All Articles

Neuroimaging in Ophthalmology

Sunil Ram, MD

Sunil Ram, MD

Ordering MRI or CT imaging of neuro-ophthalmic conditions requires not only knowing which procedure is indicated, but also what part of the anatomy should be imaged, whether or not contrast is indicated, and if angiography should be supplemented. Otherwise, these complexities may result in imaging studies that are either unneeded or unhelpful.

In a review of common neuro-ophthalmic disorders, researchers recommend MRI with contrast for unilateral or bilateral optic neuropathy, optic neuritis, bitemporal hemianopsia and several others. Sunil Ram, MD, a neuroradiologist at Scottsdale Medical Imaging (SMIL), says SMIL’s emphasis on service ensures that referring physicians obtain the appropriate imaging study required for a confident diagnosis.

“We have a close working relationship with the neurologists and ophthalmologists in the community,” Ram says. “We make ourselves available for consults at the convenience of the clinicians.

In addition, orbital CT and MRI imaging at SMIL is only interpreted by neuroradiologists with special expertise in head and neck imaging.

We employ customized protocols based on the individual’s symptoms and condition.” The most common indications for orbital imaging in the Scottsdale community are orbital infections and demyelinating disease, Ram says.

He adds that patients with orbital pathology also often have intracranial pathology requiring imaging the brain along with the orbits to evaluate the entire visual pathway.

Using 3 Tesla (3T) MRI machines, SMIL is able to provide excellent imaging for orbital pathology while eliminating the exposure to radiation.

“The 3T MRI provides the highest resolution imaging for the orbits allowing us to characterize the smallest demyelinating lesions as well as orbital tumors and other pathology,” Ram says. In cases of orbital cellulitis secondary to sinus disease, or orbital tumors that call for CT to evaluate the facial bones, Ram says SMIL uses dose-reduction techniques to limit radiation exposure.

Kruger J, Lessell S, Cestari D. Neuro-imaging: a review for the general ophthalmologist. Seminars in
Ophthalmology. 2012;27(5-6):192-196. Kim J, Hashemi N, Gelman R, et al. Neuroimaging in
ophthalmology. Saudi Journal of Ophthalmology. 2012;26:401-407.

We would like to thank you for your review and support of The SMIL Radiology Report by sponsoring your 2018 membership to the Phoenix Fine Dining Group. Your membership invites you to experience the exceptional food and distinctive personality of 30 top-tier Valley restaurants all at great savings; restaurants such as Talavera, Bistro 24, T Cook's and Roka Akor.

To receive your 2018 membership card please complete the form below. You will receive your card by mail - please allow 4 to 6 weeks (your information will not be published or shared with any other organization).

To learn more about Phoenix Fine Dining Group and Preferred Restaurants visit

    Name (required)

    Title (required)

    Speciality (required)

    Name of your practice (required)

    Address (required)

    City, State, Zip (required)


    Please rate how useful this article was to you


    What topics would you like to see covered in upcoming
    editions of the SMIL Radiology Report? (required)

    Other comments suggestions you would like to share with the SMIL Radiology Report team?