Neuro-Ophthalmology

Vision loss and eye movement abnormalities can result from neurological conditions such as strokes, brain tumors or multiple sclerosis. Our Neurosciences Center features a specialized neuro-ophthalmology team to address diseases of the optic nerve and eye muscles that can accompany neurological conditions.  

Our team conducts a thorough exam, including a patient’s medical history, to determine a diagnosis and recommend appropriate treatment. Neurological conditions can cause a number of eye problems, including double vision (diplopia), optic nerve problems (optic neuropathy), eyelid weakness (ptosis) and disorders of the pupil. 

Types of Eye Conditions

Double Vision
Patients with double vision see two of everything. Treatment consists of eye exercises, surgical straightening of the eye or a combination of the two. Therapy is aimed at re-aligning the misaligned eye where possible without surgery and re-stimulating the part of the visual pathway to the brain which is not working correctly.

TIAs can cause Optic Neuropathy
Other patients may experience sudden loss of vision or reduced visual acuity due to decreased or interrupted blood flow to the eye’s optic nerve, which is defined as ischemic optic neuropathy (ION).

This loss of vision may be detected during an eye exam by a trained ophthalmologist and is often found in patients who experience transient ischemic attacks, also known as mini-strokes or TIAs. During a TIA, blood flow to the optic nerve may be reduced or blocked, which can permanently damage the optic nerve. 

If ION is caused by inflammation of arteries in the eye, most patients will require steroid treatments so that the other eye is not also damaged. Vision loss from ION can be permanent, but our ophthalmology team can offer innovative treatments as well as training patients in the use of low-vision devices and techniques. Most of our patients continue to perform daily activities and live independently.

Ptosis (Drooping Eyelid)
Ptosis refers to the drooping of an eyelid that can obstruct the pupil and prevent normal vision. It can happen to children or adults but most often occurs in the elderly. Surgery is usually the recommended treatment. The surgeon tightens the levator muscles so that patients can achieve improved vision and appearance.

Optic Neuritis
Optic neuritis is an inflammation of the eye’s optic nerve. Damage or infection of this nerve can degrade or destroy vision. Symptoms may appear suddenly or over a period of days and include blurred vision, dim vision (as if someone turned off the lights), abnormal colors, or pain when moving the eyes or in the back of the eye. 

After testing to confirm diagnosis, most patients are treated with corticosteroids that can restore normal vision or achieve dramatic vision improvements. If you have any of these symptoms, immediate diagnosis and treatment is necessary to avoid permanent damage to the eyes. 

Pseudotumor cerebri (PTC)
Pseudotumor cerebri is a condition in which high cerebrospinal fluid pressure inside the head causes problems with vision and headache. Cerebrospinal fluid is a clear fluid that bathes the brain and spinal cord. In PTC, the fluid is blocked from flowing out of the head as it should, leading to high pressure within the fluid. This pressure results in the swelling of the optic disc at the back of the eye, which can damage the optic nerve and cause vision loss. High pressure may also damage nerves that move the eyes, causing double vision.

The most common symptoms are headache and visual loss. Medications used in treating glaucoma can lower the CSF pressure and diuretics may also be used. Pressure may also be released by draining off CSF through spinal taps.

Because other conditions may produce similar symptoms, patients should see a qualified ophthalmologist for an accurate diagnosis. Repeated visual testing may be needed to manage this condition and prevent permanent vision loss. 

New Vision Restorative Treatments

Morton Plant Mease offers the latest treatments available to preserve or restore eyesight damaged by stroke or trauma. These treatments include NovaVision VRT™ Vision Restoration Therapy, which employs the self-repairing capability of the brain to restore vision.

After stroke or traumatic brain injury, an area of residual vision exists between seeing and non-seeing regions. In most cases, this area of residual vision may be improved using precise patterns of stimulation. Healthy neurons may also be stimulated to adjust their activity to process visual information, an adaptation that contributes to vision restoration.

For more information about our treatments for neuro-ophthalmological conditions, please call (727) 461-8635.

The Neurosciences Institute
at Ptak Orthopaedic & Neuroscience Pavilion
430 Morton Plant Street
Clearwater, FL 33756
(727) 461-8635