Q&A with Chief of Neuro-ophthalmology Dr. Vivek Patel

As the Gavin Herbert Eye Institute’s chief of neuro-ophthalmology, Vivek Patel, MD leads a growing team of physicians who treat an array of disorders that affect both the brain and eyes. We asked him to explain what his specialty and what drew him to it.

Q. How did you become interested in neuro-ophthalmology?

A. I was always interested in biology and anatomy, but I especially liked neuroscience. In my fi rst year of medical school at the University of Toronto, I became fascinated by neuro-ophthalmology and asked to take a year o  to do research into eye movements at a lab at Johns Hopkins University. During that time, I learned a lot about what I love — neurosurgery and ophthalmology. When I returned to medical school, I knew exactly what I wanted to specialize in, which made my path for the next three years much clearer than it was for my peers. Neuro-ophthalmology is not just intellectually interesting, but because it’s interconnected with other fields, it also opens other doors.

Q. What kinds of conditions do you treat as a neuro-ophthalmologist?

A. Neuro-ophthalmologists treat a wide range of complex diseases. Many are auto-immune disorders, such as multiple sclerosis, myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) and neuromyelitis optica spectrum disorders (NMOSD), which we address in collaboration with neuro-immunologists. We also work with oncologists to treat cancer patients whose tumors a ect the optic nerve, such as brain or pituitary tumors. We also see Parkinson’s patients who may be experiencing symptoms that a ect their vision. Even double vision, or diplopia, is often caused by a faulty connection between the brain and eye muscles and may require a neuro-ophthalmologist. So, we work on really fascinating, complicated cases.

Q. What is the most common condition you treat?

A. We work with neuro-immunologists every day. A number of disorders involve the immune system attacking the brain and optic networks, sometimes causing severe vision loss and even blindness. Multiple sclerosis is the most common example.

Q. What is the benefit of choosing a neuro-ophthalmologist at an academic medical center like UCI Health?

A. I often say “time is vision,” and in an academic medical setting, patients have almost immediate access to subspecialists to help solve the most complex cases. We give patients the highest order of care, with collaboration across areas of multiple areas of expertise, giving us a broader base from which to fi nd and attack the problem.

Q. When should a patient urgently see a neuro-ophthalmologist?

A. Any sudden loss of vision, even if it’s just for a few minutes, could mean there’s a blood-flow issue or even an impending stroke. Vision changes can be a major predictor of stroke. Likewise, the sudden onset of double vision should be evaluated immediately. In general, we regard any sudden vision change, in one or both eyes, as a diagnostic emergency.