The Division of Neuro-Ophthalmology at The Ohio State University Wexner Medical Center is now the largest in Ohio and among the biggest at an academic institution in the Midwest.
The addition this summer of a fourth physician – Mairghread Casey, MD – means the growing program provides care for the entire neuro-ophthalmologic disease spectrum all in one place.
The team includes doctors with dual fellowship training in neuro-ophthalmology and neuro-immunology or strabismus surgery.
“We are one of the very few neuro-ophthalmology teams with this combination of expertise,” says Xiaojun Zhang, MD, division director.
Unparalleled expertise
Our Neuro-Ophthalmology team includes Dr. Casey; Nelli Galoyan, MD; Hersh Varma, MD; and Dr. Zhang.
Drs. Casey, Galoyan and Varma completed residency training in ophthalmology.
Dr. Zhang was a world-renowned neurologist in China. When she came to the U.S., she repeated her neurology residency training. In addition to her neuro-ophthalmology fellowship training at Emory University, Dr. Zhang received neuro-immunology and multiple sclerosis (MS) fellowship training at Ohio State. Dr. Zhang practices as a neuro-immunologist. MS often affects eyesight and eye movement, so there’s a large overlap between neuro-immunology and neuro-ophthalmology.
Drs. Casey and Varma received strabismus surgery fellowship training in addition to their neuro-ophthalmology fellowship training. Their dual fellowship expertise lets them offer surgical intervention for patients with eye movement disorders.
“Our team’s combination of neurology and ophthalmology residency training with extra dual fellowship training means we are able to provide patient care for not only the full spectrum of neuro-ophthalmology conditions, but also high-quality care for complicated cases by team effort,” Dr. Zhang says.
Streamlining patient care access
Neuro-ophthalmology services are in high demand and continue to grow. To increase patient access and advanced patient care, Dr. Zhang and her team launched a pilot program to better coordinate the role of the division’s neuro-ophthalmology technicians.
Neuro-ophthalmology technicians play a key part in patient care. However, their role varies greatly among large academic medical centers.
“Some just do very basic work, such as checking visual acuity or measuring eye pressure. Some do a lot more, such as history taking and even doing eye scans and the visual field testing,” Dr. Zhang says. “But so far, I am not aware of well-established certification requests or job descriptions for neuro-ophthalmology technicians.”
In partnership with department administration and technician managers, Dr. Zhang worked to delineate the different roles technicians play, such as triage technician, clinical lead and testing technician.
“Our goal is to let our patients see the right doctors at the right time,” Dr. Zhang says.
Training future specialists
The Ohio State Wexner Medical Center has a history in neuro-ophthalmology patient care dating back to the 1950s. At least one neuro-ophthalmologist has always practiced within the health system.
The recent growth to a team of four neuro-ophthalmologists at Ohio State comes after Sayoko Moroi, MD, PhD, became chair of Department of Ophthalmology and Visual Sciences. She quickly recognized the need for neuro-ophthalmology services and devoted her time to recruiting additional team members.
Under Dr. Moroi’s leadership, Drs. Varma and Zhang worked to gain ACGME (Accreditation Council for Graduate Medical Education) certification for their clinical fellowship program. Dr. Zhang hopes to attract at least one U.S.-trained fellow a year. She’s also seeking international candidates. In the future, Dr. Zhang would like to add a research fellowship to help further the team’s investigative work.
Advancing research
The division is currently conducting several research studies. Using a novel technology, Dr. Moroi, principal investigator (PI), and Dr. Zhang (co-PI) are working together on idiopathic intracranial hypotension, a very common neuro-ophthalmologic condition in the United States. Their goal is to obtain better understanding of it and provide advanced care for patients.
Dr. Zhang also uses optical coherence tomography (OCT) in caring for her patients with MS. She’s working on a databank of OCT to help monitor MS progress and predict optic neuritis attacks in those patients.
To boost the division’s academic reputation, Dr. Zhang wants to see her team members hold leadership positions on ophthalmologic society boards, scientific committees and journals. Currently, Dr. Varma is a fellowship director for the North American Neuro-Ophthalmology Society, and Dr. Zhang serves on the editorial board of Neuro-Ophthalmology.