Neuro-Ophthalmologic Evaluation of the ICU Patient

Common questions posed by patients who have been admitted to a neurosciences critical care unit (NSU) include: (1) If the patient is unresponsive, what is the cause—a structural lesion above or below the tentorium, metabolic or toxic disorder? (2) Is the patient deteriorating—especially following a procedure? (3) Are therapeutic interventions indicated? (4) What is the prognosis? Careful and systematic examination of the patient’s eyelids, optic fundi, pupils, and eye movements often provide important clues that help resolve these issues (1–3).