Nowadays, with the increasing number of diseases and patients that ophthalmologists and neurologists follow together, the term 'neuroophthalmology' has become frequently used. With increasing awareness of neuro-ophthalmological diseases and increasing scientific studies, the importance of 'neuro-ophthalmology' in medical sciences has been revealed.
Neuro-ophthalmological diseases are problems that occur primarily in the connections between the visual organ and the brain or occur due to systemic diseases in these regions. It covers. The aim of this article is to provide information about the neuro-ophthalmological problems and their solutions that we encounter most frequently in the clinic and to emphasize the importance of neuro-ophthalmological examination.
What is Neuroophthalmology?
The branch of science that examines the relationship between the eye and the brain, examines and treats common pathologies of the visual pathways and nervous system is called 'Neuroophthalmology'.
Visual pathways start from the eyeball and progress towards the brain tissue along the optic nerve called the optic nerve. Visual pathways from both eyes end in the brain region called the occipital cortex (visual area). Problems in these pathways may affect visual function or eye movements.
Diseases of the eyeball and its appendages, visual pathways, and various brain-brainstem centers, including eye movement centers, constitute the main subjects of neuroophthalmology. Diagnosis and treatment plans for neuroophthalmological diseases can be made by both ophthalmologists and neurologists.
What are the most common neuroophthalmological diseases?
There are many diseases diagnosed and followed within the scope of neuroophthalmology. Some of these diseases develop secondary to neurological diseases that are diagnosed and treated by neurologists and affect the eyeball and visual pathways secondarily. A group of neuroophthalmological diseases are diagnosed by ophthalmologists during ophthalmological examination. The most common neuroophthalmological diseases encountered in the clinic can be listed as follows:
Optic Neuritis (Inflammation of the optic nerve)
Multiple Sclerosis
Ischemic Optic Neuropathy
Pituitary Tumors Compressing the Optic Nerve
Increased Intracranial Pressure syndrome
Paralysis of eye muscles and paralytic strabismus
Diplopia (Double Vision)
Hereditary optic neuropathies
Cerebrovascular Events
Blepharospasm (Eyelid Spasm)
Thyroid Orbitopathy (Eye disease due to thyroid diseases)
Pupillary Anomalies (Pupil shape/function disorders)
What are the most common symptoms in neuroophthalmological diseases?
Neuroophthalmological diseases cause complaints that vary depending on the area affected by the disease and the loss of function it causes in patients. The most common symptoms of neuroophthalmological diseases are:
Sudden loss of vision
Impairment in color vision
Narrowing of the visual field
Around the eye or eye movements Pain with
Double vision
Different sizes of the pupils
Difficulty in focusing
Contractions on the face or eyelids
Severe headache accompanied by ringing in the ears/nausea
Dooping eyelid
Sudden onset of strabismus
The sudden onset of these symptoms usually indicates the urgency of the situation. . It is recommended that these patients undergo both a detailed eye examination and neurological examination. Since early diagnosis is of great importance in most neuro-ophthalmological diseases, it is necessary to start the examination phase without delay.
Diagnosis of Neuro-ophthalmological Diseases
In most diseases. As with neuro-ophthalmological diseases, early diagnosis is of great importance. Patients with symptoms of neuroophthalmological diseases apply to ophthalmology or neurology clinics, depending on the function primarily affected by the complaint. To these patients; A neuroophthalmological examination, which includes a number of specific tests, is performed and help is obtained from various radiological imaging methods. Neuroophthalmological examination can be performed by ophthalmologists and neurologists. However, various blood tests, neuroimaging tests such as Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) are also required for diagnosis.
Treatment of Neuroophthalmological Diseases
Most n� Treatment of roof-ophthalmological disease depends on the treatment of the underlying neurological or systemic disease. First of all, it is necessary to diagnose the neurological disease that affects the eye and visual system, and then a treatment plan is created according to the cause of the disease. For example;
If the disease has an autoimmune basis, that is, if the immune system is overworked, as in Multiple Sclerosis, the treatment is primarily planned for this mechanism in cases of eye involvement.
In the presence of increased intracranial pressure and a resulting eye muscle paralysis, the first step is to investigate the cause of the increase in intracranial pressure. Eye muscle paralysis can only be treated by regulating the increased intracranial pressure.
Which Specialists Are Treating Neuroophthalmological Diseases?
Correct diagnosis of neuroophthalmological diseases is the golden step in planning the correct treatment. In the diagnosis and treatment of these diseases, neurologists and ophthalmologists, especially those working in neuroophthalmology, carry out effective diagnostic tests and treatment arrangements. It is important for these two branches to work integratedly in the management of these diseases.
Things to Consider Regarding the Treatment of Neuroophthalmological Diseases
Neuroophthalmological disorders; They include serious eye diseases, some of which can result in blindness. Early diagnosis is essential for the effectiveness of treatment in these diseases. Treatment processes for neuroophthalmological problems should be carried out with care and attention and in a multidisciplinary manner. An ophthalmologist and an adult or pediatric neurologist are most often involved in the management of these diseases. An endocrinologist/infectious disease specialist/pediatrician/radiologist/neurosurgeon is often involved in the treatment process.
Neuro-ophthalmological diseases have a treatment spectrum that can vary from simple medical treatments to surgical interventions. The most important element in treatment effectiveness is early diagnosis of the disease and application of the appropriate treatment option at the right time.
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