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Section of Neuro-Ophthalmology

Neuro-ophthalmology is a subspecialty that combines the expertise of ophthalmology and neurology. Neuro-ophthalmologists join the patient’s care team when a patient has a neurological visual disorder that can lead to a loss of vision or peripheral visual fields, visual hallucinations, pupillary asymmetry, ocular motility dysfunction, or diplopia. These symptoms may indicate the presence of a more serious disorder; however, the disorder can often be treated.

Neuro-ophthalmology works closely with Barrow's other teams, such as Neuro-Oncology, the Multiple Sclerosis Center, the Movement Disorder Center, Stroke and Critical Care, the Cognitive and Alzheimer's Center, the Pituitary Center, the Skull Base Center, and the General Neurology inpatient service.

Diagnostic Capabilities of Visual Disorders

Barrow's neuro-ophthalmology team uses state-of-the-art equipment and tools to diagnose and treat an array of visual disorders. High-resolution digital fundus and optic nerve photography is used to document optic nerve and retinal pathology. Laser optical coherence topography (OCT) permits the visualization and exact measurement of the thickness of retinal nerve fibers and ganglion cells. This technique provides critical data that can lead to the early detection and following of optic nerve diseases such as glaucoma and multiple sclerosis. It also allows critical quantitative follow up of elevated optic nerves seen in disorders such as pseudotumor cerebri (PTC). Early detection allows patients to be treated sooner, possibly arresting the progress of the disease. Various team professionals now have working access to all of these new imaging systems, which are almost instantaneously available over the shared hospital computer network.

Neuro-Ophthalmologic Research at Barrow

The Neuro-ophthalmology Unit at Barrow is currently focusing on several research areas, including thyroid eye disease (TED), ocular myasthenia gravis (OMG), idiopathic intracranial hypertension (IIH/pseudotumor cerebri), perioperative visual loss (POVL), and traumatic optic neuropathy (TON).

Areas for Near Future Development: Establishing a state-of-the-art Visual Electrodiagnostic Electrophysiology Laboratory is a high priority for the Section of Neuro-Ophthalmology. With such an addition, the facility would add the capability to perform multifocal electroretinography (mf-ERG) and full-field electroretinography and to record multifocal visual evoked potentials (mf-VEP) and pattern visual evoked potentials. These capabilities would facilitate early detection, diagnosis, and following of inner and outer retinal disorders; optic nerve disorders such as multiple sclerosis; and toxic-nutritional neuropathies and maculopathies often associated with degenerative, heredofamilial, and acquired neurological diseases.

Other areas of research interest overlap with the field of aerospace medicine. We hope to strengthen alliances with neighboring facilities with access to high-altitude chambers and mixed gases to study the effects of hypoxia on visual fields (peripheral vision) and on central macular retinal function using multifocal electroretinography and visual-field testing in simulated high-altitude environments.