Neuro-ophthalmology is an ophthalmic subspecialty that addresses the relationship between the eye and the brain, specifically disorders of the optic nerve, orbit, and brain, associated with visual symptoms. Today, neuro-ophthalmologists provide comprehensive clinical care to a broad spectrum of patients with visual disturbance from optic nerve diseases, central nervous system disorders, ocular motility dysfunction, and pupillary abnormalities.
Headaches
Headaches are one of the most common health complaints. They are caused by a variety of factors and can be divided into the following groups:
Tension-type headaches
This is the most common type of headache. The pain may be felt in the forehead, temples, neck, or around the eyes. Doctors are uncertain about the cause of this type of headache but believe they are due to stress, sleeping or working in unusual positions, clenching jaws, grinding teeth, or chewing gum. These kinds of headaches are usually temporary and can be relieved by an over-the-counter pain reliever.
Migraine headaches
This kind of headache is also common. Migraine pain is related to activity in the brain that swells blood vessels of the scalp, causing throbbing pain, nausea, sensitivity to light, sounds, or odors, and pain that increases with movement. The exact cause of migraines is still unknown. About one in 10 people suffer from migraines, and they affect more women than men. Migraines can run in families and can affect young children as well.
Cluster headaches
Cluster headaches are less common than migraines and affect more men than women. They are called cluster headaches because they come in daily bouts of 30 minutes to two hours and continue for one to two months. These bouts can occur several times a year. The pain is felt on one side of the head, is very severe, and can be accompanied by tearing or red eye on the affected side, sweating, and stuffy nose.
Eye disease is the least common cause of headaches. Headaches caused by eye disease are usually felt in the eye or brow on the side where the disease occurs. These headaches are often associated with symptoms like blurred vision, halos, and sensitivity to light. Headaches can also be caused by high blood pressure or brain tumors, although headaches caused by brain disease are rare and become dramatically worse over time.
In general, headaches can include symptoms that may affect vision or your eyes, but they are not directly caused by eyestrain.
A thorough examination by your primary physician is recommended for any chronic or recurring headache. An eye exam by an ophthalmologist (Eye M.D.) may be helpful in some cases.
Bell’s Palsy
Bell’s palsy is a disorder of the facial nerve, the seventh cranial nerve. This condition causes partial paralysis on one side of the face, affecting the muscles of facial expression. Bell’s palsy usually occurs in adults and develops suddenly.
Symptoms of Bell’s palsy include the inability to smile on one side or close one eyelid completely, decreased tear production and sense of taste, blurry vision, and distorted hearing.
The causes of Bell’s palsy are varied. In most cases, the cause is never identified, but it is believed that Bell’s palsy often develops secondary to a viral inflammation. Other causes include activation of the body’s immune system and changes in blood flow. Bell’s palsy is more common in patients with diabetes and in pregnant women.
Most of the time, Bell’s palsy disappears on its own after a few months. Eye lubricants may be used to prevent complications. In some cases, corticosteroid or antiviral drugs may be used to help in the treatment of this condition.
Diplopia
Diplopia is double vision caused by a problem with the muscles that control the eye or the nerves that stimulate those muscles.
Many conditions can cause diplopia. Double vision is usually a symptom of strabismus (misalignment of the eyes), due to the improper movement of one or more eye muscles. Strabismus is most often found in children, but it can develop later in life. A growth in the eyelid pressing on the front of the eyeball can also cause temporary double vision. Rarely, double vision arises because of an abnormality within the eye, such as a dislocation of the eye’s natural lens.
The onset of double vision in adulthood should be brought to the attention of your ophthalmologist (Eye M.D) immediately to exclude the possibility of a tumor, aneurysm, or neurological problem. Two of the primary neurological conditions that could cause diplopia are microvascular cranial nerve palsy (MCNP) and myasthenia gravis (MG).
Microvascular cranial nerve palsy, or “diabetic palsy,” is one of the most common causes of double vision in older people. It occurs more often in patients with diabetes and high blood pressure, when blood flow is blocked to one or more of the six eye muscles that control eye movement. Although there is no known treatment for MCNP, the double vision may be treated by patching either eye. If the double vision persists, prism eyeglasses or eye muscle surgery may be prescribed.
Myastheniagravis is a disorder characterized by muscle weakness, caused by a communication breakdown between the nerves and the muscles due to an autoimmune condition. It is most common in the muscles of the face, eyes, arms, and legs, and in the muscles used for chewing, swallowing, and talking. Double vision is one of the common indicators of myasthenia gravis. Though there is no known cure for myasthenia gravis, there are a number of treatment options to manage the condition, including medication, surgery, and other procedures. If you have MG, physical therapy can help, and you can learn specific coping skills for improving your daily life. Early detection and treatment of MG is crucial to managing the condition and preventing serious problems with breathing or swallowing, which require emergency care.
Dr. Solomon see’s all of our neuro-oph patients. He keeps times available every day to accommodate the needs of our patients needing immediate care.