What is a Neuro-Ophthalmologist?

A neuro-ophthalmologist is a physician who is trained in the diagnosis and treatment of disorders that involve the relationship between the eye and the brain.  This includes problems with the muscles of the eye, the optic nerve and its connection to the brain, and the areas of the brain that receive and process the visual information.  The physician  often is trained in ophthalmology (residency) and then does further training focusing on neuro-ophthalmology (fellowship). There are also some neuro-ophthalmologist that are trained in general neurology and then do a neuro-ophthalmology fellowship.

While there are many disorders that are handled by neuro-ophthalmologists, some of the more common include:

  • double vision
  • unexplained visual loss
  • optic nerve swelling
  • optic nerve damage
  • headaches
  • brain tumors or strokes affecting vision
  • blepharospasm
  • hemifacial spasm
  • orbital disease (thyroid eye disease)
  • orbital tumors

The treatment of these above conditions, and many others, are often handled by medications or specialized surgical procedures.  Usually these treatments can stop or reverse the visual problems.

Unlike some areas of ophthalmology where the diagnosis is often made by looking at the affected part of the eye, neuro-ophthalmology often requires extensive history taking of the current problem and background leading up to it, a very through exam of the eye, and other other specific test. Some of the tests used to help with the diagnoses include:

  1. MRI/MRA
  2. CT Scans
  3. Lab work
  4. OCT
  5. Fluorescein Angiography
  6. Visual Fields

By using this information the puzzle is put together and a diagnosis that is often not at first obvious starts to form.

Normally neuro-ophthalmologists are based out of large academic centers in larger cities, requiring patients to travel long distances for care.  Here at Sarasota Retina Institute we are fortunate to have Dr. Marc Levy, Dr. Jody Abrams and Dr. Thomas Spoor, all fellowship trained in the field of neuro-ophthalmology and orbital surgery.


Jody Abrams, MD

Neuro-ophthalmology/Oculoplastic Surgeon

Sarasota Retina Institute

Sarasota, Florida