Neurologic Vision Loss

Overview

Nerves that come directly from the brain and brainstem (instead of from the spine) are called cranial nerves. Four of these nerves control vision and eye movements. One of these nerves is the optic nerve, which carries signals about vision from your eyes to your brain.

If there is damage (such as inflammation, compression or a blood flow problem) to these nerves or their protective covering, or to certain parts of the brain, the electrical signals that control vision may be blocked. When this happens, you may experience partial loss of vision, decreased vision from different areas of your field of vision—such as peripheral or central vision—or, in severe cases, blindness.

Causes

Neurologic vision loss happens when problems from certain medical conditions affect specific nerves and parts of the brain that control your vision. These conditions include:

• Infections
• Hereditary conditions
• Autoimmune disorders
• Problems with optic nerve
• Trouble with brain pathways that process vision
• Trauma

Some specific conditions that may result in vision loss include:

• Brain tumors
• Glaucoma
• Multiple sclerosis
• Neuromyelitis optica
• Optic neuritis
• Stroke

Treatment

A neuro-ophthalmologist is a specialist who can examine your vision and nervous system to determine the source of your vision problems. Treatment for your vision loss depends on the underlying cause of your condition and may include:

Anti-inflammatory Medicines

These medicines work by reducing the inflammation of the nerves and tissues around the eye. They include steroids and medications that suppress the immune system, called immunosuppressants. Intravenous (IV) steroids can be used to treat optic neuritis and help lost vision return more quickly.

Disease Management

If your vision loss is the result of an existing condition, treatment includes managing that disease to prevent further damage. Conditions that may impact the visual centers of the brain or optic nerves include:

• Brain tumors
• Diabetes
• Glaucoma
• Hypertension (high blood pressure)
• Myasthenia gravis
• Multiple sclerosis
• Stroke

Nutrition

A vitamin or other nutritional deficiency may play a role in your vision loss. A dietitian can help you plan a healthy diet to ensure you are getting the proper nutrients.

Surgery

Different surgical procedures may be used to treat severe cases of vision loss, depending on your condition. Types of surgery include:

Optic Nerve Sheath Fenestration

If there is swelling of the optic nerve related to high pressure in the head with loss of vision despite medical treatments, slits can be made in the sheath that covers the nerve to relieve the pressure.

Shunting

Another way to relieve pressure is to create a shunt, which allows fluid to be removed from around the brain, in an effort to decrease the pressure.

Surgery to Remove Tumor or Aneurysm

Some vision loss is the result of pressure on the optic nerves or brain pathways that control vision from a tumor or aneurysm, which can be treated with surgery.

Vision Rehabilitation Services

Optic specialists teach you how to best use the vision you have and work with you to find assistive devices that maximize your remaining vision.