Optic Nerve Disorders

Optic Neuritis and Optic Neuropathy

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Duke’s neuro-ophthalmologists are subspecialists who conduct extensive evaluations to identify the cause of visual concerns including unexplained visual loss, blurred vision, and blind spots that may be related to optic nerve damage (optic neuropathy). Uncovering the underlying cause of your optic nerve disorder is our goal.

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Extensive and Thorough Optic Nerve Evaluation

You may be referred to one of our neuro-ophthalmologists if your doctor suspects your optic nerve -- the nerve that connects your eyeball to your brain -- is not functioning properly. An extensive neuro-ophthalmologic examination uses sophisticated imaging and advanced diagnostic tools to evaluate your eyes and brain. This helps us uncover whether you have an optic neuropathy and if it is caused by inflammation of the optic nerve (optic neuritis), poor blood flow, poor nutrition, toxic exposure, compression on the nerve (caused by a brain tumor or aneurysm), a genetic disorder, or cancer. The evaluation is tailored to your specific visual symptoms and may take up to four hours to complete. Your evaluation will include a complete medical history, examination of your eye structure, inspection of your retina and optic nerve, and several imaging scans.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Tests for Optic Nerve Disorders

During your optic nerve evaluation, the following tests may be conducted: 

Visual Acuity

Measures the accuracy of your vision by determining the smallest letters you can see on a chart.

Color Vision Test

Measures your ability to tell the difference among colors. In optic nerve disease, the degree of color vision loss may be greater than visual acuity loss. Color vision deficiency may last even after recovery of visual acuity.

Pupillary Exam

Tests the reflex that controls pupil size in response to light. This reflex may be weaker in those with optic nerve disorders.


A lighted instrument with a special lens provides your doctor with a 3D view of the inside or your eye. Careful ophthalmoscopy is essential for detecting inflammation and damage to the optic nerve.

Optical Coherence Tomography

A computer-guided imaging device creates a 3D image map of the optic nerve and the macula of the retina. It detects small defects that may be difficult to identify during a visual field test. 

Visual Field/Perimetry

This test measures your peripheral or side visual field in each eye. During the test, you look straight ahead while lights flash at various levels of brightness in your side vision. This allows doctors to detect defects in your visual field.


Dye is injected into your arm. Then your doctor uses a specialized device to capture detailed images of your eye. The dye helps to better identify constricted or blocked blood vessels.

Vascular Imaging

Advanced imaging tests including ultrasound, CT scan, and MRI may be used to obtain a detailed view of the veins and arteries in your brain, head, and neck. These tests can also identify if structural problems, such as tumors, are responsible for your visual symptoms.

Best Eye Hospital in North Carolina

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our ophthalmology program is ranked seventh in the nation and is the highest-ranked program in North Carolina, according to U.S. News & World Report for 2023–2024.

Why Choose Duke

Team Approach
We work closely with neurologists, neurosurgeons, and other specialists throughout Duke Health to ensure you receive the best possible care for your individual condition.

Latest Retinal and Optic Nerve Imaging Devices​
We use sophisticated imaging to perform tests that help us diagnose the cause of your vision symptoms. Our imaging devices allow us to see the inner layers of the eye, a significant advance that better guides the treatment options we recommend.

Advanced Subspecialists
Neuro-ophthalmologists are ophthalmologists who undergo advanced training by completing a fellowship in neuro-ophthalmology. This allows us to focus our understanding and efforts on how the brain and the nervous system affect the visual system.

National Leaders in Neuro-Ophthalmology
Our neuro-ophthalmologists conduct and publish research in this specialized field; they also lecture and train other providers around the world on the latest advances in eye care.

Comprehensive Support
Our clinical social worker is available to help you cope with the emotional and psychological stress of vision loss, as well as other medical or environmental concerns.

Vision Rehabilitation
We work closely with our vision rehabilitation experts -- including eye doctors, occupational therapists, social workers, and others -- to maximize your vision and minimize the impact of vision loss on your daily life.

This page was medically reviewed on 06/02/2022 by