Dr. Enslin Uys
  • Suite 6, Pietermaritzburg Eye Hospital, 5 Alon Paton Drive, Pietermaritzburg
  • Mon - Fri 8.00 - 16.30

NEURO OPHTHALMOLOGICAL ASSESSMENT

NEURO OPHTHALMOLOGICAL ASSESSMENT

Proptosis

Proptosis refers to the abnormal protrusion of the eyeball causing bulging eyes. The condition can occur in one or both eyes and can be due to a number of reasons. One of the common reasons is the side effect of hyperthyroidism. Other causes can include vascular lesion, tumours, pseudotumour or trauma.

Some common symptoms of eye proptosis include difficulty closing and moving eyes, drying of the corneas, and discomfort. Dr Enslin Uys will assess the severity of the condition using an exophthalmometer, which is a special kind of ruler, to measure the protruding eyes. If the measurements are outside of the normal range, more tests are required, and it may be necessary to go for blood tests, ultrasound, MRI scan or a biopsy.

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Thyroid eye disease

Thyroid eye disease (TED) otherwise known as Graves’ disease, is a condition which occurs as a result of inflammation in the eye muscles and fatty tissues. Inflammation can cause the eyes to bulge outwards (otherwise known as exophthalmos), causing swelling in the eyes and eyelids. Some other symptoms include difficulty moving the eyes and double vision, while in rare cases, the condition can cause blindness.

If you have been diagnosed with thyroid eye disease (Graves’ disease eyes), Dr Enslin Uys may prescribe immune suppressive drugs to reduce the swelling and prevent pressure on your optic nerve. If your symptoms do not improve adequately over time, surgery may be recommended to reduce the pressure on the optic nerve or improve the appearance of the eyes.

Decompression surgery works by creating space behind the eyes and alleviates the pressure on the optic nerve, while eye muscle surgery can be helpful in treating double vision. Surgery on the eyelids improves the appearance of the eyes in cases where there is severe bulging.

Cranial nerve III, IV and VI palsies

Cranial nerve palsy is a neurological condition, which can be caused by a blockage of blood flow to the nerves between the brain stem and the eye socket or something pressing on the nerves. The condition may affect the facial nerves, muscles in or around the eyes and the nerves which affect visual function.

Some common symptoms include blurred vision, double vision, pain in the eye and drooping eyelids. In order to diagnose the condition, Dr Enslin Uys will conduct a thorough neurological eye examination. This will allow him to see if your symptoms are caused by cranial nerve palsy, or if you have another condition. If you do have cranial nerve palsy, it may be necessary to do an imaging study, which may include a CT or MRI scan.

Diplopia or double vision

Diplopia, or double vision, can occur in one eye (uncommon) or both (more common) and can occur for a number of reasons. Firstly, it is essential to know if the double vision disappears when you close one of your eyes. This distinguishes between monocular (one eye) and binocular (both eyes) causes. Secondly, it is essential to know if the double image is next to or on top of each other. This distinguishes between the horizontal and vertical causes. In some cases, there are no other symptoms other than distorted vision, although pain in and around the eyes, headaches, and nausea can also occur.

Dr Uys is able to treat such conditions. In order to determine the reason for your diplopia, Dr Enslin Uys will perform a thorough eye examination and might request several tests, including blood tests, and imaging tests like CT or MRI scans. Treatment for double vision depends on the cause of the condition.

In the case of weak eye muscles, Dr Enslin Uys may recommend surgery. In some cases, such as when diabetes or Grave’s Disease are contributing factors, medication may be sufficient in treating the condition.