Neuro-ophthalmology Service

What to Expect

To make an appointment with our service, please call 617-724-5788. A referral is required from your ophthalmologist, neurologist or primary care physician.

Our physicians offer attentive, personalized care. During your first visit, we perform a detailed eye examination and conduct a variety of tests to help us pinpoint the exact nature of your problem.

When appropriate, we refer you to other Mass General specialties for further testing, such as the Neuroradiology Division. Our relationship with the nearby Massachusetts Eye and Ear gives us access to many other advanced diagnostic tests, including optical coherence tomography, optic nerve imaging, fundus tomography and much more.

Making an accurate diagnosis is critical in identifying any risk of permanent visual loss or life-threatening disorders, or ruling out more serious conditions. Once our ophthalmologists have arrived at a diagnosis, we invite you back to discuss your individualized treatment plan.

Determining a Treatment Option

Our in-depth knowledge of these conditions and their natural progression allows us to determine the best course of treatment for each patient. Treatment options vary widely depending on your particular situation, from observation to medication or, when necessary, surgery.

As part of a world-class medical institution, we have access to the latest nonsurgical and surgical techniques. For some patients—e.g. those with multiple sclerosis (MS) or a pituitary tumor —we handle ongoing treatment within our service. For others, we make referrals to other specialists within the hospital, such as neuroendocrinologists or neurosurgeons, who have the precise knowledge necessary to treat his or her condition.

Expertise in Managing Rare Conditions

With extensive training in both neurology and ophthalmology, our physicians have specialized expertise in diagnosing and treating the many disorders affecting both neurologic pathways and the visual system, from more common conditions such as MS and pituitary tumors to rare neuro-ophthalmic conditions.

In fact, our service is well-known for handling rare neuro-ophthalmic conditions. Many patients are referred to our program because their optometrist and/or general ophthalmologist could not diagnose their visual problem. Our ophthalmologists are trained to recognize rare diseases, which helps prevent unnecessary testing—and give patients peace of mind earlier in the process.

About this Program

Much of the brain's capacity is dedicated to visual function and eye movements. As a result, many types of neurologic diseases can affect vision in some way. Our service often sees patients who are experiencing symptoms such as:

These and other symptoms are frequently caused by one of the following conditions:

• Multiple sclerosis (MS): A chronic disease of the central nervous system, MS and neuro-visual complications of MS can lead to visual problems
• Myasthenia gravis: With this complex autoimmune disorder, antibodies destroy neuromuscular connections to cause problems with the nerves that communicate with muscles
• Pituitary tumors: These usually benign brain tumors press against the optic nerves, causing vision problems
• Migraine: Visual disturbances are one of the common symptoms of migraine
• Stroke: Dimness or loss of vision in one or both eyes may be attributable to stroke
• Autoimmune disease: These diseases can often affect the optic nerve and/or parts of the brain that serve vision

Pediatric & Adult Care

For pediatric patients, our service's primary role is consultation. Working in conjunction with pediatric neurologists at Mass General for Children, Massachusetts Eye and Ear or Children's Hospital Boston, we can often help identify even the rarest of neuro-ophthalmic conditions. Following the diagnosis, we typically refer children to one of these entities for treatment.

For adult patients, we offer both diagnostic and treatment services. Our physicians evaluate patients from neurologic, ophthalmic and general medical perspectives to diagnose the origin of visual problems. We can also clarify retinal problems, which may sometimes accompany and/or mimic neurologic symptoms.

Education & Research

Shirley Wray, MD, PhD, a distinguished member of our program, is now exclusively engaged in research after a long clinical career. The neuro-ophthalmology research library that she built over a 30-year period assists our staff in making diagnoses and is valued by other physicians and scientists around the world.

We also invite patients and the community to participate in innovative clinical trials and research studies.