Neuro-Ophthalmology Unit

From the optic nerve to the cerebral cortex, many diseases may affect vision or eyeball or pupil movement.

The neuro-ophthalmologist works in coordination with the neurologist and neurosurgeon to diagnose and treat non-ocular vision disorders.

The eye works like a video camera that captures images and converts them into electrical impulses. The optic nerve and intracerebral optic pathway carry these impulses to the posterior region of the brain, which is the part that actually “sees”.

Transmission of vision impulses may be affected by various optic nerve or brain diseases, with the most common being circulatory disorders, although hereditary, metabolic and autoimmune disorders (such as multiple sclerosis) also play a role. Pituitary disorders and increased intracranial pressure can also impair vision. 

Other processes may affect vision by damaging the visual areas of the cerebral cortex.

Another point of convergence between the brain and the eye is at eye movement level: the brain coordinates the precise movements of the two eyes to construct a single three-dimensional image. When any of the motor mechanisms fails, double vision (diplopia) or eye tremors (nystagmus) occurs. In people with diabetes or hypertension, a nerve responsible for moving the eyeball may be paralysed. The neuro-ophthalmologist will determine which nerve is affected and the cause of paralysis. Pupil dynamics is also controlled by the brain and is studied by this Unit. 

The neuro-ophthalmologist can also give advice on rehabilitation in people with poor vision of cerebral origin, help prevent risk factors affecting eye circulation and the brain and be involved in the diagnosis and treatment of migraines.

The Unit is supported by highly-experienced ophthalmologists and is at the intersection of ophthalmology and neurology. The Neuro-Ophthalmology Unit is led by Dr Manuel Romera with the assistance of Dr Ana Blázquez.

What is the main focus of the Neuro-Ophthalmology Unit?

  • Diagnosis and treatment of optic nerve diseases
  • Study of the visual pathway and “cerebral” vision
  • Study of Ocular Motility and Pupil Dynamics
  • Computerised campimetry for neuro-ophthalmology patients
  • Neuroimaging studies (CT, magnetic resonance, etc.)
  • Botulinum toxin (Botox) injections
Created: 02/05/2019 / Updated: 03/12/2024

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