Neuro Ophthalmology

Ophthalmologists and doctors may refer www.thamburaj.com for more details on:

• ocular movements
• diplopia and ocular nerve palsies
• papilloedema – saetiology, differential diagnosis and management
• traumatic optic neuropathy

About 60% of the brain is occupied by eye related pathways.
The eye - brain relationship is compared to that of an electrical circuit. Eye is analogous to bulb or fan, [the former for light perception and the latter for eye movement]
Optic nerve, visual pathways etc., are analogous to Wires
Brain is analogous to Switch.
Lesions in or around these passages will reflect in the vision or the eye movements.
Certain tumours in the brain are first detected when the patient comes for treatment of headache. A complete eye check up along with fundus examination and autoperimetry will enable to clinch the diagnosis.
A comprehensive report at various period intervals, easily comprehensible by the neurosurgeon or the neuro physician is handed over to the patient.



The neuro ophthalmology report has separate columns for:
Best corrected vision- Distance and near for each eye,
Colour vision,
Autoperimetry field report of each eye
Fundus findings of each eye

These patients are given personal attention with counselling whenever required.

Cosmetic Ophthalmology

• Ptosis - Drooping of eyelids
• Wart removal
• Cosmetic squint correction
• Contact lenses
• Spectacles

Endoscopy in Ophthalmology

The nasal endoscope provides natural access through the nose to orbit, lacrimal sac, superior orbital fissure, optic canal and pituitary thus serving to treat problems in these areas.

Eg: For chronic watering problem due to infection of the lacrimal sac, Endoscopic DCR has the following advantages:

• There is no external scar
• Reduced bleeding during surgery
• The lacrimal pump mechanism is maintained.
• Patient looks unoperated.
• Takes less than 10 minutes usually
• Age no bar
• Successful in traumatic, congenital, failed DCR
• Cataract surgery can be taken up earlier than the external method
• Both sides can be taken up at the same time

Optic Nerve Schwannoma:

A 25 year old male with protrusion and pain right eye of 9 months duration underwent surgery – craniotomy and lateral orbitotomy twice elsewhere with no benefit.

• He finally approached our hospital.
• Endoscopic complete removal of the tumour was done.
• Even after 4 yrs of follow up, the patient is doing fine and has no problems.

Optic canal and the optic nerve can well be approached through the nose after a spheno ethmoidectomy for:

• Traumatic neuropathy
• Optic nerve sheath fenestration in papilloedema
• Optic canal decompression in craniosynostosis
• Optic canal decompression in fibrous dysplasia etc.