Neuro- Ophthalmology is the subspecialty of both neurology and ophthalmology concerning visual problems that are related to the nervous system.
Symptoms to be alert of:
Double vision-Sudden onset painful transient. Decreased vision-Sudden onset-Head turn to one side relieved when one eye is closed. Headache-Mild to very severe associated with vomiting, one sided headache. Photophobia-Difficulty in seeing lights. Spot in front of the eye-Only central area & one half is not seen.
Present complaints like headache, double vision, decreased vision, decreased fields-How long the patient has been suffering from. Any previous ocular history, any previous medical history like diabetes and hypertension. Family History- Anybody in the family who developed eye problems. Social History - Any history of taking alcohol and smoking. Drug History - Any medication the patient is on? any allergy to drugs. Visual acuity- Checked by snellen’s chart. Colour vision- By using Ishihara’s pseudo isochromatic plates. (This is a plate with a number in one coloured dots and surrounded by dots of different shades. This is a simple clinical test and identifies whether the patient is ‘red-green’ colour blind.)
SLIT LAMP BIOMICROSCOPY:
This instruments provided magnified excellent view of the anterior segment and with the help of special lenses the posterior segments also can be visualized.
This instruments provides a complete view of the retina upto the periphery.
Normally both the pupils are of same size. When there is a difference in size of the pupil, it could be a problem. So complete examination of pupil has to be done sometimes special eye drops is used to check the papillary reaction.
OCULAR MOTILITY EXAMINATION:
To look for face turn.
To look for extra ocular movements.
Having double vision in certain gazes.
Clinical test to find out gross visual field defect.
Using neurological fields it is possible to locate exactly the portions which the patient is not seeing. Needed for documentation and to acess the improvement after treatment.
This is a fundus photography taken by injecting a dye in the vein. The dye is metabolised in the liver and excreted in the urine. FFA gives fine details and whether there is dye leaking or staining or autoflourescence and transmission defects and filling defects.OCT Scan:
OCT uses light and creates a high resolution cross sectional image of the retina, optic nerve head, nerve fiber layer.
VEP is a gross electrical response recorded from the visual cortex. It is obtained by changing visual stimulus like multiple flash or checkerboard pattern stimuli, useful in cooperative patients also.
Neuro- Ophthalmology is the subspecialty of both neurology and ophthalmology.