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Neuro ophthalmology is an exclusive subspeciality in ophthalmology that addresses a variety of disorders concerning the eye and the central nervous system. The optic nerve that arises from the back part of the eye as seen in the image connects the eye to the brain and hence, many diseases affect the eye and the brain simultaneously.

Opic nerve

Symptoms

Neuroophthalmic symptoms are many and can include:

  1. Blurred vision/ Visual loss in one or both eyes which may be sudden in onset or progressive.
  2. Visual field defects of sudden onset or progressive.
  3. Double vision of sudden onset.
  4. Disorders of eye movement of sudden onset.
  5. Sudden onset of drooping of eyelids.
  6. Headache with symptoms of raised intracranial pressure like tinnitus, vomiting, transient visual blurring.
  7. Ocular movement disorders with gait abnormalities.
  8. Headache due to migraine, stress, cluster headache and closely related conditions.
  9. Transient visual loss.
  10. Facial paralysis.
  11. Abnormal involuntary movements of the eyes and face.
neuro ophthalmology

Treatment

Our team provides quick and comprehensive clinical care for all age groups and for a broad spectrum of disorders including:

 

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Optic neuropathies: Diseases affecting the optic nerve like optic neuritis, ischemic optic neuropathy, autoimmune optic neuropathy, compressive optic neuropathy, nutritional optic neuropathy, toxic optic neuropathy.

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Demyelination disorders affecting the visual pathway formed by the optic nerve, optic chiasma, optic tract and optic radiations.

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Cerebrovascular disorders with visual loss, transient ischemic attacks with transient visual loss

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Ocular motility disorders characterized by partial of complete inability to move either one or both the eyes due to central and peripheral nervous system diseases like myasthenia gravis and ocular motor cranial nerve palsies following trauma (injury), tumours, ischemia due to systemic diseases like hypertension or diabetes mellitus.

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Tumours  like pituitary adenoma, craniopharyngioma, meningioma causing compressive optic neuropathy which cause a direct pressure on the optic nerve and other tumours of the brain affecting the visual pathway and cause of raised intracranial pressure.

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Other conditions causing raised intracranial pressure such as idiopathic intracranial hypertension, and cerebral venous thrombosis, which can result in permanent and profound loss of vision in the long term.

Narayana Nethralaya is equipped with advanced and the latest electrodiagnostic testing facilities to study optic nerve and retinal functions, that include visual field analysis (Humphrey’s Field Analyser), OCT, B scan ultrasound, VEP (Visual Evoked Potential). Other electrophysiology testing facilities include ERG ( Electroretinography), Multifocal ERG, EOG(Electrooculography).

Nerve conduction study and testing for myasthenia gravis such as RNS and neostigmine test are also done by our Neurology team at Apollo Hospital. In addition, at Narayana Nethralaya , we have a fully equipped laboratory for blood tests required in neurological disorders.

Our Team

Our Neuro Ophthalmology and Electrophysiology department is headed by our Vice Chairman and department chief, Professor Dr. Rohit Shetty.

Narayana Nethralaya has 4 centers all over Bangalore. The department at Narayana Nethralaya Rajajinagar is run by Dr. Abdul Rawoof  along with Dr. Sujith Kumar, chief senior consultant neurologist and Dr. Ravi Mohan Rao, chief senior consultant neurosurgeon who are attached to Apollo hospital. This team also caters to the Narayana Nethralaya Indiranagar branch. We also have access to a Senior Consultant Interventional Neuro Radiologist and otorhinolaryngologist (for optic nerve disease associated with sinus disorders and infections). Our Neurologist Dr. Sujit Kumar also specializes as an epileptologist and stroke specialist. Dr. Ravi Mohan Rao, our Neurosurgeon carries out an extensive range of brain surgeries and surgeries pertaining to tumous affecting the visual pathway. Both Dr. Ravi Mohan Rao and Dr. Sujit Kumar also specialize in epilepsy surgery.

Dr. Jyoti Matalia, Neuro-ophthalmologist at Narayana Nethralaya Health City, Bommasandra works in collaboration with the Neurology & Neurosurgery department of The Mazumdar Shaw multispecialty hospital. Dr. Jyoti Matalia performs the optic nerve sheath fenestration for papilloedema threatening vision.

Dr. Pratibha Panmand who is also a part of Narayana Nethralaya Health City neuro-ophthalmology department caters to assessment and rehabilitation of children with cortical visual impairment (CVI) in addition to the regular neuro-ophthalmology clinic.

Dr. Chaithra Aroor oversees the neuro-ophthalmology department at Narayana Nethralaya Bannerghatta.

Doctors2

Patient Process Flow

If you have constant blurred vision, double vision, sudden onset of drooping of eyelids, headaches with vomiting & blurring of vision, facial paralysis or abnormal involuntary movements of the eyes and face, you should schedule an appointment with an ophthalmologist to get your eyes checked immediately. Your initial consultation with the doctor will approximately take 2 hours if you do not require cross-consultation and up to 4 hours if you require cross-consultation. During your consultation, our doctors and counsellors will determine the best course of action for your visual needs, go over the risks and benefits of treatment, and help you choose the best procedure that is suitable for preserving/improving your vision. We suggest you bring a family member or friend with you to help you with your decision-making.

 

Neuro Opthal Patient

Neuro Ophthalmology Doctors NN1

Dr Rohit Shetty 1

Dr. Rohit Shetty

Vice Chairman

Dr Abdul Raoof

Dr. Abdul Rawoof B

Consultant

Neuro Ophthalmology Doctors NN2

DR JYOTI M

Dr. Jyoti Matalia

Senior Consultant

Neuro Ophthalmology Doctors NN4

DR CHAITHRA AROOR

Dr. Chaitra Aroor

Junior Consultant

FAQ

Frequently Asked Questions

When should I consult a neuro ophthalmologist?

You must consult a neuro ophthalmologist when there is a sudden loss of vision, sudden onset of visual field defects, when one has double vision, chronic progressive visual loss, drooping of eyelids, transient visual loss, unequal pupil size. just to mention a few.

What does a neuro ophthalmological examination include?

It includes assessment of visual acuity, color vision, pupillary reaction, assessment of the optic nerve appearance and function, assessment of the visual pathway from the eye to the visual cortex in the brain, assessment of extraocular movements, assessment of the field of vision and other tests as and when required.

What special tests are required in visual loss /blurring?

Any of these tests may be required in isolation or in combination.

  1. Automated Visual fields
  2. VEP
  3. OCT
  4. Carotid and Vertebral Doppler
  5. CT brain and orbit
  6. MRI brain and orbit
  7. MRA brain and neck vessels
  8. MRV brain
  9. CT angiogram of brain and neck vessels
  10. Blood tests when necessary
What is the optic nerve?

The optic nerve is a bundle of nerve fibers which conduct visual information from the eyes to the visual cortex of the brain.

What is optic neuritis?

Optic neuritis is an inflammation of the optic nerve. The patient experiences sudden blurring of vision in one or both eyes with pain in the eye/eyes, painful eye movements, color vision abnormalities, and sometimes flashing lights.

What are the common causes of optic neuritis?

The most common causes are demyelinating illnesses like multiple sclerosis and neuromyelitis optica, viral demyelination. Other causes include infectious diseases, autoimmune diseases.

Do patients with optic neuritis recover vision?

Most certainly, they do so, but they must consult the neuro ophthalmologist and neurologist immediately. The sooner the treatment is started, the better the outcome.

Once the optic nerve is damaged, can it recover?

Unfortunately, damage to the optic nerve fibers is irreversible. They cannot regenerate on their own.

Where is the vision center in the brain?

The vision fibers in the optic nerves form the optic tracts, the optic radiations and finally end in the visual cortex in the occipital lobe at the back of the brain.

Can double vision be treated?

Yes, it can be treated. Most recover within a month or two. Sometimes double vision due to trauma/accidents may not recover fully and may require special prisms or surgical correction.

What are the common causes of headache in neuro ophthalmology?

Headache may occur in migraine, vascular headache, tension headache, cluster headache, meningitis, raised intracranial pressure due to any cause, double vision, inflammation of the eye which may include optic neuritis, inflammation behind the eye in conditions like para nasal sinusitis, orbital apex syndrome, Tolosa Hunt syndrome, cavernous sinus syndrome.

What are the common causes of raised intracranial pressure?

The common causes are idiopathic intracranial hypertension, cerebral venous thrombosis, intracranial tumors, meningitis, intracranial hemorrhage, traumatic brain injury.

What does the patient experience when there is raised intracranial pressure?

The common symptoms of raised intracranial pressure include severe headache with nausea, projectile vomiting, transient visual blurring, tinnitus, double vision, loss of consciousness.

Can stroke cause loss of vision?

Yes it can. If the clot or bleed in the brain involves the optic radiation or the visual cortex there will be visual loss along with other features.

Can a stroke cause double vision?

Yes, it can. If the stroke involves the brain stem, where the nerves controlling eye movements originate, the patient can have sudden onset of double vision.

Why does somebody have double vision?

Double vision may be monocular or binocular. Monocular double vision is not neurological. Binocular double vision is usually neurological in origin. When any nerve which controls eye movements is affected, double vision can occur.

Can smoking and alcohol affect vision?

Yes, they can affect your vision directly or indirectly.

Case Study

Neuro Ophthalmology

Case Study 1

A 13 year old girl came with sudden blurring of vision in the right eye, with  pain since 1 week and right sided headache.

On evaluation her vision was very poor in the right eye. Though she did not complain of visual disturbances in the left eye,  detailed evaluation showed that the left eye was also affected, but to a lesser extent. She was diagnosed to have optic neuritis in both eyes. Neuroimaging showed optic neuritis in both eyes and additional changes in the brain suggestive of neuromyelitis optica spectrum disorder.

She was referred to our Consultant Neurologist who  immediately admitted and treated her. She recovered her vision completely in both eyes after treatment and was on subsequent treatment with disease modifying drugs. The field defects in both eyes also had recovered completely. On follow up she  was doing well and responding extremely well to treatment. She needed long term treatment and regular follow-up. The parents were explained regarding the condition and the need for regular eye check up and also regular followup with the Neurologist.

The parents and the child were very happy that the vision had recovered completely in both eyes.

Book an appointment with our Neuro OphalmologyTeam

Case Study

Neuro Ophthalmology

Case Study 2

A 27 year old gentleman came to Narayana Nethralaya with poor vision in the right eye which was progressively worsening since 6 months. He also had headache since 4 years which was worse since 6 months.

He underwent a thorough ophthalmic evaluation.  His vision in the right eye was very poor  and both optic nerves appeared pale or had optic disc pallor. He also  had poor vision in the outer half of the field of vision in both eyes which was confirmed after evaluation. A compressive mass lesion at the optic chiasm was suspected.  Neuroimaging confirmed this and he was diagnosed as having a Rathke’s cleft cyst. He was immediately referred to our Consultant Neurosurgeon,  who evaluated him and the gentleman underwent surgery for removal of the tumor.

2 months later , on followup,  his vision in both eyes had recovered  to normal. His field defects in both eyes recovered completely.

The patient had no visual symptoms and no headache. On subsequent follow up, he was doing well after 2 years also and the follow up neuroimaging showed no recurrence of the tumor.  The patient was extremely happy with the results.

Book an appointment with our Neuro OphalmologyTeam

Neuro Ophtalmology Patient Reviews

At Narayana Nethralaya, we are committed to providing our patients with advanced quality eye care at affordable prices. These  experiences stand testimony to the excellence in eye care that we offer.

We have consulted Dr. Abdul for double vision problem. Hospitality very well organized and appointment scheduling is very convenient.. overall a great experience..

Dr.Abdul and Dr.Sujit

Dr.Abdul is best doctor.. he guides and treats very well very politely and guides very well.. best doctor to consult for good results.. I recommend and suggest this doctor for any eye related issues..

and Dr.Sujit is also a good doctor with nice smile on face and he too guides very well.. he treats patient very calmly…both of them explained patient about the disease very well…

I suggest both the doctor..

and thank you so much for the support doctor and staffs also.

Visited Narayana Nethralaya for my son. It was good experience starting from the reception. The staff and specifically Dr Jyothi was very supportive with addressing the queries and concerns and to complete the formalities quickly. Thanks.

Dr. Chaithra Aroor is one of the best doctors i have ever met. We visited Narayana Nethralaya to get treatment for an eye problem. We met Dr Chaithra, She explained to us about the infection, the cause and suggested a simple treatment. She was very patient with us. She understood the condition of the patient treated with empathy and patient responded well. Thanks to Dr Chaithra.

Consulted Dr Chaithra aroor..I can confidently say she is the best opthalmologist I have met in the LST forty three years in seven states and two foreign countries! Very pleasant though professional. Does not scatre patient. Answers all queries clarifies doubts. All misconceptions I had by going to other eye hospitals in the last nine !months were cleared and I am going a very Happy man. No doubt narayana is number one in Bangalore Above all always smiling. May God bless Dr Chaithra with long and happy life..bye thanks. Even all supporting staff are very co operative and helpful.

Our patient care philosophy

At Narayana Nethralaya, “Quality of Care” and “Patient Safety” is our priority.  Concern for our patients’ well being is at the core of what we do, and what drives us.  Three units of Narayana Nethralaya are NABH Accredited – the highest national recognition for quality in patient care and safety. Our Neuro ophthalmology team help patients make an informed treatment choice on the type of treatment and surgery that is best suited for their lifestyle. We have an exclusive counseling team to address any doubts or questions that people may have about Neuro ophthalmology treatment options and procedures.

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