Neuro-Ophthalmic problems tend to be more complex, requiring longer consultation and investigations. During the first visit to the clinic, patients can expect to spend up to two to three hours for consultation.
Driving on the day of consultation is not advised, you are advised to bring along your glasses and any old medical records. Depending on your symptoms, your doctor may perform perimetry, imaging of your nerves and retina, MRI scans and blood tests.
Visual Electrophysiology
‘Electrical testing of vision’, so called ‘visual electrophysiology’, is a measurement of the very small
signals generated by the eye and the brain in response to what we see or look at.
These signals provide information regarding the eye, nerve and brain function that helps the doctor make decisions on diagnosis and treatment.
The main reasons for visual electrophysiology are:
- To confirm or exclude a suspected diagnosis
- Unknown diagnosis
- To determine the characteristics and severity of disease
- To monitor the disease before and after treatment
You can expect to take a series of tests including Electroretinogram (ERG), Pattern Electroretinogram (PERG), and Visual Evoked Potential (VEP) tests.
It can take up to three hours to complete all the tests, but they are all non-invasive, and it is rarely necessary to use numbing drops in the eye. There are no injections into the eye or arm. The drops used to dilate the pupils may cause a slight stinging sensation for a few seconds, and vision will be blurred for a few of hours after testing, so you should refrain from driving. Dark glasses may help on a sunny day. Patients having a VEP will usually wash their hair when they get home.
The tests will be carried out by Clinical Physiology Technicians. The results will be interpreted by a Consultant Electrophysiologist. A report will be sent to the doctor who referred the patient.
Tests for specific Neuro-Ophthalmic conditions
Inflammation
- Tests that your doctor may order are a Magnetic Resonance Imaging (MRI) of the brain, a Lumbar Puncture to obtain cerebrospinal fluid, and blood tests to look for antibodies.
Compression
- Tests that your doctor may order are a Computed Tomography (CT) scan or MRI, and blood tests to determine the cause.
- Referral to an orbital surgeon or neurosurgeon may be necessary.
Raised intracranial pressure
- Tests that your doctor may order are a CT scan or MRI, which is usually necessary, together with a lumbar puncture to obtain cerebrospinal fluid for analysis.
- Referral to a neurologist or neurosurgeon is usually required.