Optic Nerve Disorders

You may be referred to one of our neuro-ophthalmologists if your doctor suspects your optic nerve -- the cable 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 whether it is caused by inflammation of the optic nerve (optic neuritis), poor blood flow, poor nutrition, 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.

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.

Ophthalmoscopy

A lighted instrument with a special lens provides your doctor with a 3-D view of the inside or your eye. Careful ophthalmoscopy is the most important way to detect inflammation and damage to the optic nerve.

Optical Coherence Tomography

A computer-guided imaging device creates a 3-D 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

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. The test allows doctors to detect defects in your visual field.

Angiography

After dye is injected into your arm, a specialized device captures detailed images of your eye, helping your doctor identify constricted or blocked blood vessels.

Color Doppler Flow Imaging

Uses ultrasound to evaluate blood flow through the vessels around the eye to determine if there are any restrictions.

CT and MRI Scans

May be scheduled if needed to identify if there are structural causes, such as tumors, that may be responsible for your visual symptoms.

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 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 outer edges 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.