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Neuro-Ophthalmology: An Eye-Brain Connection

Frank B. Walsh at the Wilmer Eye Institute in 1967. www.researchgate.net/publication/334185460

Did you know that the brain is really where the image of what you see is created? In fact, neuro-ophthalmology explains how our brain uses light absorbed by our eyes through visual pathways and neurological processes. This connection is crucial for the management of many vision and neurological problems. However, how was this discovery made? And how does this connection work?


First and foremost, while the understanding of neurological disorders affecting vision dates back much further, it was during the 20th century that dedicated research and clinical efforts began to coalesce into a specialized field where neuro-ophthalmology began to emerge. During this century, a Canadian-American ophthalmologist by the name of Frank B. Walsh contributed significantly to the establishment of neuro- ophthalmology as a recognized discipline. He is often referred to as the father of neuro-ophthalmology because he pioneered the

understanding of the relationship between the eyes and the brain, particularly in terms of how neurological disorders can affect vision. Walsh's research and clinical work laid the foundation for neuro-ophthalmology, which focuses on diagnosing and treating visual disorders related to the nervous system.


Moreover, in the seventeenth century, subsequent research on the optic nerve and the blood supply to the brain was carried out by a physician named Thomas Wills. His work focused on neurology and its connection to the brain, as well as ophthalmology, and this essential work helped people understand the neural pathways involved in vision. In the centuries that followed, advancements in optometry and ophthalmology further developed the world's understanding of neuro-ophthalmology. For instance, the ophthalmoscope invented in 1850 by Hermann von Helmholtz enabled physicians to visualize the interior of the eye. There was also the development of various imaging techniques that contributed heavily to a deeper understanding of the connection from the eye to the brain, such as magnetic resonance imaging (MRI) and computed tomography (CT) scans.

In addition, the process of how the eye transfers information to the brain begins as light enters the cornea, which is the outermost part of the eye, and passes through the pupil, which is the round opening in the center of the iris. When light eventually hits the retina, special cells called photoreceptors will convert the light into electrical signals. These electrical signals then travel along the optic nerve to the brain, and the point where the optic nerves from each eye cross at the brain is called the optic chiasm. Essentially, these signals will move to the visual cortex at the back of the brain where they undergo complex processing to form visual representations. This whole process happens in less than a hundred milliseconds


Sources:

"How the Eyes Work.” National Eye Institute, 20 April 2022, https://www.nei.nih.gov/learn-about-eye-health/healthy-vision/how-eyes-work. Rubens, Peter Paul, and Guido Reni. "The history of optic chiasm from antiquity to the twentieth century.” NCBI, 14 August 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5644697/. "We live in the past and our brain makes up for it." Salk Institute, 1 February 2006, https://www.salk.edu/news-release/we-live-in-the-past-and-our-brain-makes-up-for-it/.

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