Synopsis
A patient presents with sudden visual loss. Another complains of persistent or intermittent double vision. Someone else has an abnormal pupil, an unexplained visual-field defect, or optic-disc swelling discovered during examination. These findings may appear unrelated, yet each can provide an important clue to disease involving the optic nerve, visual pathways, ocular motor system, or brain.
The Practical Neuro-Ophthalmology Handbook offers a structured and clinically grounded approach to evaluating these challenging presentations. Rather than treating neuro-ophthalmology as a difficult collection of isolated syndromes and eponyms, this handbook emphasizes the practical reasoning that connects the patient’s history, examination findings, anatomical localization, differential diagnosis, investigations, and management.
The central principle is straightforward: a careful clinical assessment often reveals where the problem lies before extensive testing is ordered. By learning to recognize meaningful patterns and relate them to anatomy and disease mechanisms, clinicians can approach complex visual and neurological complaints with greater clarity and confidence.
The handbook examines the assessment of visual loss, optic nerve disorders, optic neuritis, ischemic optic neuropathy, papilledema, compressive lesions, pupillary abnormalities, diplopia, cranial nerve palsies, nystagmus, ocular motility disorders, visual-field defects, and lesions affecting the visual pathways. It also explores the relationship between neuro-ophthalmic findings and systemic or neurological disease, together with the role of visual-field testing, neuroimaging, and other targeted investigations.
Throughout the book, clinical pearls draw attention to subtle findings that can alter the diagnostic direction, while discussions of time-critical conditions reinforce the importance of recognizing presentations that require urgent assessment. The inclusion of clinical cases allows readers to apply the principles discussed and appreciate how diagnostic reasoning develops when patients do not present in perfectly predictable textbook patterns.
Written for ophthalmology and neurology residents, optometrists, emergency clinicians, internists, and other healthcare professionals, this handbook is designed to function both as a practical introduction to clinical neuro-ophthalmology and as a useful reference during patient evaluation.
When visual symptoms do not fit an obvious explanation, the most valuable skill is not memorizing more diagnoses—it is knowing how to think through the evidence. This handbook provides that framework, helping clinicians move from observation to localization, from localization to diagnosis, and from diagnosis to appropriate management.
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