Neuro-Ophthalmology

THYROID EYE DISEASE
– Clinical Presentation

  • Proptosis
  • Eyelid retraction
  • Double vision
  • Pain
  • Redness and swelling
  • Dry eyes
  • Corneal compromise
  • Optic nerve compression

– Therapeutic Options

  • Medical (corticosteroids, Tepezza, external beam
    radiation)
  • Surgical (decompression, eyelid retraction repair,
    strabismus surgery)

STROKE
BRAIN

  • Visual Field Defects
  • Diplopia
  • Vestibular dysfunction

OPTIC NERVE

  • Acute ischemic optic neuropathy

OCULOMOTOR NERVES

  • Third Nerve Palsy
  • Fourth Nerve Palsy
  • Sixth Nerve Palsy

NEUROTROPHIC CORNEA (fifth cranial nerve)

SEVENTH NERVE PALSY

BLEPHAROSPASM/HEMIFACIAL SPASM

OPTIC NERVE DYSFUNCTION

  • Laboratory evaluation
  • Orbital and brain imaging
  • Medical therapeutics

DIFFERENTIAL DIAGNOSIS

  • Optic neuritis
  • Neuromyelitis optica (NMO)
  • Anti-MOG
  • Compressive optic neuropathy
  • Infectious optic neuropathy
  • Toxic optic neuropathy
  • Non-arteritic ischemic optic neuropathy
  • Arteritic ischemic optic neuropathy
    – Giant Cell Arteritis
    – Lab evaluation
    – Temporal artery biopsy
    – Medical therapeutics
  • Myasthenic Gravis
    – Evaluation and therapeutic interventions

ALTERATIONS IN BRAIN PRESSURE/PAPILLEDEMA

  • Idiopathic Intracranial Hypertension
  • Chronic meningitis
  • Venous sinus thrombosis
  • Venous sinus stenosis

CAVERNOUS SINUS DISORDERS

  • Carotid cavernous fistula
  • Cavernous sinus thrombosis

INFECTIOUS DISEASE AFFECTING VISUAL FUNCTION

  • COVID-19
  • Syphillus
  • Tuberculosis
  • Fungus
    – Mucor
    – Aspergillosis
  • Hepatitis
  • HIV

TRAUMATIC BRAIN INJURY

BRAIN TUMOR EVALUATION AND MONITORING OF STRUCTURE AND FUNCTION

MULTIDISCIPLINARY APPROACH TO TUMORS THAT IMPACT THE OPTIC NERVE OR CRANIAL NERVES