Focus on Neuro-Ophthalmology: from Blindness to Anisocoria

Neuro-ophthalmologic disorders can arise from dysfunction of any part of the neuro-ophthalmologic tracts. The clinical signs may be decreased vision, blindness, abnormal pupillary light reflex, anisocoria, abnormal eye movements and strabismus alone or in association with multifocal neurological/systemic signs, depending on the distribution and type of lesion. A firm understanding about the neuroanatomy of the neuro-ophthalmologic pathways is essential to perform a correct neuroanatomic diagnosis. Based on the information obtained from signalment, a detailed history (including disease onset and progression), and physical, ophthalmic and neurological examination, the clinician can formulate a list of differential aetiologic diagnoses and subsequently select and interpret diagnostic investigations. The aetiologic diagnosis enables the initiation of specific treatment and predicting prognosis. Advances in diagnostic imaging have expanded the knowledge of neuro-ophthalmologic conditions. Prompt diagnosis and correct treatment can result in vision recovery in some disorders.