Neuro-Ophthalmology

Common symptoms of vision problems caused by Nerve issues

Neuro-ophthalmologic disorders often present with a variety of symptoms. If you experience any of the following, it is essential to seek medical attention:

• Double vision (diplopia): Seeing two images of the same object.
• Blurred vision: Difficulty focusing or seeing clearly.
• Drooping eyelids: Known as ptosis, occurs when the upper eyelid falls lower than normal and may affect one or both eyes. It can be related to age, muscle or nerve changes, and in some cases may require treatment if it interferes with vision.
• Eye movement problems: Difficulty controlling or coordinating eye movements, often leading to dizziness or disorientation.
• Loss of peripheral (side) vision: Difficulty seeing objects outside your direct line of sight.
• Involuntary eye movements: Conditions like nystagmus, where the eyes move rapidly without control.
• Headaches: Persistent headaches may be linked to optic nerve swelling or other neurological issues.
• Sudden vision loss: Immediate or gradual vision loss may signal a serious underlying condition

Diagnosing neurological vision problems

Diagnosing neuro-ophthalmologic disorders requires a thorough eye and neurological examination. At Moorfields Eye Hospital Dubai, our neuro ophthalmologists use advanced diagnostic tools to assess the condition of the eyes and nerves, including:

• Visual field tests: To assess peripheral vision and detect blind spots.
• Comprehensive Orthoptic examination: To accurately assess the movement of the eyes and binocular functions
• HESS Charting: A clinical tool used to assess and diagnose eye movement issues, particularly paralytic or restrictive strabismus.
• Optical coherence tomography (OCT): A non-invasive imaging test that examines the optic nerve and retina.
• Magnetic resonance imaging (MRI) or computed tomography (CT): To obtain detailed images of the brain, optic nerves, and surrounding structures, which can help identify tumours, swelling, or other abnormalities.
• Electromyography (EMG): A test to measure muscle activity in patients with muscle and nerve conditions like myasthenia gravis.
• Blood tests: To detect any underlying autoimmune or inflammatory conditions affecting vision

Conditions treated

We provide treatment for the following conditions:

• Double vision: Misalignment of the eyes or neurological issues causing patients to see two images instead of one.
• Blepharospasm and facial movement disorders: Involuntary movements of the eyelids or face, often linked to nerve dysfunction.
• Eyelid abnormalities: Such as ptosis, where the eyelid droops due to nerve or muscle issues.
• Myasthenia gravis: A condition that affects the muscles responsible for eye movement, leading to droopy eyelids and double vision.
• Nystagmus: Involuntary, rapid eye movements that can cause vision problems.
• Optic nerve disorders: Including optic neuritis, ischemic optic neuropathy, and compressive optic neuropathies.
• Orbital tumours: Tumours around the eyes that can affect vision and eye movement.
• Papilledema: Swelling of the optic nerve head due to increased pressure in the brain.
• Pupillary abnormalities: Unequal pupil sizes (anisocoria), which may indicate underlying neurological conditions such as third nerve palsy or Horner’s syndrome.
• Strabismus: Misalignment of the eyes, often causing double vision or visual discomfort.
• Thyroid eye disease: A condition related to thyroid dysfunction that affects the muscles and tissues around the eyes.
• Unexplained vision loss: Sudden or gradual vision loss that may have a neurological cause.
• Visual field defects: Often related to stroke, brain tumours, or multiple sclerosis, these defects can cause blind spots or reduced peripheral vision.

Treatment options for neurological vision problems

Treatment for neuro-ophthalmologic disorders often involves a multi-disciplinary approach. At Moorfields Eye Hospital, our neuro-ophthalmologists in Dubai work closely with orthoptists, neurologists, neurosurgeons, and radiologists to develop a comprehensive treatment plan. Some treatment options include:

• Medication: This is used to manage underlying conditions such as myasthenia gravis, optic neuritis, or inflammation of the optic nerve.
• Botox injections: These are used to treat conditions like blepharospasm and certain types of strabismus.
• Surgical interventions: These are used for cases such as orbital tumours, eyelid abnormalities, or severe strabismus that requires correction.
• Vision therapy and/or therapeutic prisms: To address double vision or strabismus and improve eye movement coordination.
• Corticosteroids: These are used to reduce inflammation in conditions like optic neuritis.
• Radiation or chemotherapy: Oncological treatments may be necessary if a tumour is affecting the eyes or optic nerves.