Neuro-Ophthalmology

Whitsett Vision Group offers comprehensive neuro-ophthalmology services by Dr. Cybele Woon, one of our experienced physicians, and a sub-specialist in neuro-ophthalmology who has completed a neuro-ophthalmology fellowship. Dr. Woon is one of only a handful of neuro-ophthalmologists in Houston, making her expertise invaluable to Whitsett Vision Group.

Up-to-date diagnostic equipment and state-of-the-art facilities complement our caring staff, who recognize that patients with neuro-ophthalmological problems require communication and counseling along with comprehensive clinical services.

What is a neuro-ophthalmologist, and what do they treat?

A neuro-ophthalmologist is a doctor who specializes in visual problems that relate to the nervous system. This includes loss of sight due to injury to the brain or the optic nerves which transmits visual signals from the eyes to the brain. Such injury can be caused by trauma, inflammation, strokes, tumors, toxicities and infections. The neuro-ophthalmologist also sees patients who have problems controlling eye movement, which may result in difficulty looking in certain directions, or double vision due to misalignment. This misalignment, which is also called strabismus, can sometimes be treated with prism lenses or in some cases with surgical procedures.

Typical disorders we treat:

• Temporal Arteritis

• Stroke

• Multiple Sclerosis

• Myasthenia

• Optic Neuritis

• Tumors

• Eye pain

• Migraine

• Facial and eyelid spasm

Why should you be seen by a neuro-ophthalmologist?

Patients who experience any of the following should be seen by a specialized neuro-ophthalmologist.

• Any loss of visual acuity, visual field or color vision due to a problem with the brain or optic nerves or perhaps an unknown or undiagnosed cause

• Suspected to have high intracranial pressure (pressure in the head)

• Problems moving eyes or double vision due to misalignment which may result from injury to the brain centers, nerves or muscles that control eye movements or from a nerve transmission problem called myasthenia gravis

• Tumors of the pituitary gland or other tumors that may compress the vision pathway

• Unequal pupils

• Involuntary shaking of the eyes (nystagmus)

• Diagnosis of blepharospasm or hemifacial spasms

​​​​​​​What takes place during a neuro-ophthalmology examination?

The neuro-ophthalmology exam begins with a careful history of the patient’s concern and a review of any neurological or medical problems that could be relevant.

This is followed by an evaluation of the patient’s vision and eye movements and typically includes testing of the visual acuity, color vision and visual fields. The eye will be examined under the microscope (slit lamp) with special attention paid to the optic nerve and retina in the back of the eye.

In most cases, dilating drops will be administered to allow easy viewing of these important structures. The pressure and size of each eye may be checked as well.

Eye movements will be evaluated, which may include the use of prism lenses and special charts. In cases of unequal pupils, certain drops may be administered which help identify the cause of the problem.

Visual field testing is conducted at a machine which displays lights in various parts of the visual world while the patient presses a button to acknowledge each light. In this way, patterns of visual field loss may emerge that can help lead to a diagnosis.

Finally, Dr. Woon will sit down with the patient and discuss their condition and any treatments or management strategies that may be offered. Further outside testing or referral to other specialists may follow.