When her vision began to decline and her local eye doctor told her she needed cataract surgery, Pat Perrine, a 74-year-old retired home economics teacher and accomplished seamstress from York, Pennsylvania, wasn’t especially worried. “Everybody at my health club said, ‘Oh, no big deal, the next day you’re going to be fine,’” she says.

Instead, Perrine woke up the day after surgery on her right eye unable “to read even the biggest ‘E’ on the eye chart.” Her surgeon seemed both mystified and alarmed, and suggested she find a retina specialist. A local specialist agreed to see her immediately and, worried by the sudden and unexplained vision loss in the affected eye, promptly referred Perrine to Wilmer Eye Institute at Johns Hopkins Medicine in Baltimore. “Within a week, I was with Dr. Henderson,” Perrine says.

Amanda Dean Henderson, M.D., chief of Wilmer’s Division of Neuro-Ophthalmology, is trained to tease out obscure connections between the eye and the brain. “We think of the visual system as a whole, not just the eyeball,” says Henderson, who in December succeeded her Wilmer mentor, Neil R. Miller, M.D., as the second Frank B. Walsh Professor of Neuro-Ophthalmology.

When she first saw Perrine, Henderson says she was concerned about the possibility of stroke or “some form of irreversible vision loss” and, after a thorough exam, scheduled Perrine for an MRI. The scan revealed a benign brain tumor called a meningioma enveloping the optic nerve behind her right eye.

“It was a scary diagnosis for her at first,” says Henderson, who turned next to a key collaborator, Risheng Xu, M.D., Ph.D., assistant professor of neurosurgery and assistant director of the neurosurgery residency program. Xu specializes in the extremely delicate procedure of debulking (or removing) skull base tumors, and Perrine’s tumor was located at the base of her skull.

“I was scared,” Perrine says, “and it was a massive 12-hour surgery. But the nurses were wonderful, everyone was so kind and reassuring, and Dr. Xu’s assistant told me the whole team looked at my tumor and decided he was the best person for the job.”

The immediate goal of the surgery was to prevent further vision loss, but the team was also hopeful that they could restore some vision. “The optic nerve has an extremely limited ability to recover,” says Xu, “and a tumor that grows unchecked in this area will eventually cross over to compress the other optic nerve, and the patient will end up totally blind in both eyes.”

So everyone was thrilled when the vision in Perrine’s right eye was completely restored. “At my first follow-up appointment with Dr. Henderson, I had 20/20 vision in that eye,” she says. “God was really holding my hand.”

Xu says Perrine’s case is cause for celebrating the “very, very close working relationship between the Department of Neurosurgery and Wilmer’s Division of Neuro-Ophthalmology. Collaboration is one of Hopkins’ great strengths, and it’s the key to great health care.”

It’s also the very heart of neuro-ophthalmology, Henderson says. “We are able to collaborate not only with great neurosurgeons like Dr. Xu but with endocrinologists who work with pituitary tumors and neurologists who might work with neuroinflammatory conditions like multiple sclerosis.”

Wilmer is one of the few places in the world that supports a robust neuro-ophthalmology division. “The current medicine model of having to move patients through so quickly is not conducive to these complicated cases that require a bit more thought and time, so I think we are fortunate to have been able to develop a practice at Hopkins where we’re able to provide patients with this service that involves support not only from our colleagues at Wilmer but also from all of our colleagues at Johns Hopkins Medicine,” Henderson says.

As the new Frank B. Walsh Professor of Neuro-Ophthalmology, Henderson is heir to a tradition she cherishes. Not only is Walsh remembered as the father of neuro-ophthalmology, he was also a mentor to her own mentor, the legendary Neil Miller, who recently retired after serving on the Wilmer faculty since 1976 and being named the first Frank B. Walsh Professor of Neuro-Ophthalmology in 1987.

“It’s clearly a huge honor and an incredible opportunity because it’s an endowed professorship that will support our work,” Henderson says. “It means more funding for some of our projects — optic nerve research, for instance, and the important work some of our students and residents are doing to improve the efficiency and quality of care for our patients.”

Henderson is passionate about education, and the professorship also provides her more dedicated time to mentor young researchers. “Neuro-ophthalmologists tend to be thinkers, and most of us like to interact with learners and teach them the intricacies of how we think through these problems to get to the bottom of a patient’s issue,” she says.

“But on the more sentimental side of things, it means a great deal to me, both because of Dr. Frank B. Walsh’s legacy here at Wilmer and because Dr. Neil Miller is such an incredible mentor and role model. It’s just a very special recognition and opportunity.”