmology involves research on topics such as visual system pathophysiology, electrophysiology, non-invasive imaging, molecular genetics, and clinical outcome research. These studies are necessary to gain a better understanding of visual anatomy, development of new diagnostic and therapeutic tools, and to gain exposure to new treatments and therapies. In addition, gene-therapy and pre-clinical research provide insight into tissue and cell responses to various treatment strategies. Ultimately, neuro-ophthalmology is both a clinical and a basic science, providing the foundation for recent advances in the diagnosis and management of eye diseases through advances in both neurology and ophthalmology. By combining knowledge from both specialties, neuro-ophthalmologists are able to provide optimal, coordinated care to patients with eye diseases.