Neuro-Ophthalmology at UCLA: Comprehensive Care for Vision and Neurological Disorders

The UCLA Stein Eye Institute stands as a leading center for vision care, research, and education. Established in 1966, it embodies the vision of Jules Stein, MD, and Bradley R. Straatsma, MD, JD, who sought to prevent blindness through comprehensive programs encompassing patient care, vision science research, education, and community outreach. Today, under the leadership of Bartly J. Mondino, MD, the institute has expanded significantly, including the opening of the Stein Eye Center in Santa Monica in 2012, the affiliation with the Doheny Eye Institute in 2013, and the opening of the Edie & Lew Wasserman Building in 2014. Together, these entities provide comprehensive vision care to patients throughout Southern California.

A Legacy of Patient Care and Innovation

The Stein Eye Institute's philosophy centers on patient care as both the primary goal and the ultimate expression of its research and education initiatives. From its initial 23,000 patient visits, the institute now serves over 1,000 patients daily at its Westwood campus, in addition to those treated at affiliated hospitals and vision care centers. Recognized by U.S. News & World Report and Ophthalmology Times, the institute offers a wide array of services for patients of all ages, delivered through consultations with highly skilled specialists.

Neuro-Ophthalmology: Bridging Vision and Neurology

Neuro-ophthalmology addresses the intersection of eye disorders and the nervous system. UCLA Health's neuro-ophthalmologists provide comprehensive management for neurological diseases affecting vision and eye movements, as well as optic nerve diseases. The program emphasizes team-based care, working closely with the Optic Neuropathy Center and departments of neurology and neurosurgery. This collaborative approach ensures comprehensive care, utilizing advanced diagnostic tools to create individualized treatment plans. Eligible patients can also access promising new therapies through participation in clinical trials.

Areas of Care and Conditions Treated

Neuro-ophthalmologists specialize in nerve-related eye problems and vision loss. At UCLA, they provide inpatient and outpatient care for a wide range of conditions, including:

Brain tumors: Masses that can press on the optic nerve, causing vision problems.
Cranial nerve palsy: Loss of function in cranial nerves, affecting eye movement and causing double vision or strabismus.
Horner syndrome: A rare disorder affecting nerves running from the brain to the face and eye, leading to eyelid drooping and decreased pupil size.
Multiple sclerosis (MS): An autoimmune disorder that can cause optic nerve inflammation (optic neuritis), leading to vision loss and pain.
Myasthenia gravis: An autoimmune disorder affecting communication between muscles and nerves, causing eyelid drooping and double vision.
Optic neuropathy: Damage to the optic nerve from various causes, leading to vision loss and other symptoms.
Optic atrophy: Loss of function in optic nerve fibers, resulting in blurred vision and limited color or peripheral vision.
Pseudotumor cerebri: Pressure buildup in the skull, causing blurred or double vision.
Retinal vascular disease: Conditions blocking blood flow in the eye, causing blurred vision, floaters, or vision loss.
Strabismus (crossed eyes): Eyes that don't look in the same direction, often caused by nerve damage or muscle dysfunction.

The Optic Neuropathy Center

Since 1991, UCLA neuro-ophthalmologists have offered multidisciplinary treatment for complex optic nerve diseases. The center utilizes advanced diagnostic tools and collaborates with neurologists, neuroradiologists, and neurosurgeons to develop effective treatment plans.

Read also: Pioneering Neuro-Oncology Research

Neuro-Ophthalmology Treatments

UCLA neuro-ophthalmologists create personalized treatment plans to restore vision and improve quality of life. Treatments may include:

Visual aids: Magnifiers and large-print devices for people with vision loss.
Medications: Corticosteroids to reduce inflammation.
Eye muscle surgery: Corrects strabismus by realigning eye muscles.

They also work closely with neurologists and neurosurgeons to manage neurological diseases affecting the visual system.

Howard R. Krauss, MD: A Leader in Neuro-Ophthalmology

Howard R. Krauss, MD, is a prominent figure in neuro-ophthalmology and a founder of the Pacific Neuroscience Institute. As Chief Financial Officer for the Pacific Neuroscience Institute Medical Group and a Director of the Pacific Eye, Ear and Skull Base Center, he specializes in diagnostic neuro-ophthalmology, strabismus, and orbital and anterior skull base surgery. Dr. Krauss cares for patients with a wide range of conditions, including eyelid disorders, ocular pain, double vision, and tumors of the eye socket, face, head, or brain. He offers complex procedures such as oculoplastic surgery, adult strabismus surgery, and orbital and anterior skull base surgery.

Dr. Krauss's background includes engineering degrees from Cooper Union and MIT, followed by a career at Hughes Aircraft Company. He then pursued medicine, completing postgraduate training in Ophthalmology at the UCLA Jules Stein Eye Institute and fellowship training in Neuro-ophthalmology and Orbital Surgery at the University of Pittsburgh. He served as Assistant Professor at the University of Texas Health Science Center, Southwestern Medical School, where he was Chief of Ophthalmology at Parkland Memorial Hospital and Director of the Residency Training Program.

Returning to the west coast, Dr. Krauss co-founded the UCLA Skull Base Surgery and Orbitocranial Tumor Programs. In 2001, he and Dr. Griffiths pioneered Transnasal Image-Guided Endoscopic Orbital Tumor Surgery, a less invasive approach to managing orbital apex tumors. Dr. Krauss has lectured worldwide and is a recognized expert in his field, with numerous publications and book chapters. He is a founding member and past Board Member of the North American Skull Base Society and Past President of the California Academy of Eye Physicians and Surgeons.

In addition to his clinical, research, and teaching activities, Dr. Krauss has been actively involved in medical and professional organizations. He was elected Vice President of the Medical Board of California in 2020.

Research at the Doheny Eye Institute

The Doheny Eye Institute complements UCLA's neuro-ophthalmology program with its research into the structure and function of the optic nerve in health and disease. Research focuses on optic neuropathies, genetic causes of vision disorders, and the effects of conditions like multiple sclerosis, AIDS, and thyroid disorders on the visual system. Doheny neuro-ophthalmologists are actively involved in revealing details about genetic causes of optic neuropathies and the role of mitochondrial malfunctions.

Conclusion

UCLA's neuro-ophthalmology program, encompassing the Stein Eye Institute and the Doheny Eye Institute, offers comprehensive care for patients with vision and neurological disorders. Through team-based care, advanced diagnostic tools, and innovative research, UCLA is dedicated to restoring vision and improving the quality of life for its patients. The expertise of specialists like Dr. Howard R. Krauss, combined with ongoing research efforts, ensures that UCLA remains at the forefront of neuro-ophthalmology care.

Appendix: Selected Publications

The following is a selection of publications that highlight the research and clinical contributions of neuro-ophthalmologists affiliated with UCLA:

Demer JL, Clark RA. Functional Anatomy of Ocular Counter-Rolling in Superior Oblique Palsy.. Investigative ophthalmology & visual science, 2025.
Meng Q, Parunakian E, Yehezkeli V, Demer JL. Surgical Dosing for Correction of Consecutive Exotropia.. American journal of ophthalmology, 2025.
Yehezkeli V, Parunakian E, Suh SY, Meng Q, Demer JL. Surgical Dosing for V-Pattern Exotropia.. American journal of ophthalmology, 2025.
Jafari S, Cai S, Demer JL. Finite Element Model of the Effect of Optic Nerve Sheath Anisotropy on Ocular Loading During Horizontal Duction.. Bioengineering (Basel, Switzerland), 2025.
Meng Q, Yehezkeli V, Demer JL. Surgical Management of Masquerading Superior Oblique Palsy.. American journal of ophthalmology, 2025.
Yehezkeli V, Demer JL. Common Forms of Adult Esotropia Require Augmented Surgical Dosing.. American journal of ophthalmology, 2025.
Yehezkeli V, Pineles SL, Demer JL, Meng Q, Velez FG. Strabismus Surgery in Patients Aged Over 80 Years: Indications, Safety, and Outcomes.. American journal of ophthalmology, 2025.
Manta AI, Demer JL, Goldberg RA. Magnetic Resonance Imaging Demonstrates Differences in Brow and Upper Eyelid Fat and Muscle Layers Between East Asians and Caucasians.. Ophthalmic plastic and reconstructive surgery, 2025.
Demer JL, Clark RA, Suh SY, Giaconi JA, Nouri-Mahdavi K, Law SK, Bonelli L, Arnold AC, Quiros P, Coleman AL, Caprioli J. Eye Movements and the Intraorbital Subarachnoid Space: Potential Contribution of Altered Cerebrospinal Fluid Pumping in Optic Neuropathies.. Investigative ophthalmology & visual science, 2025.
Jafari S, Hollister J, Kavehpour P, Demer JL. Shear viscoelastic properties of human orbital fat.. Journal of biomechanics, 2024.
Lai WY, Demer JL. Cutaneous Lower Eyelid Retractor Release Averts Lower Lid Malposition After Inferior Rectus Muscle Recession.. American journal of ophthalmology, 2024.
Lai WY, Demer JL. Laterality Targeting in Graded Inferior Rectus Tenotomy Corrects Lateral Incomitance of Hypertropia in Sagging Eye Syndrome.. American journal of ophthalmology, 2024.
Park J, Lee I, Jafari S, Demer JL. Tensile properties of glaucomatous human sclera, optic nerve, and optic nerve sheath.. Biomechanics and modeling in mechanobiology, 2024.
Lim S, Kim C, Jafari S, Park J, Garcia SS, Demer JL. Postmortem Digital Image Correlation and Finite Element Modeling Demonstrate Posterior Scleral Deformations during Optic Nerve Adduction Tethering.. Bioengineering (Basel, Switzerland), 2024.
Kim CZ, Lim S, Demer JL. Biomechanics Explains Variability of Response of Small Hypertropia to Graded Vertical Rectus Tenotomy.. American journal of ophthalmology, 2024.
Demer JL. Phenotype and Genotype in Exotropia.. JAMA ophthalmology, 2024.
Jafari S, Park J, Lu Y, Demer JL. Finite element model of ocular adduction with unconstrained globe translation.. Biomechanics and modeling in mechanobiology, 2024.
Dallalzadeh LO, Villatoro GA, Chen L, Sim MS, Movaghar M, Robbins SL, Karlin JN, Khitri MR, Velez FG, Korn BS, Demer JL, Rootman DB, Granet DB, Kikkawa DO. Teprotumumab for Thyroid Eye Disease-related Strabismus.. Ophthalmic plastic and reconstructive surgery, 2024.
Moon S, Park J, Lim S, Suh SY, Le A, Demer JL. Scanning Laser Ophthalmoscopy Demonstrates Pediatric Optic Disc and Peripapillary Strain During Horizontal Eye Rotation.. Current eye research, 2024.
Kim C, Demer JL. Magnetic Resonance Imaging of Globe Translation in Abducens Palsy.. American journal of ophthalmology, 2023.
Lim S, Demer JL. Empirical Quantification of Optic Nerve Strain Due to Horizontal Duction.. Bioengineering (Basel, Switzerland), 2023.
Tenney AP, Di Gioia SA, Webb BD, Chan WM, de Boer E, Garnai SJ, Barry BJ, Ray T, Kosicki M, Robson CD, Zhang Z, Collins TE, Gelber A, Pratt BM, Fujiwara Y, Varshney A, Lek M, Warburton PE, Van Ryzin C, Lehky TJ, Zalewski C, King KA, Brewer CC, Thurm A, Snow J, Facio FM, Narisu N, Bonnycastle LL, Swift A, Chines PS, Bell JL, Mohan S, Whitman MC, Staffieri SE, Elder JE, Demer JL, Torres A, Rachid E, Al-Haddad C, Boustany RM, Mackey DA, Brady AF, Fenollar-CortÃ©s M, Fradin M, Kleefstra T, Padberg GW, Raskin S, Sato MT, Orkin SH, Parker SCJ, Hadlock TA, Vissers LELM, van Bokhoven H, Jabs EW, Collins FS, Pennacchio LA, Manoli I, Engle EC. Noncoding variants alter GATA2 expression in rhombomere 4 motor neurons and cause dominant hereditary congenital facial paresis.. Nature genetics, 2023.
Park J, Moon S, Lim S, Demer JL. Scanning Laser Ophthalmoscopy Demonstrates Disc and Peripapillary Strain During Horizontal Eye Rotation in Adults.. American journal of ophthalmology, 2023.
Qureshi A, Lim S, Suh SY, Mutawak B, Chitnis PV, Demer JL, Wei Q. Deep-Learning-Based Segmentation of Extraocular Muscles from Magnetic Resonance Images.. Bioengineering (Basel, Switzerland), 2023.
Demer JL, Clark RA. Letter Regarding Adade and Das "Investigation of Selective Innervation of Extraocular Muscle Compartments".. Investigative ophthalmology & visual science, 2023.
Song D, Lim S, Park J, Demer JL. Linear viscoelasticity of human sclera and posterior ocular tissues during tensile creep.. Journal of biomechanics, 2023.
Lim S, Tran A, Garcia SS, Demer JL. Optical Coherence Tomography Angiography Demonstrates Strain and Volume Effects on Optic Disk and Peripapillary Vasculature Caused by Horizontal Duction.. Current eye research, 2023.
Demer JL, Clark RA. Reply to Comment on: Masquerading superior oblique palsy.. American journal of ophthalmology, 2022.
Park J, Shin A, Demer JL. Finite element modeling of effects of tissue property variation on human optic nerve tethering during adduction.. Scientific reports, 2022.
Stoddard-Bennett T, Jackson NJ, Robbins L, Villanueva P, Suh SY, Demer JL, Pineles SL, Fung SSM. Agreement of iCare IC200 tonometry with Perkins applanation tonometry in healthy children.. Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus, 2022.
Wei Q, Clark RA, Demer JL. Can Binocular Alignment Distinguish Hypertropia in Sagging Eye Syndrome From Superior Oblique Palsy?. Investigative ophthalmology & visual science, 2022.
Demer JL, Clark RA. Masquerading Superior Oblique Palsy.. American journal of ophthalmology, 2022.
Wei Q, Mutawak B, Demer JL. Biomechanical modeling of actively controlled rectus extraocular muscle pulleys.. Scientific reports, 2022.
Anastasio TJ, Demer JL, Leigh RJ, Luebke AE, von Opstal AJ, Optican LM, Ramat S, Zee DS. Preface.. Progress in brain research, 2022.
Demer JL, Kline LB, Vaphiades MS, Tavakoli M. Comments on Disorders of the Fourth Cranial Nerve: Response.. Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society, 2021.
Aleassa M, Le A, Demer JL. Special features of superior oblique hypofunction due to tendon abnormalities.. Strabismus, 2021.
Gundlach BS, Kokhanov A, Altendahl M, Suh SY, Fung S, Demer J, Pineles S, Khitri M, Chu A, Tsui I. Real-World Visual Outcomes of Laser and Anti-VEGF Treatments for Retinopathy of Prematurity.. American journal of ophthalmology, 2021.
Demer JL. Vertical Comitance of Hypertropia in Congenital and Acquired Superior Oblique Palsy.. Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society, 2021.
Kline LB, Demer JL, Vaphiades MS, Tavakoli M. Disorders of the Fourth Cranial Nerve.. Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society, 2021.
Park J, Shin A, Jafari S, Demer JL. Material properties and effect of preconditioning of human sclera, optic nerve, and optic nerve sheath.. Biomechanics and modeling in mechanobiology, 2021.
Solanes F, Demer JL. Clinical and imaging features of congenital and acquired isolated inferior rectus muscle hypofunction.. Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus, 2021.
Jafari S, Lu Y, Park J, Demer JL. Finite Element Model of Ocular Adduction by Active Extraocular Muscle Contraction.. Investigative ophthalmology & visual science, 2021.
Goseki T, Suh SY, Robbins L, Pineles SL, Demer JL, Velez FG. Reply to: Comment on Prevalence of Sagging Eye Syndrome in Adults with Binocular Diplopia.. American journal of ophthalmology, 2020.
Clark RA, Suh SY, Caprioli J, Giaconi JA, Nouri-Mahdavi K, Law SK, Bonelli L, Coleman AL, Demer JL. Adduction-Induced Strain on the Optic Nerve in Primary Open Angle Glaucoma at Normal Intraocular Pressure.. Current eye research, 2020.
Demer JL, Clark RA. Functional Anatomy of Muscle Mechanisms: Compensating Vertical Heterophoria.. American journal of ophthalmology, 2020.
Ugradar S, Joshi S, Goldberg RA, Demer JL. The Adnexal Phenotype of Sagging Eye Syndrome.. Ophthalmic plastic and reconstructive surgery, 2020.
Robbins L, Goseki T, Law SK, Nouri-Mahdavi K, Caprioli J, Coleman AL, Giaconi JA, Demer JL, Velez FG, Pineles SL. Strabismus After Ahmed Glaucoma Valve Implantation.. American journal of ophthalmology, 2020.
Demer JL, Clark RA. Letter to the Editor of IOVS From Joseph L. Demer and Robert A. Clark Regarding Joel M. Miller, "EOM Pulleys and Sequelae: A Critical Review".. Investigative ophthalmology & visual science, 2020.
Gunzenhauser RC, Tsui I, Velez FG, Fung SS, Demer JL, Suh SY, Sarraf D, Pineles SL. Comparison of Pre-Treatment vs. Post-Treatment Retinal Vessel Density in Children with Amblyopia.. Journal of binocular vision and ocular motility, 2020.
Chen JY, Le A, Caprioli J, Giaconi JA, Nouri-Mahdavi K, Law SK, Bonelli L, Coleman AL, Demer JL. Orbital Fat Volume After Treatment with Topical Prostaglandin Agonists.. Investigative ophthalmology & visual science, 2020.
Lee YH, Maniglia M, Velez F, Demer JL, Seitz AR, Pineles S. Short-term Perceptual Learning Game Does Not Improve Patching-Resistant Amblyopia in Older Children.. Journal of pediatric ophthalmology and strabismus, 2020.
Le A, Chen J, Lesgart M, Gawargious BA, Suh SY, Demer JL. Reply to Comment on Age-Dependent Deformation of the Optic Nerve Head and Peripapillary Retina by Horizontal Duction.. American journal of ophthalmology, 2020.
Clark RA, Demer JL. The Effect of Axial Length on Extraocular Muscle Leverage.. American journal of ophthalmology, 2020.
Le A, Shin A, Park J, Poukens V, Demer JL. Bilaminar Structure of the Human Optic Nerve Sheath.. Current eye research, 2020.
Shin A, Park J, Le A, Poukens V, Demer JL. Bilaminar Mechanics of the Human Optic Nerve Sheath.. Current eye research, 2019.
Ugradar S, Le A, Lesgart M, Goldberg RA, Rootman D, Demer JL. Biomechanical and Morphologic Effects of Collagen Cross-Linking in Human Tarsus.. Translational vision science & technology, 2019.
Demer JL, Clark RA, Suh SY, Giaconi JA, Nouri-Mahdavi K, Law SK, Bonelli L, Coleman AL, Caprioli J. Optic Nerve Traction During Adduction in Open Angle Glaucoma with Normal versus Elevated Intraocular Pressure.. Current eye research, 2019.
Gawargious BA, Le A, Lesgart M, Ugradar S, Demer JL. Differential Regional Stiffening of Sclera by Collagen Cross-linking.. Current eye research, 2019.
Chen JY, Le A, De Andrade LM, Goseki T, Demer JL. Compression of the Choroid by Horizontal Duction.. Investigative ophthalmology & visual science, 2019.
Clark RA, Choy AE, Demer JL. Reply.. Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus, 2019.
Goseki T, Suh SY, Robbins L, Pineles SL, Velez FG, Demer JL. Prevalence of Sagging Eye Syndrome in Adults with Binocular Diplopia.. American journal of ophthalmology, 2019.
Le A, Chen J, Lesgart M, Gawargious BA, Suh SY, Demer JL. Age-dependent Deformation of the Optic Nerve Head and Peripapillary Retina by Horizontal Duction.. American journal of ophthalmology, 2019.
Essilfie JO, Kattan J, Demer JL, Rootman DB. Cross-Sectional Soft-Tissue Composition and the Distribution of Blue Cutaneous Discoloration in the Lower Eyelid after Hyaluronic Acid Injection.. Plastic and reconstructive surgery, 2019.
Demer JL, Clark RA. Translation and eccentric rotation in ocular motor modeling.. Progress in brain research, 2019.
Demer JL. Non-commutative, nonlinear, and non-analytic aspects of the ocular motor plant.. Progress in brain research, 2019.
Demer JL, Clark RA. Functional anatomy of extraocular muscles during human vergence compensation of horizontal heterophoria.. Journal of neurophysiology, 2019.
Clark RA, Choy AE, Demer JL. Lateral rectus sag and recurrent esotropia in children.. Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus, 2019.
El-Abedin Rajab GZ, Demer JL. Long-term results of surgical excision of conjunctival retention cyst using trypan blue with methylcellulose.. American journal of ophthalmology case reports, 2019.
Li Y, Wei Q, Le A, Gawargious BA, Demer JL. Rectus Extraocular Muscle Paths and Staphylomata in High Myopia.. American journal of ophthalmology, 2019.
Demer JL. Childhood Self-perceptions in Children With Amblyopia: Is the Problem the Disease or the Treatment?. JAMA ophthalmology, 2019.
Clark R, Demer J. Reply.. Ophthalmology, 2019.
Clark RA, Demer JL. Reply.. American journal of ophthalmology, 2018.
Demer JL, Clark RA. Functional anatomy of human extraocular muscles during fusional divergence.. Journal of neurophysiology, 2018.
Ali MH, Berry S, Qureshi A, Rattanalert N, Demer JL. Decompensated Esophoria as a Benign Cause of Acquired Esotropia.. American journal of ophthalmology, 2018.
Clark RA, Demer JL. Magnetic Resonance Imaging of the Globe-Tendon Interface for Extraocular Muscles: Is There an "Arc of Contact"?. American journal of ophthalmology, 2018.
Suh SY, Clark RA, Demer JL. Optic Nerve Sheath Tethering in Adduction Occurs in Esotropia and Hypertropia, But Not in Exotropia.. Investigative ophthalmology & visual science, 2018.
Shin A, Park J, Demer JL. Opto-mechanical characterization of sclera by polarization sensitive optical coherence tomography.. Journal of biomechanics, 2018.
Tam EK, Lonngi M, Demer JL. MRI findings of contralateral oculomotor nerve palsy in Parry-Romberg syndrome.. American journal of ophthalmology case reports, 2018.
Chaudhuri Z, Demer JL. Long-term Surgical Outcomes in the Sagging Eye Syndrome.. Strabismus, 2018.
Demer JL. Knobby Eye Syndrome.. Strabismus, 2017.
Cifuentes DL, Pineles SL, Demer JL, Velez FG. Surgical success and lateral incomitance following thr…

tags: #neuro #ophthalmologist #ucla