Dr Sudhir Kumar MD DM Profile picture
May 26 7 tweets 2 min read Twitter logo Read on Twitter
Eyes are the windows into the Brain

Here, I discuss 9 situations where symptoms are related to eyes or vision, but disease pertains to brain or nervous system.
1. Sudden onset painless loss of vision- Optic neuritis (inflammation of optic nerve)- Multiple sclerosis
2. Sudden onset loss of vision on one half (left or right)- called homonymous hemianopia- usually caused by an infarct (clot) of occipital lobe of brain.

3. Inability to see on outer aspects of visual field (temporal visual field loss)- usually caused by pituitary tumor.
4. Drooping of one or both eyelids- called ptosis, usually caused by myasthenia gravis or third cranial nerve palsy.

5. Double vision (diplopia)- caused by 3rd, 4th or 6th cranial nerve palsies; also myasthenia gravis.
#neurotwitter #eyes #Neurology
6. Patient can not see, but he thinks otherwise (denial of blindness)- typical of stroke involving occipital lobe of brain.

7. Person is unable to recognize faces of familiar people, but vision is otherwise normal- called prosopagnosia, caused by damage to right fusiform gyrus.
8. Seeing flashes of light or zigzag lines or having blurry vision usually on one side, lasting 10-30 minutes, followed by headache- suggestive of migraine with visual aura.
9. Optic fundus showing swelling of optic disc- papilloedema, suggestive of raised intracranial pressure.
10. Take home message
Several neurological diseases can present with symptoms that may be related to eyes or vision.
One needs to suspect the underlying diagnosis & consult a neurologist for detailed evaluation.
An ophthalmologist opinion is also valuable in these cases.
One more important one:
Transient (short duration) loss of vision in one eye- called amaurosis fugax- can be a sign of imminent brain stroke (paralysis).

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