Cost effectiveness of neuro-ophthalmic referral for ischemic fourth or sixth nerve palsies and nonarteritic anterior ischemic optic neuropathy

The purpose of this retrospective review was to determine if deferral of laboratory and neuroimaging testing and referral to neuroophthalmic specialists is cost effective. The consecutive records of 15 patients with isolated vasculopathic fourth nerve palsy, 13 patients with isolated vasculopathic sixth nerve palsy, and 20 patients with nonarteritic anterior ischemic optic neuropathy were reviewed. Based on the results, we believe that neuro-ophthalmology referral for patients with these entities is cost effective.