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Subspecialties Comprehensive, Oculoplastics, Health Economics and Policy

It Takes a Village

When most healthcare workers hear the word “ophthalmology,” they quite appropriately think about pathology that occurs in the eye rather than near the eye. A more encompassing metric is to consider the eye an extension of the brain and a critical structure making up the skull base.

To exemplify the need for this critical distinction, consider the following case: a 65-year-old patient was referred to Wills Eye Hospital from Arizona with a 14-month history of progressive facial problems.

His symptoms started with numbness of the right side of his forehead, developing over several months to a facial palsy and double vision. He was eventually sent to us because his right eye had progressively worsening motility.

Multiple MRIs performed locally were read as normal. He was evaluated by the Neuro-Ophthalmology Service and was found to have multiple cranial nerve abnormalities and severe restriction of the movement of the right eye. A detailed past medical history was not contributory. So, what should we do now?

At Wills, we have ophthalmologic sub-specialists that can manage any ocular problem. We’re also extremely fortunate to be affiliated with Thomas Jefferson University Hospital (TJUH) and a group of neurosurgeons, otolaryngologists, neuroradiologists, oncologists, and radiation therapists that are second to none.

Over several decades, I’ve had the privilege of working closely with these professionals and we have established a collaborative skull base team that has managed complex cases from the entire country and abroad.

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About the Author

Jurij R. Bilyk

Attending Surgeon on the Oculoplastic and Orbital Surgery Service at Wills Eye Hospital, and Professor of Ophthalmology at Thomas Jefferson University.

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