Paraneoplastic disorders of neuro-ophthalmologic interest.

Certain paraneoplastic disorders associated with degeneration of the retina, optic nerve, brainstem, and cerebellum may cause visual loss, impairment of ocular motility, or nystagmus and other saccadic intrusions and oscillations. Most of these remote effects of cancer are probably autoimmune conditions. Many affected patients have circulating antineuronal antibodies that serve to identify the autoimmune nature of their clinical presentation and allow the treating physician to target the evaluation to certain organs likely to be harboring an occult malignancy associated with that particular remote effect. Because patients with paraneoplastic disorders affecting vision and eye movement frequently develop symptoms before their underlying cancer is diagnosed, they will typically seek the assistance of an ophthalmologist first. Recognition that their symptoms or findings reflect a paraneoplastic syndrome may allow the tumor responsible for its presentation to be diagnosed at an earlier stage, which might positively influence the patient's overall prognosis.