Know Your Neuro, Save A Life

Cross Section. Cf. Image 0209706 For The Numbers. 1. Eyeballs2. Optic Nerves. 3. Anterior Cerebral Vein. 4. Sulcus Lateralus Called Of Sylvius. 5. Third Ventricle. 6. Internal Cerebral Veins Called Small Veins Of Galien Or Deep Cerebral Veins. 7. Trigones Of The Lateral Ventricles Collateral Trigones. (Photo By BSIP/UIG Via Getty Images)
Andrew G. Lee, MD, presents a breakdown of 6 potentially deadly neuro-ophthalmic conditions.

The following article is a part of Ophthalmology Advisor’s conference coverage of the Southeastern Educational Congress of Optometry (SECO) 2021, held in Atlanta and virtually from April 28 to May 2, 2021. The team at Ophthalmology Advisor will be reporting on the presentations offered by these leading experts in optometry and ophthalmology. Check back for more from the SECO 2021 Meeting.


The next time you see a patient with a potential neuro-ophthalmic diagnosis, be on the lookout for any of 6 diagnoses. According to Andrew G. Lee, MD, it could save a life. Dr Lee’s Southeastern Educational Congress of Optometry (SECO) 2021 conference presentation specifically identifies the neuro-ophthalmic conditions optometrists and ophthalmologists may encounter that could be life-threatening, and he offers guidance on triaging and managing these patients. The conference was held April 28 to May 2 in Atlanta.

To remember the life-saving diagnoses, learn the 6 “As:” arteritis (giant cell), apoplexy (pituitary), abscess (mucor), aneurysm (pupil involved third nerve palsy), arterial (carotid or vertebral) dissection, acute fulminant idiopathic intracranial hypertension (IIH). Triaging these patients requires memorizing 5 acute presentations, each of which spells trouble for the patient. The presentations included acute headache — especially in older patients who are also experiencing visual symptoms, jaw claudication, or scalp pain — acute painful ophthalmoplegia or orbital apex, acute painful anisocoria (small or big pupil), acute no light perception, and acute bilateral visual loss.

The presentation guided clinicians through the urgent work-ups for these conditions and offers a variety of pearls from Dr Lee, the past president of the North American Neuro-Ophthalmology Society. The cases present guidelines for managing patients with 1 of the 6 As that are also complicated by systemic diseases, such as acute ophthalmoplegia in a patient with diabetes. 

The course also offers a tour of magnetic resonance imaging (MRI) scans and other key clinical or radiographic features of these potentially deadly conditions. The guidance shared in this course puts the power to save lives into the hands of optometrists and ophthalmologists.

Visit Ophthalmology Advisor’s conference section for complete coverage of the SECO 2021 Meeting and more.



Lee A. Special session: an eye on neuro. Presented at: Southeastern Educational Congress of Optometry (SECO) 2021 Annual Meeting; April 28-May 2, 2021; Atlanta, GA. Course 60.