Neuro-ophthalmology

Patient Population
The Neuro-ophthalmology Unit provides diagnostic and treatment services for more than 3,500 ambulatory patients per year. Neuro-ophthalmology and neuro-otology are the disciplines concerned with the physiology, diagnosis and management of diseases involving the visual pathways, the control of eye movements, and vestibular circuits in the cranial nerves, brain stem, cerebellum, and cerebral hemispheres.

Patients served by this Program include those with loss of vision, visual disturbances caused by eye movement abnormalities and vertigo or balance difficulty.

Education
Education of residents, graduate students, postgraduate students, and postdoctoral fellows is a fundamental function of the program. Residents in neurology, neurosurgery, otolaryngology and ophthalmology acquire an understanding of visual and vestibular neuroscience through participation in the ambulatory program.

Research
This research program has sustained continuous support from the Medical Research Council of Canada for 28 years (from 1974 through 2002) at Toronto Western Hospital.

The physiology of disordered gaze and vestibulo-ocular reflex functions are being investigated in normal humans and patients with lesions of the cerebral hemispheres, brainstem and cerebellum and in patients with acquired and developmental strabismus. Parallel studies in animals are performed in our vestibular-ocular motor neurophysiology laboratory. Correlation of disorders of saccadic eye movement, head movement, smooth pursuit, and vestibulo-ocular reflex disorders with the site, nature and evolution of brain lesions:

1. Clarifies the anatomical and physiological bases of ocular motor and vestibular control in normal humans and animals,

2. Provides sensitive quantitative parameters of abnormal brain function,

3. Establishes bases for understanding and managing disabilities suffered by patients with disorders of vision, gaze, and equilibrium caused by diseases of the nervous system.