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 — by pioneering the deployment of specially trained optometrists to ensure that every patient who needs it can be evaluated immediately.

“The shortage of neuro-ophthalmologists is currently at the forefront of discussions in ophthalmology departments, publications and national meetings across the country,” says Amanda Henderson, M.D., chief of Wilmer’s small but storied neuro-ophthalmology division and associate professor of ophthalmology and neurology. “I’ve been invited to present our approach, using optometrists as ‘neuro-ophthalmologist extenders’ — which we initiated about 10 years ago — at the North American Neuro-Ophthalmology Society’s annual meeting in March 2024.”

There are currently two optometrists on Henderson’s team. They do triage in urgent cases and see long-term patients for routine follow-up exams. Colin Kane, O.D., assistant professor of ophthalmology, and Kelly Seidler, O.D., clinic director of Wilmer’s 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.

“A lot of what I do is rule things out,” says Kane. “A 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.” And because Kane works closely with Henderson and ophthalmologist Michael Carper, M.D., assistant professor of ophthalmology and neurology, “they are always ready to step in,” Kane says, “if I see anything atypical that needs immediate attention.”

Seidler plays a key role in staffing Wilmer’s Frederick office, under the supervision and mentorship of neuro-ophthalmologist 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’s robust teamwork. “I am in constant close touch with the neuro-ophthalmology team and other Wilmer specialists,” she says. “We 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.”

Patients Drive Treatment Breakthroughs

Finding better treatment for their patients is almost an obsession for physician-scientists like 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.

“This is a fast-moving field and there are a lot of conditions we have many good treatments for that we didn’t have 20 years ago,” Henderson says. “Grateful patients are helping to make that happen, and there is no gift too small to have a big impact.”

All in the Wilmer Family

“I practically grew up at Wilmer,” says 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’s strabismus surgery when he was three. And, post-college, Colin’s 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.

“I 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,” he says.