Why Would I Need to See a Neurologist for My Eye?

Neurologists specialize in disorders and diseases that affect the brain and the nervous system. Since the eyes can be affected by some of these conditions, doctors who specialize in neurology may be needed to diagnose and treat certain visual conditions. Some ophthalmologists specialize in neurology and eye issues, but for most eye conditions involving the brain, a neurologist would be needed to make the diagnosis.

Symptoms

When a person develops ocular problems, an eye doctor is usually the first physician consulted. The eye doctor may refer the patient to a neurologist for specific signs and symptoms. Eye symptoms that may require an evaluation from a neurologist include vision loss in one or both eyes, development of double vision and visual field loss. The eye doctor will generally send previous records to the neurologist to assist in the evaluation.

Vision Loss Problems

Vision loss may be caused by damage to the neurologic system, and the location of the problem can be established according to the symptoms and the time course of the symptoms, according to the Academy of Neurology 1. A stroke may cause sudden vision loss; intermittent visual loss in one or both eyes may be caused by increased pressure inside the head or a blockage in a blood vessel. These conditions should be referred to a neurologist immediately. Another cause of vision loss is optic neuritis, which is caused by inflammation of the optic nerve in one eye, according to the MayoClinic 3. Optic neuritis is often a sign of multiple sclerosis, and a patient who develops this condition should be referred to a neurologist for further evaluation 3.

Eye Movement Problems

Double vision is often caused by problems with the muscles that move the eyes or the nerves that control these muscles, according to the Michigan State University website 2. Double vision may not always involve a problem in the brain, however. Diseases like Guillain-Barre Syndrome and diabetes may cause double vision, according to the Minneapolis Clinic of Neurology 4. An aneurysm or a brain tumor may also cause double vision and require an immediate evaluation by a neurologist. Double vision that gets worse over time and that improves with rest may be caused by the disorder myasthenia gravis; this condition requires a referral to a neurologist too, according to the Academy of Neurology 1.

Visual Field Loss

Visual field defects can be the result of a problem with the eye or a problem further along in the visual path, according to the Patient UK website 5. By mapping out the defect in the visual field, using a visual field testing machine, the doctor can establish where the lesion in the brain is that is causing the visual field loss. Visual field loss that affects both eyes typically is caused by a problem in the brain. For example, if the left upper portion of the visual field is missing in both eyes, the lesion may be located in the right temporal lobe region. Bilateral visual field loss may also be caused by a tumor, such as a pituitary tumor. These conditions should be evaluated by a neurologist because further treatment may be required for the lesion.

Examination

An eye examination by a neurologist includes a visual acuity measurement and a confrontation visual field examination in the office, according to the American Academy of Neurology 1. During a confrontation visual field exam, the doctor holds up an object and asks the patient to note when the object can no longer be seen; this determines if there is an area missing in the patient's visual field.The neurologist will also evaluate the movement of the eyes to make sure that the eyes are moving together and have full range of motion 5. Problems with eye movements can cause double vision. The neurologist may also order brain imaging with a CT scan or MRI, to take a look at the brain of a patient with neurological eye complaints.