Neuro-ophthalmology

Neuro-ophthalmology is a subspecialty of ophthalmology that deals with the relationship between the eyes and the brain, specifically disorders of the optic nerve (nerve connecting our eyeball to the brain), orbit (bony cavity in which the eyeball is located), eye movement abnormalities and brain disorders associated with eye symptoms.

Our eyes act like a camera, only to capture an image of what we see. This visual information is then carried by the optic nerve from the eyes to the brain, where it is interpreted and this is how we understand what we are seeing. The optic nerves not only carry information from the central fixing point (i.e. where we are looking directly), but also from all around this fixation point giving us central as well as peripheral field of vision. Our brain also controls and co-ordinates the movement of both our eyes to maintain steady, single vision in all positions of gaze.

A neuro-ophthalmologist is a doctor who specialises in visual disturbances related to the nervous system and optic nerve, eye movement disorders and pupillary abnormalities. Such disturbances can be caused by trauma, inflammation, strokes, tumors, toxicities and infections.

The disorders evaluated by a neuro-ophthalmologist include:

  • Optic Nerve Disease causing vision Loss - typically presents as a sudden drop in vision or decrease in contrast or colour perception
  • Visual Field Loss – loss of peripheral/ side vision
  • Double Vision or Ocular Motility Dysfunction
  • Papilledema - optic disc swelling
  • Intracranial Hypertension
  • Nystagmus - involuntary shaking of eyes
  • Abnormality of Pupils - may be sign of life threatening condition needing urgent attention

A typical neuro-ophthalmology examination begins with a detailed history of the patient’s problem and relevant past history, systemic (especially medical & neurological problems if any) & medication history. This is followed by a comprehensive eye examination which in addition to your routine eye check up includes evaluation of eye movements, colour vision, contrast acuity and visual field testing wherever necessary. Visual field testing is conducted at a machine which displays lights in various parts of the visual field while the patient presses a button in response to each light. In this way, patterns of visual field loss may emerge that can help lead to a diagnosis. In cases of pupillary abnormalities, certain drops may be administered which help identify the cause of the problem. Additionally, your neuro-ophthalmologist may request neuroimaging (MRI or CT scan of the brain or orbits) to help with further diagnosis and management.

STEREOPSIS

What is stereopis?
Stereopsis is the ability of our eyes to see objects in 3 dimensions or 3-D.
How do we develop stereopsis?
When we look at an object, each of our eyes perceives a slightly different image. These two images are then joined in our brain and interpreted as a 3D shape. This can be possible provided there is good vision in both the eyes and the two eyes are aligned together.
How do we check for stereopsis?
Stereopsis can be tested in different ways, all of which work by presenting each eye a slightly different view of a flat image. This can be done either by using red/green glasses, polaroid glasses or cylindrical grating or by presenting an actual image in depth.

When do we develop stereopsis?
Development of stereopsis begins at about 3 months of age and is completed by 6-7 years of age. This period is also termed as the critical period for stereopsis because development of squint or amblyopia (lazy eye) during this age can cause the stereopsis to degrade, sometimes even permanently if not identified and treated immediately.
What happens if one has poor or no stereopsis?
We often see individuals without stereopsis learn depth perception using visual inputs and clues from one eye, like relative size of the objects, motion parallax, texture gradients, interposition of objects etc. However, some professions like armed forces personnel, surgeons etc need a high grade of stereopsis which may then render such people unfit for the position.

Neuro-ophthalmology

Neuro-ophthalmology is a subspecialty of ophthalmology that deals with the relationship between the eyes and the brain, specifically disorders of the optic nerve (nerve connecting our eyeball to the brain), orbit (bony cavity in which the eyeball is located), eye movement abnormalities and brain disorders associated with eye symptoms.

Our eyes act like a camera, only to capture an image of what we see. This visual information is then carried by the optic nerve from the eyes to the brain, where it is interpreted and this is how we understand what we are seeing. The optic nerves not only carry information from the central fixing point (i.e. where we are looking directly), but also from all around this fixation point giving us central as well as peripheral field of vision. Our brain also controls and co-ordinates the movement of both our eyes to maintain steady, single vision in all positions of gaze.

A neuro-ophthalmologist is a doctor who specialises in visual disturbances related to the nervous system and optic nerve, eye movement disorders and pupillary abnormalities. Such disturbances can be caused by trauma, inflammation, strokes, tumors, toxicities and infections.

The disorders evaluated by a neuro-ophthalmologist include:

  • Optic Nerve Disease causing vision Loss - typically presents as a sudden drop in vision or decrease in contrast or colour perception
  • Visual Field Loss – loss of peripheral/ side vision
  • Double Vision or Ocular Motility Dysfunction
  • Papilledema - optic disc swelling
  • Intracranial Hypertension
  • Nystagmus - involuntary shaking of eyes
  • Abnormality of Pupils - may be sign of life threatening condition needing urgent attention

A typical neuro-ophthalmology examination begins with a detailed history of the patient’s problem and relevant past history, systemic (especially medical & neurological problems if any) & medication history. This is followed by a comprehensive eye examination which in addition to your routine eye check up includes evaluation of eye movements, colour vision, contrast acuity and visual field testing wherever necessary. Visual field testing is conducted at a machine which displays lights in various parts of the visual field while the patient presses a button in response to each light. In this way, patterns of visual field loss may emerge that can help lead to a diagnosis. In cases of pupillary abnormalities, certain drops may be administered which help identify the cause of the problem. Additionally, your neuro-ophthalmologist may request neuroimaging (MRI or CT scan of the brain or orbits) to help with further diagnosis and management.

STEREOPSIS

What is stereopis?
Stereopsis is the ability of our eyes to see objects in 3 dimensions or 3-D.
How do we develop stereopsis?
When we look at an object, each of our eyes perceives a slightly different image. These two images are then joined in our brain and interpreted as a 3D shape. This can be possible provided there is good vision in both the eyes and the two eyes are aligned together.
How do we check for stereopsis?
Stereopsis can be tested in different ways, all of which work by presenting each eye a slightly different view of a flat image. This can be done either by using red/green glasses, polaroid glasses or cylindrical grating or by presenting an actual image in depth.

When do we develop stereopsis?
Development of stereopsis begins at about 3 months of age and is completed by 6-7 years of age. This period is also termed as the critical period for stereopsis because development of squint or amblyopia (lazy eye) during this age can cause the stereopsis to degrade, sometimes even permanently if not identified and treated immediately.
What happens if one has poor or no stereopsis?
We often see individuals without stereopsis learn depth perception using visual inputs and clues from one eye, like relative size of the objects, motion parallax, texture gradients, interposition of objects etc. However, some professions like armed forces personnel, surgeons etc need a high grade of stereopsis which may then render such people unfit for the position.

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Testimonials

Hello..this is Mr Sameer Bhambere from thane. One month back my mom underwent the cataract operation for both her eyes within the span of 2 months. Done by Dr Nikhil Negular along with his efficient n prompt team. The experience was amazing n soothing for my mom. Her reaction was that I didn't even come to know when it started n ended. Dr nikhil took me in encrossed me in some talks by asking questions n was doing something thinking that he is preparing for the operation she too kept chatting but in 10 minutes he told my mom maushi zhale and she was amazed. A very spectaculared n well handled it was for us as with senior citizens operation word is tuff to be handled, but he made it ease for her. Overall a well equipped, clean, efficient set up lead by Dr Nikhil Negular and will go a long way. The knowledge of new technologies and standards carried him make an impact thus creating further faith with his down to earth n spectacular personality. I and my parents are really thankful to him and his entire staff for giving us a friendly n comfortable support and making life n vision simplier, easier and clearer for my mom.

Sameer Bhambere

Well what can I say. Dr. Dilip and Dr Aruna have been our Family eyecare Doctor. He has treated my father my mother me and my wife Thanks to his care I still am having good eyesight and have successfully kept cataract at bay. My parents have been successfully operated by him and never had to face any issues thereafter. Great Doctor Great team just everything about Bhaskar eye care is about Caring.

Hariharan Iyer

Hi . My husband Suhas had his cataract surgery at Bhaskar eye care . Apart from the medical proficiency of Dr Dilip Gaitonde , we were extremely impressed by the overall care and efficiency.....the very courteous and helpful staff , the cleanliness around , the soothing soft music in the room , the personal attention of Dr. Dilip and his anasthetist wife , Dr Aruna ....instantly allayed whatever apprehentions we had . All this matched the post - operative care and follow up. An almost holistic experience......!

Almitra Shah

I had cataract surgery for both eyes recently at Bhaskar eye care on Ghodbhunder road. Dr Nikhil Negalur and his team were very polite, supportive and caring. I was very impressed by their willingness to answer all my questions. Dr Nikhil took the time to call me after the surgery to see how I was doing - I sincerely appreciate this personal attention. Even during the surgery he made sure that I was comfortable. Ms Vaibhavi was also very kind and patient in clarifying doubts. Right from the people at the reception desk, to the doctors and even the service staff, all the people here provide the best care possible. I wish them success in all they do and may they scale greater heights.

Lakshmi Iyer

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