Neuro-ophthalmology

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Neuro-ophthalmology is an academically-oriented

physical exam
is essential, and neuro-ophthalmologists often spend a significant amount of time with their patients.

Common pathology referred to a neuro-ophthalmologist includes afferent visual system disorders (e.g.

university-based medical centers. Patients often have co-existing diseases in other fields (rheumatology, endocrinology, oncology, cardiology, etc.), thus the neuro-ophthalmologist is often a liaison between the ophthalmology department and other departments in the medical center.[3]

Description

Neuro-ophthalmology focuses on diseases of the nervous system that affect vision, control of eye movements, or pupillary reflexes. Neuro-ophthalmologists often see patients with complex multi-system disease and exotic diagnoses—“zebras” in medical jargon—are not uncommon. Neuro-ophthalmologists are often active teachers in their academic institution, and the first four winners of the prestigious Straatsma American Academy of Ophthalmology teaching awards were neuro-ophthalmologists.[4] Neuro-ophthalmology is mostly non-procedural, however, neuro-ophthalmologists may be trained to perform eye muscle surgery to treat adult strabismus, optic nerve fenestration for idiopathic intracranial hypertension, and botulinum injections for blepharospasm or hemifacial spasm.[5]

Historical developments

At the turn of the 20th century, there was no textbook in the English language on neuro-ophthalmology. In 1906, Dr. William Campbell Posey, Professor of Ophthalmology in the Philadelphia Polyclinic and Dr. William G. Spiller, Professor of Neurology in the University of Pennsylvania, edited The Eye and Nervous System: Their Diagnostic Relations By Various Authors

J.B. Lippincott & Co. According to the Preface to this book, "Although it is generally conceded that a knowledge of neurology is indispensable to the ophthalmologist and that an acquaintanceship with ophthalmology is of the greatest service to the neurologist, there is no book in the English language which covers the ground where the two specialties meet."[6]

Frank B. Walsh was a pioneer of neuro-ophthalmology, helping to popularize and develop the field. Walsh was born in Oxbow, Saskatchewan in 1895 and earned a degree from University of Manitoba in 1921. He joined the Wilmer Ophthalmological Institute at Johns Hopkins University and began organizing Saturday morning neuro-ophthalmology conferences. Walsh compiled the first neuro-ophthalmology textbook, which was published in 1947 and has been updated over the years by generations of his students.[7]

Future

Improved

Leber hereditary optic neuropathy,[9] which is one of the first uses of gene therapy in the central nervous system. Progress has also been made in understanding retinal ganglion cell regeneration and in re-establishing synaptic connections from the optic nerve to the brain,[1] more than in other regions of the central nervous system.[10][11] One of the goals of the National Institutes of Health is to use the visual system as a window to understand neural plasticity and regenerative medicine in the central nervous system,[12] an area of neuroscience
that has a promising future and is intimately intertwined with neuro-ophthalmology.

References

  1. ^ .
  2. ^ "North American Neuro-Ophthalmology Society". North American Neuro-Ophthalmology Society Home Page. Archived from the original on 26 September 2014. Retrieved 28 September 2014.
  3. ^ McDonnell, Peter (1 Nov 2004). "Is neuro-ophthalmology in jeopardy?". Ophthalmology Times. 29 (21): 4. Archived from the original on 2 April 2015.
  4. PMID 18769291
    .
  5. .
  6. ^ Posey, William Campbell; Spiller, William G. (1906). The Eye and Nervous System: Their Diagnostic Relations by Various Authors. Philadelphia and London: J.B. Lippincott Company.
  7. ^ Angelucci, Diane. "Groundbreaking neuro-ophthalmologist honored". EyeWorld. Archived from the original on 5 March 2015. Retrieved 28 September 2014.
  8. S2CID 35672897
    .
  9. .
  10. .
  11. .
  12. ^ "NEI Audacious Goal Initiative". National Eye Institute. Retrieved 28 September 2014.

External links