“You can resist an invading army, but you cannot resist an idea whose time has come“
This quote epitomizes one of the most important junctures Indian Ophthalmology is at currently. Although strides are being made in the cutting-edge world of refractive surgery and intravitreal injections are seemingly providing all the answers to retinal surgeons; there is one sub-specialty, which has quietly been making strides in its own evolution – neuro-ophthalmology. No one can deny that neuro-ophthalmology, today has carved its own niche in ophthalmology and is truly an idea whose time has come. Every ophthalmologist needs to know the basics of neuro-ophthalmology to deal with the complex pathogenesis of diseases in this genre.
Shaw in his Editorial “Tigers and Snakes in Neuro-ophthalmology” has given a beautiful description of clinical dilemmas faced by neuro-ophthalmologists. This epitomizes the training that is needed to look at the disease in its totality and provide best clinical solutions.
As life expectancy increases, so does the list of morbidities that affect the aging human body and it is not uncommon to see metabolic, genetic and immune-related disease affect the visual pathway first. Over the years, imaging modalities such as computed tomography, magnetic resonance imaging, and positron emission tomography techniques have also advanced enabling neuro-ophthalmologists to seek and obtain more information.
To celebrate this unique sub-specialty, the Indian Journal of Ophthalmology has taken the initiative to compile a special issue comprising of state-of – the-art review articles, controversial treatment modalities, relevant original articles and unique case reports from across the globe; and present this special issue on neuro-ophthalmology.
Nair and Gandhi in their editorial have lucidly charted the reasons for the development of the sub-specialty of neuro-ophthalmology in India. Spitze et al., in “neuro-ophthalmology as a career,” provide insightful pearls from personal experience about how the practice of neuro-ophthalmology can be so rewarding.
Eic Ahn et al. in their review on the treatment modalities for thyroid related orbitopathy have highlighted the need for more research for an evidence based treatment of this disease given its complex pathogenesis. The management of thyroid eye disease is a challenging task due to its complex pathophysiology and unpredictable clinical manifestation. There is a need for a multi modal team approach and development of newer therapeutics for management of this disease spectrum.
This issue has also highlighted controversies in the management of some important conditions like traumatic optic neuropathy and has also focused on myasthenia gravis, a condition more common than thought of.
I am sure it will make for some delightful reading and will enrich the knowledge of all seekers. I invite you to partake of this academic feast.
1. Shaw HE Jr. Tigers and snakes in neuro-ophthalmology J Neuroophthalmol. 2014;34:213–7
2. Bhatti MT, Dutton JJ. Thyroid eye disease: Therapy in the active phase: A comment: Reply J Neuroophthalmol. 2014;34:426–7