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NEURO OPHTALMOLOGY

What is Neuro-ophtalmology?

It is a discipline dealing with common diseases of the eye and the nevre system. Seeing an object is possible by perception of the eye at first and then perception of visual center at the back of the brain. Visual pathways from optic nerve, an eye nerve, to the visual cortex in the brain which seeing is realized and diseases occurred in brain cortex is the subject of Neuro-ophtalmology. Also it deals with compatible movement of both eyes. Reasons and differential diagnosis of the head-ache caused by eye disorders are in the scope of the Neuro-ophtalmology. It assesses the complaints such as fleeting lossof vision, double vision and the size difference between the eye pupils.

What are the problems in Neuro-ophtalmology?

• Size difference between the eye pupils,
• Eye complaints related to Multiple sclerosis (MS),
• Eye complaints related to Myasthenia gravis,
• Color vision defects,
• A region that cannot be seen in the visual field,
• Double vision,
• Thyroid-related eye disease,
• Sudden loss of vision,
• Slowly progressing vision loss,
• Fleeting loss of vision,
• Migraine and migraine related eye pains,
• Eye complaints related to strokes,
• Facial palsy and facial spasms.

What are the symptoms and causes that might be considered important ?

• Fleeting loss of vision: blackout of one or two eyes or sight loss in a temporary manner may be the symptom of temporary obstruction of the vessels going to the eye or the visual center in the brain It should be evaluated immediately. It may be related to problems of heart valves of the young or problems of cardiovascular and jugular vein at the neck of the old people. If not treated it may cause embolism and finally permanent loss in vision.
• Sudden loss of vision: it is a medical emergency. It may be a symptom to narrowing or obstruction of one of the vessels going to eye or visual center in the brain. It is necessary that a doctor should see it within a few hours. Sometimes it is not related to vessels, but to diseases causing conduction disorders in optic nerve.
• Slowly progressing vision loss: Generally slowly progressing vision loss related with reasons inside the eye such as diseases like cataract, glaucoma, yellow dots may also be related with life threatening reason causing a pressure on optic nerve at the brain, although it is seen rarely.
• Double vision: In case there is unbalanced working of muscles that move the eye due to a problem of muscles or nerves moving the muscles, eyes would not be in parallel position and when two eyes send different messages to the brain, double vision arises. Ophthalmologist should control it as soon as possible and should find its reason. If problems at the nerves originate from the brain, neurological diseases should be searched and it should be cured. If it is related with the vessels, again the reasons at heart or situation at the brain are checked aand they should be treated. Treatment should be planned with neurology doctors if it is related with muscle disease affecting other muscles of the body and with endocrine surgeons if there is a problem at eye muscle related with hormonal disorders.
• Opening or decrease of the eyelid: In case there is an unbalanced operation of muscles that moves the eye due to a problem of nerves and muscles operating the eyelids, one or both of the eyelids may open or decrease. Opening is seen frequently on goiter disease, while the decrease is caused by expansion of brain vessels or muscle diseases. Since expansion of brain vessels is a life threatening case, ophthalmologist should be consulted immediately if eyelids are decreased especially if pupils are grew.
• Pupil inequality: Size difference between the eye pupils is a natural case. If this difference is very big, or the difference becomes greater in the light or darkness, it may be a sign that there is an important problem at brain or neck vessel or an important lung disease. Without losing any time, getting in contact with an Ophthalmologist might save a life.
• Accident and impacts: Muscles or nerves of the eyelids may hurt visual nerve with eye muscles themselves or eye nerves. For the accidents and impacts that does not give any symptom at early period, an early symptom or treatment can be provided only after the careful examining of the ophthalmologist.