Neuro-ophthalmology

The rotations through the Neuro-ophthalmology service at UPMC Eye Center provide residents with the opportunity to learn by providing care to a diverse patient population with a broad range of neuro-ophthalmologic problems
 
Types of conditions seen and treated include:
  • optic neuropathy / optic neuritis
  • intracranial tumors
  • cranial neuropathies
  • nystagmus
  • pupillary abnormalities
  • evaluation of visual loss / visual field defects
  • neuro-ophthalmic manifestations of systemic conditions such as
    • multiple sclerosis
    • mysasthenia gravis
    • cancer
    • diabetes
    • thyroid eye disease
    • autoimmune disorders

Adult Neuro-Ophthalmology service is located on the 6th floor Eye and Ear Institute, UPMC Eye Center in Oakland. Dr Shazly is a Mercy Eye Center. 
Pediatric Neuro-Ophthalmology is located at Childrens Hopital of Pittsburgh. Dr Ellen Mitchell and Dr Priti Patel.

For Medical Students and Neurology Residents:

  • Welcome to Neuro-Ophthalmology. We have you scheduled to start your Adult Neuro-Ophthalmology rotation soon with Dr. Gabrielle Bonhomme, Dr. Kocasarac, Dr. Park, Dr. Shazly, and Dr. Zaydan on the Adult Neuro-Ophthalmology service.
  • You may follow the senior Ophthalmology resident or fellow during the first few days on rotation, but we would like you to begin seeing patients on your own.
  • Patient notes are currently completed in Epic Care.  You are expected to document history, exam, and A/P, or scribe for attending.
  • Please let us know if you would like to learn to use the slit lamp, lenses, or indirect, but you should become comfortable and adept with your handheld ophthalmoscope.
  • Examine as many patients as possible, particularly after pupil dilation.
  • Please feel free to perform focused Neurologic examination on all patients.
  • Please feel free to contact us with any questions. We look forward to your time with us at the Eye Center, and hope you find your time with us enlightening and beneficial to your medical education

Essential Reading and References for All Trainees

  1. The 5-year risk of MS after optic neuritis: experience of the optic neuritis treatment trial Neurology. 2001;57(12 Suppl 5):S36-45.
  2. Optic nerve decompression surgery for nonarteritic anterior ischemic optic neuropathy (NAION) is not effective and may be harmful. The Ischemic Optic Neuropathy Decompression Trial Research Group." JAMA. 1995;273(8):625-32
  3. Multiple Sclerosis Risk after Optic Neuritis: Final Optic Neuritis Treatment Trial Follow-Up.  Arch Neurology. 2008 Jun; 65(6): 727–732.doi: 10.1001/archneur.65.6.727. Beck RW, Trobe JD, Moke PS, et al.
  4. Effect of acetazolamide on visual function in patients with idiopathic intracranial hypertension and mild visual loss: the idiopathic intracranial hypertension treatment trial NORDIC Idiopathic Intracranial Hypertension Study Group Writing Committee, Wall M, McDermott MP, Kieburtz KD, Corbett JJ, Feldon SE, Friedman DI, Katz DM, Keltner JL, Schron EB, Kupersmith MJ.. JAMA. 2014 Apr 23-30;311(16):1641-51. PMID: 24756514
  5. The Idiopathic Intracranial Hypertension Treatment Trial. Clinical Profile at Baseline. JAMA Neurology. 2014 Jun; 71(6): 693–701. doi: 10.1001/jamaneurol.2014.133. Michael Wall, MD, Mark J. Kupersmith, MD, Karl D. Kieburtz, MD, MPH, James J. Corbett, MD, Steven E. Feldon, MD, Deborah I. Friedman, MD, MPH, David M. Katz, MD, John L. Keltner, MD, Eleanor B. Schron, PhD, and Michael P. McDermott, PhD, for the NORDIC Idiopathic Intracranial Hypertension Study Group.
  6. Occult giant cell arteritis: ocular manifestations. Am J Ophthalmology 1998 Apr;125(4):521-6. doi: 10.1016/s0002-9394(99)80193-7.  S S Hayreh 1, P A Podhajsky, B Zimmerman
  7. Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology 2013;81:1159–1165. Friedman DI, Liu GT, Digre KB. Abstract/FREE Full TextGoogle Scholar
  8. MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 4: Afferent visual system damage after optic neuritis in MOG-IgG-seropositive versus AQP4-IgG-seropositive patients. Journal Neuroinflammation. 2016 Nov 1;13(1):282. doi: 10.1186/s12974-016-0720-6. Florence Pache 1 2, Hanna Zimmermann 1 2, Janine Mikolajczak 1, Sophie Schumacher 1, Anna Lacheta 1, Frederike C Oertel 1, Judith Bellmann-Strobl 1 3, Sven Jarius 4, Brigitte Wildemann 4, Markus Reindl 5, Amy Waldman 6, Kerstin Soelberg 7 8, Nasrin Asgari 7 8, Marius Ringelstein 9, Orhan Aktas 9, Nikolai Gross 10, Mathias Buttmann 11, Thomas Ach 12, Klemens Ruprecht 2, Friedemann Paul 1 2 3, Alexander U Brandt 13, in cooperation with the Neuromyelitis Optica Study Group (NEMOS)