Newly Diagnosed With Chiari Malformation? Here's Why You Should See An Ophthalmologist

A diagnosis of Chiari malformation may have your head spinning and aching, literally and figuratively, as you realize that it may be the answer to all of the various symptoms and problems that you or your loved one has been experiencing, including vision problems. If you or your child has been diagnosed with Chiari malformation, it will be a good idea for you to see an ophthalmologist. Here's why and what can be done.

The connection between Chiari malformation and vision problems 

Due to the cerebral tonsils sinking down into and sometimes past the foramen magnum, there's a risk of the cranial nerves in the brain stem being compressed. This is why the symptoms of Chiari can occur throughout the body, including vision problems. Another issue with Chiari is that the herniation causes the flow of the cerebrospinal fluid to be compromised, which can also cause vision problems, such as optic neuritis, if there's a reduction or increase of the fluid through the perivascular spaces around the optic nerves as they go to the eyes.

Vision problems that can be associated with Chiari malformation

You'll likely be asked by your neurosurgeon, neurologist, or other medical professional about your vision when you are seen for complaints of your Chiari symptoms. Blurry vision and floaters are common complaints of Chiari, but here is a list of vision problems that can be caused by Chiari or associated with it in some way:

  • blepharoclonus—eyelid spasms
  • nystagmus—rapid eye movement
  • abducens palsy—an eye turns outward
  • papilledema—temporarily blurred, double, flickering, or loss of vision
  • strabismus—abnormal eye alignment
  • esotropia—both eyes turn inward
  • optic neuritis—eye pain, temporary vision loss
  • diplopia—double vision
  • photophobia—sensitivity to light

Have your vision tested whether you currently have symptoms or not 

Chiari is a progressive condition, which can also cause the various symptoms to progress. Therefore, it's important to tell your medical team if you notice any vision changes or problems with your eyes so you can get a referral to an ophthalmologist or a neuro-ophthalmologist. Even with a Chiari diagnosis, it's important to rule out any other causes and to see if there's any treatment from an eye doctor that may help you deal with eye symptoms.

Even if you do not currently have vision problems, it's a good idea to get a thorough evaluation done by an ophthalmologist so a baseline can be documented. That way, if your Chiari and the associated symptoms progress, the ophthalmologist, neurosurgeon, and other medical team members will be able to compare results to determine if decompression surgery is necessary to stop or slow down the progression of symptoms.

Vision therapy may help before & after decompression surgery

Vision therapy is a form of treatment that may help you gain control of the symptoms by strengthening your optic muscles to attempt to counteract the changes that may be due to the Chiari malformation. Vision therapy, however, may be more beneficial after Chiari decompression surgery which is done to try to stop or slow down the progression of the symptoms of Chiari. The reason for this is simply because Chiari is progressive. At some point, you'll need decompression surgery.

It's important to understand that decompression surgery is not a cure and it will not reverse all damage to the nerves. Vision therapy can, however, resolve some vision problems after surgery, such as esotropia. This can be done with the use of prisms that are placed in eyeglasses to help train the affected eye(s) to work differently so the eyesight can improve. Of course, the placement of the prisms depends on the type of vision problems that are being corrected with vision therapy.

Contact a company like Absolute Vision Care for more information about your vision therapy options.

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