Neuroophthalmology is an academically oriented, narrowly specialized category of medicine that combines neurology and ophthalmology, most generally concerned with complex systemic disorders that occur in the visual system. At first, neuroophthalmologists examine it entirely in the fields of neurology or ophthalmology, and then continue in the additional zone. Diagnostic tests in patients with severe neuroophthalmic illnesses can be common. Neuroophthalmologists also spend considerably more time with the patient than experts in other fields require a comprehensive medical history and physical exam.
The general pathology of the neurophthalmologist includes afferent visual system disorders (e.g., optic neuritis, optic neuropathy, optic disc edema, brain tumor or stroke) and visual system disorders (e.g., anisocoria, diplopia, ophthalmoplegia, ptosis, and hemifacial spasm).
Symptoms and Alarms
Vision loss
The optic nerve can be damaged anywhere in the nerve trunk, beginning with the disk or nipple (visible when inspecting the eye's fundus) and ending with the channels that link it to the cerebral cortex. How to determine where the injury is and what is its cause?
Retrobulbar neuritis or optic neuritis
A term for sudden loss of vision due to demyelination of a nerve. Most frequently multiple sclerosis is followed by optic neuritis. Patients experience visual disability which is sharp, often unilateral (unilateral). An initial fundus examination should be usual except when the presentation of the papillitis resembles the optic disk edema, even in cases of disc injury. In most cases, vision is recovered within a few weeks, but the healing is improved by intravenous corticosteroids.
Ischemic optic neuropathy
It occurs in the nerve disk due to a heart attack. Typically happens in people over 50 with a history of diabetes or cardiovascular disorder with a history of hypertension. It leads to a pronounced visual disability which is unilateral. It is obvious, when inspecting the fundus, that the optic nerve disk is swollen (initially the edema is pale). It's not rare that the same will happen to the other eye after a while (contralateral eye).
Temporary arteritis, a condition that typically affects people over 70 years of age, may also result in an optic disk infarction. In case of a danger, treatment with high doses of corticosteroids should be started urgently. To validate the diagnosis a temporary biopsy of the artery is performed.
The toxic-nutrient optical neuropathy and hereditary atrophy of Leber's optic nerve must also be taken into account in the differential diagnosis of optical neuropathy.
Blindness transient
Episodes of transient monocular blindness last from a few seconds to several minutes, indicate a transistor ischemic attack arising from the manifestation of atherosclerosis at the level of the carotid artery.
Migraine with aura
Visual impairment during migraine attacks is very diverse: starting with the classic ciliated scotoma and ending with impaired perception of objects. In some cases, episodes of complete blindness are described as a secondary effect of an anomaly in the occipital cortex. In exceptional cases, retinal migraine occurs when the visual disturbance is caused by a lack of blood supply to the optic nerve or retina.
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