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      Neuro-Ophthalmology at the Bedside: A Clinical Guide

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          Abstract

          Neuro-ophthalmological signs and symptoms are common in the emergency department but are a frequent source of diagnostic uncertainties. However, neuro-ophthalmological signs often allow a precise neuro-topographical localization of the clinical problem. A practical concept is presented how to perform a neuro-ophthalmological examination at the bedside and to interpret key findings under the aspect of emergency medicine with limited resources.

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          Ischemic Optic Neuropathies.

          Valérie Biousse, Nancy Newman (2015)
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            The neuro-ophthalmology of head trauma.

            Rachel E. Ventura, Laura Balcer, Steven Galetta (2014)
            Traumatic brain injury (TBI) is a major cause of morbidity and mortality. Concussion, a form of mild TBI, might be associated with long-term neurological symptoms. The effects of TBI and concussion are not restricted to cognition and balance. TBI can also affect multiple aspects of vision; mild TBI frequently leads to disruptions in visual functioning, while moderate or severe TBI often causes structural lesions. In patients with mild TBI, there might be abnormalities in saccades, pursuit, convergence, accommodation, and vestibulo-ocular reflex. Moderate and severe TBI might additionally lead to ocular motor palsies, optic neuropathies, and orbital pathologies. Vision-based testing is vital in the management of all forms of TBI and provides a sensitive approach for sideline or post-injury concussion screening. One sideline test, the King-Devick test, uses rapid number naming and has been tested in multiple athlete cohorts.
            Article 0 comments Cited 64 times – based on 0 reviews     Review now
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              The demise of direct ophthalmoscopy: A modern clinical challenge.

              Devin Mackay, Philip Garza, Beau B. Bruce … (2015)
              Ocular funduscopy appears to be a dying art. Physicians and medical students alike lack confidence in the use of an ophthalmoscope. As a result, few clinicians perform ophthalmoscopy, and many who do are unable to reliably detect abnormalities of the ocular fundus. Approaches to remediation in undergraduate medical education have included simulators, longitudinal skill reinforcement, Web-based teaching, and other techniques. Preservation of the ophthalmoscopic art has been hindered by technical difficulty, waning enthusiasm for ophthalmoscopy, and even discouragement from preceptors in medical education. Ocular fundus photography may serve a role in medical education to help improve student confidence in interpretation of ocular fundus findings and improve awareness of the importance of examination of the ocular fundus. Because neurology clerkships and clinical practices remain an important forum for honing ocular funduscopy skills, the neurologist should be familiar with novel alternative techniques that facilitate examination of the ocular fundus.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Neurosci Rural Pract
                Journal ID (iso-abbrev): J Neurosci Rural Pract
                Journal ID (publisher-id): JNRP
                Title: Journal of Neurosciences in Rural Practice
                Publisher: Medknow Publications & Media Pvt Ltd (India )
                ISSN (Print): 0976-3147
                ISSN (Electronic): 0976-3155
                Publication date (Print): Oct-Dec 2018
                Volume: 9
                Issue: 4
                Pages: 561-573
                Affiliations
                [1]Department of Neurology, Municipal Hospital, Landshut, Bavaria, Germany
                [1 ]Department of Neurology, University Hospital Erlangen, Erlangen, Germany
                [2 ]Orbital Center, Bürgerhospital, Frankfurt, Germany
                Author notes
                Address for correspondence: Prof. Josef G. Heckmann, Department of Neurology, Municipal Hospital Landshut, Robert-Koch-Street 1, Landshut-84034, Bavaria, Germany. E-mail: josef.heckmann@ 123456klinikum-landshut.de
                Article
                Publisher ID: JNRP-9-561
                DOI: 10.4103/jnrp.jnrp_145_18
                PMC ID: 6126320
                SO-VID: d8ee6e05-b8a2-4cde-a3a6-606376305e91
                Copyright © Copyright: © 2018 Journal of Neurosciences in Rural Practice
                License:

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                Categories
                Subject: Point of View

                ScienceOpen disciplines: Neurosciences
                Keywords: blurred vision,diplopia,headache,horner's syndrome,neurological emergencies,neuro-ophthalmological examination
                Data availability:
                ScienceOpen disciplines: Neurosciences
                Keywords: blurred vision, diplopia, headache, horner's syndrome, neurological emergencies, neuro-ophthalmological examination

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