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Working in both the neurology and ophthalmology fields, our neuro-ophthalmology specialists focus on treating eye conditions that result from neurological disorders.

UMMC's newly developed neuro-ophthalmology department includes Rachid Aouchiche, MD, FACS, who treat adults and children with the following diseases that affect the eyes.

Microvascular Cranial Nerve Palsy

This condition is common in older adults and patients who have diabetes and high blood pressure. This disease blocks blood vessels and limits blood reaching your eyes. The results are weak eye movement and double vision. Some people refer to this condition as “diabetic palsy.” The palsy lasts between 6 and 12 weeks, but it can be treated to reduce symptoms sooner.

Surgery is not needed, but you can take an anti-inflammatory such as ibuprofen for pain. You should also maintain proper blood pressure and blood sugar levels.

If this condition does not go away after 12 weeks, or if you get symptoms of other eye dysfunctions, see your eye doctor.

Myasthenia Gravis

Patients with myasthenia gravis often have eye disorders that cause weak eye muscles and lids. You may experience double vision and eyelid drooping. Unfortunately, the more you use the muscles, the weaker they get.

Our neuro-ophthalmology team provides treatment options depending on the severity of the muscle loss. Medications, including steroids, can help increase neurotransmitter activity to strengthen eye muscles.

We may also suggest surgery to remove the thymus, which guides the immune system, if grows too large and can no longer protect the immune system. Double vision can be fixed by wearing an eye patch or prism glasses or having surgery on the eye muscles.

Learn more about Myasthenia Gravis.

Pseudotumor Cerebri

This is a disease that mimics a tumor in the brain, causing the back of the optic nerve to swell and affect vision. This condition can also cause strong headaches. Cerebrospinal fluid (CSF), which surrounds and protects your brain, increases and creates swelling. You may experience severe headaches, nausea and could possibly lose your sight.

It is not always clear how this disease occurs—it can result from too much Vitamin A, in supplement or diet. Overweight younger women have an increased rate of pseudotumor cerebri. It could occur from increased antibiotic or steroid use. However, anyone can get this disease.

Treatment includes weight loss, lowering Vitamin A intake and medication. In severe cases, our neuro-ophthalmology team will suggest surgery to drain off the extra fluid.

Strabismus Surgery

Strabismus is a weakness in eye muscles, often called crossed eye, which occurs when both eyes are unable to focus on the same object at the same time.

Neuro-ophthalmology treatment can include glasses or contacts, prism lenses and vision exercises. If the condition is more severe, we can perform surgery to strengthen the eye muscles.

Thyroid Eye Disease

Having an overactive or underactive thyroid can damage eye muscles. In thyroid eye disease, the eye muscles grow large and stiff, making it difficult to move them. This can result in bulging eyes and eyelid retraction. You may also have blurry or dark vision and double vision.  

Smoking greatly affects thyroid eye disease. If you are smoking, you will need to quit immediately. UMMC offers information on smoking cessation classes.

Neuro-ophthalmology treatment is done through surgery and medication:

  • Prisms
  • Oral steroids
  • Drops and creams
  • Lid surgery
  • Eye muscle surgery
  • Radiation therapy

This condition can go away, but it may take years. In some cases, eye movement may not be completely cured and double vision will continue.