Neuro-ophthalmic afferent system diagnoses a general ophthalmologist should (almost) never make alone

The general ophthalmologist might be called upon to make the diagnosis of neuro-ophthlamic conditions which are either rare or require extensive testing to exclude alternative diagnoses. This paper reviews some common afferent system neuro-ophthlamologic diagnoses that the general ophthalmologist should rarely if ever make alone. These include posterior ischemic optic neuropathy, chronic optic neuritis, retinal migraine, and optic atrophy. Although these diagnoses do exist they are typically diagnoses of exclusion that require neuroimaging and ancillary testing and have no diagnostic test to confirm the diagnosis.