Causes And Diagnoses

Causes and Diagnoses of Neuro-Ophthalmologic Disease

The causes of neuro-ophthalmologic diseases are as varied as the conditions themselves. Some causes include:

  • Infections: Bacterial and viral infections, such as Lyme disease, measles, mumps and some sexually transmitted diseases can cause inflammation of the optic nerve.
  • Autoimmune diseases: Multiple sclerosis, lupus, myasthenia gravis and other chronic conditions are related to optic neuritis and other neuro-ophthalmologic conditions.
  • Medications: Some drugs, including quinine and some antibiotics, can cause neuro-ophthalmologic symptoms.
  • Cardiovascular disease: Clots, plaque and other issues with the blood vessels that feed the eye and optic nerve can cause vision problems.
  • Traumatic brain injury: Concussions and other injuries to the brain and head can cause temporary or permanent vision loss.
  • Tumors and other obstructions: Tumors and other obstructions could be the cause of a neuro-ophthalmologic disease.

Diagnosing neuro-ophthalmologic disease

Neuro-ophthalmologic diseases can be diagnosed by your ophthalmologist, or you may receive a referral to a neuro-ophthalmologist. Both ophthalmologists and neurologists can train to be neuro-ophthalmologists. Your diagnosis will begin with a thorough medical history and a routine eye exam where your vision, color perception and peripheral vision are tested. Other tests may include:

  • Pupil dilation: The pupil is widened with eye drops to allow a close-up examination of the eye's lens and retina.
  • Pupillary reaction test. Your physician will test how your pupils respond when they're exposed to a light from a bright flashlight.
  • Ophthalmoscopy: A doctor looks very closely at the retina and optic disk using a special magnifying glass.
  • Fluorescein angiography: A special dye is injected into a vein in the arm, and pictures are taken as the dye passes through the blood vessels in the back of the eye. The dye helps the physician see if blood vessels are inflamed.
  • Imaging tests: An MRI may be necessary if your physician wants to rule out the possibility of brain lesions or a tumor.
  • Blood tests: Antibodies for certain conditions, such as neuromyelitis optica, can be identified through lab tests.
  • Optical coherence tomography (OCT): The thickness of your retinal nerve fiber layer is measured in this test.
  • Visual evoked response: This test records the effects of visual stimuli on your brain.