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Pediatric Neuro-ophthalmology

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Neuro-ophthalmology is a subspecialty within ophthalmology that focuses on the connection between the eyes and the brain. Doctors in this field diagnose and treat vision problems that arise from conditions affecting the optic nerve, brain, or blood flow to the eyes.

Neuro-ophthalmologists undergo advanced fellowship training to understand how the nervous system impacts vision. Pediatric neuro-ophthalmologists specialize further to address how children’s eyes develop and function, including the muscles and nerves controlling movement.

At Bascom Palmer Eye Institute, part of the University of Miami Health System, our team looks beyond the eye itself to diagnose and treat conditions that involve the optic nerve, brain, or underlying metabolic issues impacting your child’s vision.

Conditions We Treat

Children’s eye and brain disorders can range from common to highly complex. Some of the conditions we manage include:

  • Brain tumor-related vision loss
  • Delayed visual maturation
  • Double vision
  • Eye movement disorders
  • Ptosis (drooping eyelids)
  • Pupil abnormalities
  • Septo-optic dysplasia (early brain development disorder)
  • Unexplained vision loss
  • Vision issues related to epilepsy or seizures

Symptoms to Watch For

Neuro-ophthalmologic conditions may appear at birth or develop later in childhood. Because infants and young children often cannot describe what they are experiencing, parents should watch for signs such as:

  • Abnormal or impaired eye movement
  • Unequal pupil size
  • Pupils that do not respond to light
  • Unexplained or sudden vision loss
  • Double vision
  • Drooping eyelids or facial spasms

If you or your pediatrician suspect a neurological issue, a referral to a pediatric neuro-ophthalmologist is an important next step.

Diagnostic Tests

A careful evaluation is essential to guide treatment. At Bascom Palmer, our pediatric neuro-ophthalmologists use the most advanced optical and brain imaging technologies to reach an accurate diagnosis. As part of a comprehensive exam, your child may undergo:

  • Electrophysiology tests
  • Cerebral angiography
  • Blood tests
  • Optical coherence tomography (OCT)
  • CT scan
  • MRI scan

Treatments

Every child receives a customized treatment plan tailored to their condition. Depending on the diagnosis, treatment options may include:

  • Visual therapy aids
  • Medication
  • Visual therapy aids
  • Specially fitted eyeglasses (such as prism lenses)
  • Minimally invasive or traditional surgery

Why Choose Bascom Palmer Eye Institute?

#1 in the Nation

  • Ranked by U.S. News & World Report as the top eye hospital in the country, Bascom Palmer provides world-class care for even the most complex pediatric eye conditions.

Depth of Experience

  • For more than 45 years, our neuro-ophthalmologists have treated thousands of patients, building one of the world’s leading programs.

Compassionate Support

  • We partner with families, offering guidance, resources, and reassurance throughout the care journey.

Multidisciplinary Expertise

  • As part of UHealth, our team collaborates with specialists across multiple disciplines to provide comprehensive, coordinated care.

Research & Innovation

  • Many of our physicians are also researchers and educators, leading advancements in imaging, brain-eye studies, and new treatments.

Specialized Pediatric Surgical Suites

  • Our surgical teams include nationally recognized pediatric ophthalmologists, anesthesiologists, and nurses, supported by the latest technology.

Advanced Imaging Technology

  • Cutting-edge diagnostic resources ensure accurate evaluation and personalized treatment planning.

FAQ

What makes pediatric neuro-ophthalmology unique compared to adult care?
It tackles vision-brain glitches in kids, from congenital optic nerve hypoplasia to nystagmus (shaky eyes), where developing brains amplify impacts—untreated, it hampers learning or coordination. Unlike adults’ targeted symptoms, kids show subtle cues like head bobs; specialists use play-based exams, blending neuro and eye expertise for holistic fixes that support milestones.
Top ones: septo-optic dysplasia (hormone-vision links), idiopathic intracranial hypertension causing headaches and papilledema, or post-chemo optic neuropathy. Trauma or hydrocephalus can mimic, stressing early screening—think of it as wiring the visual highway before traffic builds, preventing detours like amblyopia.
Parents note poor tracking of toys, light aversion, or clumsiness; exams use preferential looking (babies gaze at patterns) or OKN drums for motion sense. Advanced: sedated MRI or flash VEPs measure pathways. It’s detective work with patience, decoding toddler tantrums as visual distress signals.
Refractive surgery corrects common vision problems by reshaping the cornea using a laser. For LASIK, a thin flap is created on the cornea, the laser removes tiny amounts of tissue underneath to adjust focus, and the flap is repositioned. It’s quick, with most people seeing better within a day, but not everyone is a candidate—factors like thin corneas or dry eyes may steer you toward alternatives like PRK.
Varies: patching for suppression, low-dose steroids for neuritis, or shunts for pressure buildup. Vision therapy builds skills, surgery rare but for compressive lesions. Multidisciplinary—neuro, endo—ensures growth-friendly plans; many outgrow mild forms with support, blooming into sharp-sighted kids.
Newborn screenings catch 70% early; vaccinate against meningitis, use car seats for trauma-proofing. Track milestones like smiling at faces by 2 months, seek eval for regressions. Nutrition (DHA for nerves) and screen limits aid—empowered parents turn vigilance into victories over hidden hurdles.

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