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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.
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:
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.
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.
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 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.
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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