Ayer Neuroscience Institute Neuro-Ophthalmology Department

Neuro-ophthalmologists bridge the gap between eye specialists and neurologists. They specialize in treating vision problems that relate to your nervous system.

These vision problems are often part of neurological disorders such as multiple sclerosis or myasthenia gravis or are the result of a brain injury, stroke or other trauma. Your optometrist, ophthalmologist or neurologist may refer you to a neuro-ophthalmologist for several reasons including loss of vision, blurred vision, headaches or double vision.

Our neuro-ophthalmologists have established a practice that meshes with multiple specialties across the Ayer Neuroscience Institute including general neurology, vascular neurology, neuro-oncology, neurosurgery and interventional neuroradiology.

Our office in Hartford has the most up-to-date equipment to perform visual field assessments, special scans of the optic nerve and retina and high-definition fundus photography – or photos of the back of the eye.


Conditions We Treat

Neuro-ophthalmologists diagnose and treat many different types of vision problems. Some of the most common include:

  • Pseudotumor cerebri or idiopathic intracranial hypertension, which happens when the pressure inside your skull increases for no obvious reasons. The pressure can cause swelling of the optic nerve(s) resulting in vision loss.
  • Pituitary tumors, which are a growth arising from the pituitary gland. They can cause eye problems because of the pressure on the optic nerve or chiasm (crossing of optic nerves).
  • Double vision or diplopia – seeing two images of the same thing.  Typically, one image goes away when covering one eye or the other ("binocular diplopia").
  • Pupillary abnormalities, which include uneven pupil sizes, reduced response to light or convergence and being unresponsive to light.
  • Temporal arteritis or giant cell arteritis, when the arteries at the temples and in the brain become inflamed. It can cause severe headaches, double vision and/or acute loss of vision.
  • Ischemic optic neuropathy (ION), a condition in which blood does not flow normally to the optic nerve. It can cause lasting damage and loss of vision.
  • Monocular visual loss –  a sudden loss of vision in one eye due to a temporary lack of blood to your eye.
  • Visual loss after stroke often causes a "homonymous hemianopia" when you only see one half of your visual field, either left or right, in each eye.
  • Visual difficulties associated with multiple sclerosis such as optic neuritis, which causes pain with eye movement, blurred vision, diming of vision or loss of color vision.
  • Vision difficulties associated with myasthenia gravis, which can cause weakness of eye muscles resulting in blurred or double vision and drooping of eyelids.
  • Inflammatory or infectious diseases affecting the optic nerve
  • Nutritional and toxic damage to the optic nerve
  • Acquired forms of nystagmus where the eyes make repetitive, uncontrolled movements. These develop later in childhood or adulthood and may be due to central nervous system disorders.

Neurodiagnostics

In addition to a thorough medical history and detailed visual and oculomotor examination, diagnostic testing for conditions can include:

  • Visual field testing measures how much vision you have in each eye and can be used to determine vision loss or blind spots.
  • Optical coherence tomography (OCT) uses infrared light waves to take pictures of your retina. It can also be used to determine disorders of the optic nerve.
  • Fundus photography takes high-resolution photographs of the back of the eye including the optic nerve and retina.

Treatments

Treatments vary according to the condition and each patient’s situation. The most common treatments include:

  • Medications used to treat conditions such as increased intracranial hypertension, temporal arteritis and myasthenia gravis.
  • Prism lenses help individuals with double vision by aligning the two images

Our experts will also determine if a referral to other vision specialists is required, such as retina or glaucoma specialists.


For Patients

For your first visit, you can expect it to last between two and three hours.

The visit is divided into three major components:

  1. A visual assessment, such as visual acuity by a technician. This measures your ability to distinguish shapes from 20 feet away.
  2. Testing including visual field testing, scans of the optic nerve and macular region of the retina, and photographs of the back of your eye.
  3. Physician evaluation including a detailed history and additional eye examinations.

Most new patients have their eyes dilated so that the physician can evaluate the status of the optic nerve and the retina.

For Referring Providers

Most patients are referred by an optometrist, ophthalmologist, neurologist or neurosurgeon.

Direct referrals from internists and other primary care providers must demonstrate a clear need for neuro-ophthalmologic care (for example, a tumor or other major abnormality on MRI, or distinct clinical symptoms such as binocular diplopia or acute visual loss.) Records from ALL prior practitioners who have evaluated the visual problem(s) must be included. A CD of images (MRI or CT) obtained outside of the Hartford HealthCare system must be brought to the visit.

Hartford HealthCare providers:

Please send a referral through Epic.

External Providers:

Please send a referral through fax.


Meet Our Neuro-Ophthalmology Specialists:

Editha Johnson

4.8

Neuro Ophthalmology

Medical Group Hartford HealthCare Medical Group at Hartford Hospital Department of Neuro-Ophthalmology
Hartford, CT 06106
The Ayer Neuroscience Institute

The Ayer Neuroscience Institute works to treat the full range of neurologic conditions. Our mission is more personal - to provide advanced, collaborative services across the state.

About the Institute

Neuro-Ophthalmology Locations

Medical Office Building
85 Seymour Street Suite 825
Hartford, CT 06106
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Neuro-ophthalmology
80 Seymour Street
Hartford, CT 06102
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Brain Surgery
Brain Tumors
Endovascular
Epilepsy
General Neurology
Interventional Neuroradiology
Memory Care
Minimally-invasive Surgery
Movement Disorders
Neurocritical Care
Neuroimmunology
Neuro-oncology
Neuro-ophthalmology
Neuropsychology
Neurotrauma
Neurovascular
Parkinson’s Disease
Radiofrequency Ablation
Reconstructive and Revision Spine Surgery
Skull Base Surgery
Spine Surgery
Stroke
Vascular Neurology