If asked what the significance of neuro-ophthalmology is in the evaluation of severe head injury, many medical and surgical practitioners of neurology would promptly reply that it consists of monitoring pupillary reactivity in anticipation of the uncal herniation syndrome. A discussion of two broad premises of a factual nature, however, should easily convince these same practitioners that the neuro-ophthalmic evaluation of patients with severe head injuries offers far more than the Hutchinson pupil
