Neuro-ophthalmology?

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liz101

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Hi-
I was reading about ophthalmology and ran into a mention of neuro-ophthalmology, which seems interesting. Can someone give me more information? for example, how is it different from ophthalmology? How much longer does the training take? What are the hours and compensation like? Do they tend to have private practices? What does the future of the career look like? Also, I know that job fields are generally saturated in New York, but subspecialists like neuro-ophthalmologists tend to in demand in large cities, right?

Thanks,
liz
 

Retinamark

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Neuro-ophth is that fascinating zone lying between ophthalmology & neurology. Intellectually, it is an incredibly satisfying and interesting job. If you like neurology, but would like to be able to operate a bit as well, it is perfect. It isn't as competitive to get into as some other ophthalmic subspecialties like retina & plastics because the renumeration isn't as great. (Because they do less surgical procedures and each patient is more complicated & takes longer).
So, it has advantages & disadvantages like all sub-specialties & it is one of those specialities that some people really love it, & some people really hate it.
 

NR117

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Liz101,

A neuro-ophthalmologist is someone who has completed a residency either in neurology or ophthalmology, followed by 1-2 years of fellowship training in neuro-ophthalmology. They deal with diseases of the optic nerves, cranial nerves 3,4, 5 and 6; pupillary abnormalities, eye movement abnormalities and nystagmus, disorders of visual processing centers in the brain and visual problems in patients with certain neurological diseases. As Retinamark pointed out, the assessments are usually a LOT longer than your typical ophthalmological exam as they do both an eye exam AND a neurological exam; so they see far fewer patients than a general ophthalmologist. The typical neuro-ophthalmology case is a patient who has already seen 1-2 ophthalmologists and neurologists, with no diagnosis. That's one of the reasons it's not the most popular subspecialty to go into, and hence the demand - supply is short.
There are people who go into private practice but I think there are more of them going for academic positions.
Your typical neuro-ophthalmologist is someone who enjoys analytical thinking and being challenged with patients who have complex problems.
 

Retinamark

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excellent reply nr117, that is a great summary of neuro-ophth
 

JL_Nightwing

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mostly academic setting (otherwise combined with something else)
see mostly referrals
eye exam much longer (maybe 4 news and 8 followups in a morning) b/c much more complete, i.e. everyone gets a VF
undilated exam often
surgery -- mostly muscle cases and TABs

common pts:
*NAION (arteritic ION in batches--summer/winter) + other optic neuropathies
*diplopia eval and tx (CN III w/u, CN IV--congenital/traumatic/microvascular, skew, CNI VI, INO, CI, consecutive XT)
*optic neuritis w/u
*disc edema/pseudopapilledema eval. (neuroretinitis/papillitis/IIH/ONH drusen)
*migraine/entopic phenomena eval.
*transient visual loss w/u
*chronic ocular pain tx
*suprasellar masses eval.
*MG w/u, tx
*Graves w/u
*anisocoria eval.
*blepharospasm botox inj.
*PSP (vertical gaze disturbances)
*and the usual nonphysiologic visual loss
 

Andrew_Doan

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liz101 said:
for example, how is it different from ophthalmology? How much longer does the training take? What are the hours and compensation like? Do they tend to have private practices? What does the future of the career look like? Also, I know that job fields are generally saturated in New York, but subspecialists like neuro-ophthalmologists tend to in demand in large cities, right?

Liz,

If you train in neuro-op after neurology, then you cannot do surgery. If you trained in ophthalmology first then a 1 year neuro-op fellowship, then you can do surgery.

Compensation is poor if you don't do surgery. To make a high salary (>$250K/year), then you need a surgical practice in addition to being a neuro-ophthalmologist. It's hard to make over $150K/year if you're only seeing clinic patients because the neuro-op patient often requires long consultations.

The future is good for neuro-op because there is a high demand due to few graduates entering the field. I think this is because compensation is low for neuro-op. Most neuro-ophthalmologists practice general ophthalmology too or combine it with another sub-specialty. If you go purely academic, then you can do neuro-op and research.

I don't know what the job market is like in NY for neuro-op.
 

kassie

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Neuro-op is fascinating but it is my understanding that it is in pretty low demand. There are only a few neuro-ops in the NY area...I believe they are all academic physicians. Not much demand because of low compensation so the profitability of a neuro-op is less than others in the field. However, if you end up loving it and are willing to relocate you can do anything...

liz101 said:
Hi-
I was reading about ophthalmology and ran into a mention of neuro-ophthalmology, which seems interesting. Can someone give me more information? for example, how is it different from ophthalmology? How much longer does the training take? What are the hours and compensation like? Do they tend to have private practices? What does the future of the career look like? Also, I know that job fields are generally saturated in New York, but subspecialists like neuro-ophthalmologists tend to in demand in large cities, right?

Thanks,
liz
 
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