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Faced with a worldwide shortage of neuro-ophthalmologists, Wilmer Eye Institute, Johns Hopkins Medicine, pioneered an approach to ensure that every patient who needs it can be evaluated immediately.

Trained to tease out the often subtle connections between vision anomalies and a wide range of nervous system disorders, the ultra-specialized Wilmer neuro-ophthalmology team is in high demand.

A worldwide shortage of neuro-ophthalmologists has made it increasingly difficult to meet that demand, but the division has risen to the challenge 鈥� by pioneering the deployment of specially trained optometrists to ensure that every patient who needs it can be evaluated immediately.

鈥淭he shortage of neuro-ophthalmologists is currently at the forefront of discussions in ophthalmology departments, publications and national meetings across the country,鈥� says听Amanda Henderson, M.D., chief of Wilmer鈥檚 small but storied neuro-ophthalmology division and associate professor of ophthalmology and neurology. 鈥淚鈥檝e been invited to present our approach, using optometrists as 鈥榥euro-ophthalmologist extenders鈥� 鈥� which we initiated about 10 years ago 鈥� at the North American Neuro-Ophthalmology Society鈥檚 annual meeting in March 2024.鈥�

There are currently two optometrists on Henderson鈥檚 team. They do triage in urgent cases and see long-term patients for routine follow-up exams.听Colin Kane, O.D., assistant professor of ophthalmology, and听Kelly Seidler, O.D., clinic director of Wilmer鈥檚 Frederick, Maryland, office and instructor of ophthalmology, are both members of what is still a small, but elite new cohort of optometrists with special training in medical and neurologic eye disease.

鈥淎 lot of what I do is rule things out,鈥� says Kane. 鈥淎 doctor might be worried about a patient with double vision or a suspicious-looking optic nerve and refer them to us and I can usually schedule them for a preliminary workup right away.鈥� And because Kane works closely with Henderson and ophthalmologist听Michael Carper, M.D., assistant professor of ophthalmology and neurology, 鈥渢hey are always ready to step in,鈥� Kane says, 鈥渋f I see anything atypical that needs immediate attention.鈥�

Seidler plays a key role in staffing Wilmer鈥檚 Frederick office, under the supervision and mentorship of neuro-ophthalmologist听Andrew Carey, M.D., assistant professor of ophthalmology and neurology. Carey and Carper join her in seeing patients there twice a month, and Seidler says patients benefit from the division鈥檚 robust teamwork. 鈥淚 am in constant close touch with the neuro-ophthalmology team and other Wilmer specialists,鈥� she says. 鈥淲e have such a depth of expertise available, and if I need to consult or need help ordering tests and imaging, they are always immediately there for me.鈥�

Patients Drive Treatment Breakthroughs

Finding better treatment for their patients is almost an obsession for physician-scientists like听Amanda Henderson, M.D., and her neuro-ophthalmology team.

But patients are not only the inspiration for the translational and clinical research that produces new treatments. They are very often the donors whose gifts make that research possible.

鈥淭his is a fast-moving field and there are a lot of conditions we have many good treatments for that we didn鈥檛 have 20 years ago,鈥� Henderson says. 鈥淕rateful patients are helping to make that happen, and there is no gift too small to have a big impact.鈥�

All in the Wilmer Family

鈥淚 practically grew up at Wilmer,鈥� says听Colin Kane, O.D., now an assistant professor of ophthalmology at the institute where his father, James Kane, worked as an equipment technician for 41 years.

David Guyton, M.D., now the Zanvyl Krieger Professor of Pediatric Ophthalmology, performed Colin Kane鈥檚 strabismus surgery when he was three. And, post-college, Colin鈥檚 dad encouraged him to train as an ophthalmic technician and to join the Wilmer team, which he did.

Colin says he loved the job, but an almost unquenchable curiosity and a desire to better equip himself to help patients inspired him to leave to pursue a doctorate in optometry with special training in ocular disease.

鈥淚 have always been fascinated by the connection between the eyes and the brain and I feel so lucky to not only be back at Wilmer, which feels like home to me, but working in the division I so much wanted to be in,鈥� he says.

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