Neuro-ophthalmology Service

What is a Neuro-Ophthalmologist?

Neuro-ophthalmology combines the specialties of neurology and ophthalmology, and focuses on visual problems that are related to the nervous system, such as peripheral vision, pupil changes, eye movement, and the optic nerve. Given the complexity of these conditions, visual testing plays a central role in your evaluation and diagnosis.

What to Expect During Your Visit:

• A physician referral is required to schedule your appointment.
• Information from your referring doctor provides crucial information and prevents unnecessary repetition of testing.
• Bring images (on disk or film) of all recent brain MRI or CT scans for review.
• Your pupils will be dilated to allow comprehensive examination.
• You may be in the office for 4-6 hours so that doctors can review your case and scans and obtain diagnostic testing.
• You may be sent for more blood work/neuroimaging to aid the diagnosis.
• For scan results, patients should call the office the day after the scan is obtained or completed.

Conditions for Which Patients are Often Referred Include:

• Optic Neuritis, a condition involving loss of central vision
• Ischemic Optic Neuropathy, vision loss due to low blood flow to optic nerve
• Pseudotumor Cerebri or Idiopathic Intracranial Hypertension (IIH), elevated spinal fluid pressure in the head
• Pituitary Tumor
• Orbital or Brain Tumor
• Temporal Arteritis, a condition that causes blindness in both eyes in people over age 55
• Stroke leading to a loss of brain function that may result in loss of peripheral visual field, nystagmus, or eye misalignment
• Homonymous Hemianopsia, visual field loss to the same side of both eyes
• Optic Nerve or Chiasmal Glioma
• Cranial Nerve Palsy
• Optic Disk Drusen, which results in small, rock-like deposits in the optic nerves that may affect peripheral vision
• Nystagmus, a condition of involuntary, repetitive movements of the eyeballs that often accompanies other brain problems
• Anisocoria, or pupils of different sizes, which may result from various brain and eye conditions
• Myasthenia Gravis, an autoimmune condition often affecting the eyelids and extraocular muscles
• Double Vision, a condition in which the eyes are out of line relative to one another and which resolves when covering one eye

At the UPMC Vision Institute, the Division of Neuro-Ophthalmology provides many diagnostic services through the Ocular Imaging Center, including:

• Visual Field Examination (Humphrey and Goldmann)
• Ocular Coherence Tomography (OCT)
• Ultrasound Biomicroscopy
• Visual Evoked Potential (or Response) (VEP or VER)
• Anterior Segment and External Photography
• Fundus Photography
• Ocular Ultrasound
• Fluorescein Angiography (FA)
• Electro-Retinography (ERG)
• Electrooculography (EOG)