Michael X. Repka, MD in Baltimore: Pediatric and Adult Neuro-Ophthalmology

Michael X. Repka is a pediatric and neuro-ophthalmologist on faculty at the Wilmer Ophthalmological Institute at Johns Hopkins, where he also directs the pediatric ophthalmology division. His practice handles conditions that cross pediatric and neurological territories—strabismus, amblyopia, nystagmus, and eye movement disorders in children—as well as complex eye problems in adults tied to nervous system disease.

What Pediatric and Neuro-Ophthalmology Entails

Pediatric ophthalmology addresses eye development, alignment, and vision problems specific to children; neuro-ophthalmology applies eye exams to diagnose and manage neurological disease. When these overlap, patients land with a specialist trained in both. Repka's training and Johns Hopkins affiliation position him to manage cases that would overwhelm a general ophthalmologist: a child with unexplained vision loss tied to a brain lesion, an adult with double vision caused by cranial nerve palsy, or a toddler whose eyes don't track together.

This is not a high-volume, high-turnover practice. Neuro-ophthalmology cases require time to examine, image, and sometimes refer for imaging or neurology consultation. Pediatric cases involving behavioral assessment (how a nonverbal toddler sees) or complex alignment problems add length to appointments.

Services and Referral Pathways

Repka evaluates and manages:

• Strabismus (eye misalignment) in children and, when neurological, in adults.
• Amblyopia (lazy eye) and its correction.
• Nystagmus (involuntary eye movements) and oscillopsia (the sensation of a moving world).
• Eye movement disorders, including those from myasthenia gravis, thyroid disease, or brainstem lesion.
• Vision loss in children when neurological disease is suspected.
• Refractive error in children and its role in strabismus.

Access requires a referral from a primary care physician or another ophthalmologist. Johns Hopkins accepts most major insurances; patients should verify coverage before scheduling. Appointment wait times in pediatric specialties at Johns Hopkins typically run 4 to 12 weeks depending on urgency and season.

Pricing for ophthalmology at Johns Hopkins is not posted online. Out-of-pocket cost depends on your insurance plan, deductible status, and whether the visit is classified as consultation or established-patient care. Contact Johns Hopkins' patient financial services before your first visit to estimate your portion.

How Pediatric Neuro-Ophthalmology Fits into Baltimore's Specialist Landscape

Baltimore has general pediatric ophthalmologists in private practice and at other health systems, and it has neuro-ophthalmology expertise distributed among Johns Hopkins, University of Maryland Medical Center, and Sinai Hospital. Repka's specific credential—a pediatric ophthalmologist with additional training in neuro-ophthalmology and faculty status at an academic institute—creates a narrow specialist pool. Parents of children with complex alignment or neurological vision problems, or adults with eye symptoms tied to systemic neurological disease, will find fewer local alternatives. General pediatric ophthalmologists in the area handle routine strabismus and refractive error; if a case hints at neurological underpinning (unusual nystagmus, progressive vision loss, or eye movement tied to headaches or balance problems), a referral to neuro-ophthalmology becomes necessary. Neuro-ophthalmologists in private practice in Baltimore are limited; the next nearest academic neuro-ophthalmology center is University of Maryland in College Park, where appointments can similarly run weeks.

Who This Fits and Who It Doesn't

Repka's practice suits parents whose child's eye problem hasn't resolved after seeing a general pediatric ophthalmologist, children with nystagmus or complex strabismus, and adults whose eye symptoms (double vision, unexplained vision loss, eye movement problems) point to neurological disease. It suits patients comfortable with academic medical culture, longer appointment slots, and the possibility of being examined by trainees (residents, fellows) under faculty supervision.

It does not suit patients seeking a quick refractive-error exam, a contact-lens fitting, or routine vision screening. It is not the right first step for a child with new glasses-responsive blurred vision; a general pediatric ophthalmologist is faster and appropriate. It does not suit patients who need same-day or next-day care.

What a First Visit Involves

Expect 90 minutes to 2 hours. The appointment will include:

• History from parent or patient about vision onset, eye alignment, light sensitivity, eye movements, and relevant medical or family history.
• Vision testing (age-appropriate for children; Snellen or visual field for adults).
• Pupil and eye-movement examination.
• Dilated fundus exam to assess the optic nerve and retina.
• Often, ocular motility testing using specialized equipment to measure eye alignment and movement precision.
• Discussion of findings and a plan, which may include glasses, patching, surgery, or referral for imaging (MRI, CT) or neurology.

Bring any prior eye exams, imaging reports, and records from your pediatrician or previous ophthalmologist. If your child is non-verbal or very young, the visit will take longer than standard; come prepared to spend the morning.

Hours, Location, and Parking

Michael X. Repka practices at Wilmer Ophthalmological Institute, part of Johns Hopkins Hospital in East Baltimore (601 N. Wolfe Street). Clinic hours run weekdays; specific days and times vary by season and academic calendar. Call 410-955-8342 to schedule or confirm hours, as neuro-ophthalmology clinics are often consolidated to specific days. Parking is available in Johns Hopkins' patient lots (paid); validate at clinic or inquire about validation when you call. Public transit: the MTA's #3 and #13 buses serve the hospital area; the Light Rail stops at Charles Center, a 10-minute walk away.

Wilmer's pediatric neuro-ophthalmology clinic is essential for children and adults whose eye and neurological symptoms intertwine beyond the scope of a general eye exam.