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Program spotlight: Pediatric Neuro-Ophthalmology Service

Children's Hospital Boston's Department of Ophthalmology is home to a new Pediatric Neuro-Ophthalmology Service—one of the few pediatrics ophthalmology programs in the country with a dedicated specialization in ophthalmic diseases that have a neurological basis.

The service works with Children's specialists in Ophthalmology, Neurology, Neurosurgery, Neuroradiology, Genetics, Oculoplastic Surgery and Endocrinology to deliver the best possible multidisciplinary care for patients with complex conditions.

Program basics
Gena Heidary, MD, PhD, is the Neuro-Ophthalmology Service's primary clinician—she recently joined Children's full-time after completing her fellowship in pediatric ophthalmology and strabismus in the Department of Ophthalmology and a second fellowship in neuro-ophthalmology at Massachusetts Eye and Ear Infirmary. Dr. Heidary holds a doctorate in neuroscience and is one of a handful of dually fellowship-trained pediatric neuro-ophthalmologists in the United States. Dr. Heidary works closely with other ophthalmological specialists here at Children's, including:

Conditions treated
The service focuses on the medical and surgical treatment of a broad spectrum of eye conditions that are neurological in origin, including:

  • idiopathic intracranial hypertension, also known as pseudotumor cerebri
  • vision loss secondary to brain tumors
  • neurofibromatosis
  • developmental changes of the optic nerve
  • eye movement disorders

Dr. Heidary is also experienced in managing adult strabismus and eye muscle problems linked to thyroid disease.

Innovative diagnostics and treatment
Children's Neuro-Ophthalmology Service uses the most sophisticated diagnostic and interventional approaches available, incorporating minimally invasive techniques whenever possible. Our services include:

  • non-invasive imaging using optical coherence tomography (OCT). This technique uses light waves to capture high-resolution, detailed, cross-sectional images of structures in the eye. OCT, which has been applied in the settings of retinal disease and glaucoma, is ideally suited for detecting and monitoring several neuro-ophthalmic processes, including:
    • optic nerve edema
    • optic nerve atrophy
    • retinal nerve fiber layer loss
    • macular edema
  • the optic nerve sheath fenestration procedure, a well-tolerated surgical procedure for the treatment of optic nerve swelling in the setting of elevated intracranial pressure. During the procedure, the neuro-ophthalmologist makes a small incision in the sheath covering the optic nerve and uses this "window" to safely drain the excess fluid for
    re-absorption by surrounding tissues.

Research
Children's clinicians are engaged in a variety of studies with significant potential to advance the field of neuro-ophthalmology. Current projects include:

  • clinical characterization of patients with idiopathic intracranial hypertension, or pseudotumor cerebri to identify risk factors affecting prognosis and to optimize treatment outcomes
  • exploring the mechanisms of optic nerve regeneration
  • developing a non-invasive method of measuring
  • intracranial pressure

Referrals
Referrals to the service tend to be the most complex examples of the listed conditions. Comprehensive pediatric ophthalmologists in the Department of Ophthalmology are also available to see children with relevant symptoms, and routinely consult with clinicians in Children's Departments of Neurology and Neurosurgery as needed.

Meet the Team

Gena Heidary, MD, PhD,
pediatric ophthalmologist and pediatric
neuro-ophthalmologist

 

 


David G. Hunter, MD, PhD,
ophthalmologist-in-chief

 

 

Make a referral: 617-355-6401

 
 
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