Neuro-Ophthalmology Center of Excellence
The eyes can look, but it is the brain that sees!
Neuro-Ophthalmology is a unique and rare field that requires highly detailed and specialized training in the Neuro-visual system of the human body.
There are no more than 4 Neuro-Ophthalmologists in the entire state of Arizona currently practicing Neuro-Ophthalmology.
Our Neuro-Ophthalmologist, Dr. Subei, evaluates all visual diseases arising from systemic disease to the brain and nervous system utilizing the latest technology offered in the 21st century to evaluate both the anatomy and physiology of your Neuro-Visual system including high resolution 3 Tesla Magnetic Resonance Imaging, Computed Tomography Angiography, Optical Coherence Tomography, Perimetry visual fields, Fundus Photography, Fluorescein Angiography as well as physiological studies including Videonystagmography, Visually Evoked potentials, Electro-Retinography, and Electroencephalography.
Dr. Subei has designed his own MRI protocol that detects the majority of Neuro-Ophthalmic disease entities based on his experience working at many University programs and with many pioneering Neuroradiologists.
Some of the many conditions that Dr. Subei treats patients for are listed here:
- Double Vision
- Visual Hallucinations
- Ocular Migraine
- Optic Neuropathy
- Optic Neuritis
- Facial Spasm
- Optic Nerve Swelling
- Optic Nerve Atrophy
- Visual Feild Loss
- Mulitple Sclerosis
- Myasthenia Gravis
Did you know that 50 % of your brain is dedicated to vision?
The visual pathways in the brain span the entirety of the horizontal axis from the back of the eyes all the way to the back of the brain where the visual cortex recreates the images received by your eyes.
Dr. Subei is an expert at managing visual disturbances, flashes of light, positive visual phenomena, visual hallucinations, and visual disturbances that may be due to abnormal brain activity caused by serious Neurological illnesses such as seizures, brain tumors, Posterior Reversible Encephalopathy Syndrome, Encephalitis, Meningitis, Strokes, Visual Snow Syndrome and Ocular Migraines.
Did you know that your optic nerves are not actually nerves?
They are literally portions of your brain that form cylinder-shaped extravasations and extend into the back of the eye where all the information gathered from the eye is transported back to the brain and processed to recreate your vision as you see it.
This portion of your brain’s “optic nerves” may become diseased by infection, inflammation, stroke, compressed by a mass, vascular abnormality or tumor, pressurized by increased intracranial pressure, or even attacked by your immune system by various autoimmune diseases.
Dr. Subei has dedicated his career to treating such disease entities that may involve your optic nerves such as optic neuritis from Multiple Sclerosis, Neuro-Myelitis Optica, Anti- Myelin Oligodendrocyte Glycoprotein antibodies, Neuroretinitis, as well as ischemic optic neuropathies such as Non-arteritic Ischemic Optic Neuropathy (NAION), and Giant Cell Arteritis (GCA).
Dr. Subei is also an expert in treating patients with increased intracranial pressure such as Idiopathic Intracranial Hypertension, and Cerebral Venous Sinus Thrombosis which without treatment can lead to permanent blindness in both eyes.
3 cranial nerves and a significant portion of the brainstem nuclei, nuclear integrators,inter-nuclear tracts, and balance center (cerebellum) control the perfectly precise eye movements, fixation, accommodation, coordinating, and adapting to changes in the head and body positioning, as well as the constantly moving environment. Any disease entity that disrupts these delicate neuronal pathways can lead to debilitating symptoms such as double vision (Diplopia), droopy eye lids (Ptosis), unequal pupil size (Anisocoria).
Dr. Subei has extensive experience with treating double vision and finding out if your symptoms are caused by serious systemic Neurological diseases such as autoimmune diseases like Myasthenia Gravis, Multiple Sclerosis, Thyroid eye disease, stroke, traumatic brain injury, cancer, blood vessel dissections, malformations, brain bleeds, infections, meningitis, and other inflammatory neurological illnesses.
Did you know that your brain’s balance center is directly hardwired to your inner ears, brainstem and eyes?
Dr. Subei is an expert in managing pts with spinning sensations (Vertigo), the sensation of trailing and after images (Palinopsia), the sensation of the environment rocking back and forth (Oscillopsia), non-volitional uncontrolled eye movements (Nystagmus), non-volitional eyelid closure (Blepharospasm) and utilizes video nystagmography to detect subtle abnormalities in the visual-balance Neuronal axis and treats patients with diseases such as Benign Paroxysmal Positional Vertigo, Optokinetic Hypersensitivity, Vertiginous Migraine, Vestibular Neuritis, masses involving the balance center.
The Neuro-Ophthalmologic evaluation is unlike any other medical evaluation. It is very detailed and precise, as it encompasses the most complex organ systems and utilizes an extensive amount of testing to localize the visual issues you may have within your complex Neuro-visual system. Due to insurance company policies, testing time, and scheduling constraints, these tests will NOT be performed on the same day you see the Neuro-Ophthalmologist.
In order to accommodate for the constraints mentioned, initial evaluations will consist of some visual testing that will be performed on a separate visit prior to being scheduled to see Dr. Subei. Some testing may be repeated, as the progression of the visual findings is one of the most important keys to the cause of the Neuro- visual deficits and symptoms and is essential to reaching an accurate diagnosis.
For initial evaluations, it is expected that you arrive 30 minutes prior to your testing visit appointment. The records from the referring physician MUST be obtained prior to seeing Dr. Subei in order to get an accurate and precise assessment. Please complete your new patient intake forms online via the Foothills Neurology website link prior to your initial visit: Dr. Subei New Patient Paperwork
Dr. Subei is extremely thorough and reviews many tests for every single patient every visit. Expect to be tested very thoroughly. More information about Dr. Subei can be found on his page here.