Symptomatic Treatment of Neuro-ophthalmic Visual Disturbances

Neuro-ophthalmic deficits can significantly impair quality of life. This article reviews neuro-ophthalmic symptoms and their impact on activities of daily living and discusses therapies that can improve quality of life.

Loss of central vision, peripheral visual field deficits, and diplopia can result in loss of driving privileges, restricted ambulation, impaired reading, and poor social interaction. Poor vision is associated with worse cognition and mental health deterioration in older patients, which can be reversed by ophthalmic interventions such as cataract surgery. Ophthalmic conditions such as dry eye syndrome and convergence insufficiency are common in patients with neurologic diseases such as Parkinson disease and can affect daily activities such as reading and watching television. Low-vision occupational therapy can improve quality of life by helping patients adjust to visual disturbances from neuro-ophthalmic disorders. Vision-related quality of life is an important outcome measure in studies of neuro-ophthalmic diseases. It is most frequently measured using the National Eye Institute Visual Function Questionnaire.

Neurologists should screen vision, visual symptoms, and vision-related quality of life when managing patients with neurologic diseases. Patients must be encouraged to consult an eye care provider to manage common ophthalmic conditions such as refractive error, dry eyes, and cataracts. Neurologists should partner with low-vision occupational therapy services to improve vision, cognition, mental health, and quality of life in patients with these conditions.