At The Bedside: Comprehensive eye exam at UTHealth Houston reveals life-threatening brain tumor

Last summer, 50-year-old Verna Blackwell of Houston was experiencing vision distortion and having repeated episodes of blacking out. Her symptoms interfered with her job at a car dealership, where she was tasked with driving vehicles around the lot.

“It was scary to get behind the wheel of a car. Seeing black dots, and at times, complete blackness, wasn’t just disruptive; it was frightening,” Blackwell said.

Blackwell made an appointment with a local optical chain. The doctor there told her she most likely just needed new glasses. Trusting her intuition, she chose to seek a second opinion.

Soon after, Blackwell’s son, concerned for his mom’s safety, took Blackwell to see Arnoldo Treviño, OD, an optometrist in the Ruiz Department of Ophthalmology and Visual Science at McGovern Medical School at UTHealth Houston.

“When Verna told me that she was blacking out, it was a red flag that her condition was most likely something beyond a vision issue and probably neurological in nature,” Treviño said.

A comprehensive eye exam revealed that Blackwell’s optic nerves were extremely swollen. Treviño immediately referred Blackwell to the emergency room so she could get an MRI. The MRI showed a massive meningioma, a tumor that grows on the meninges, the membranes that surround the brain and spinal cord.

The meningioma was exerting pressure on Blackwell’s optic chiasm, an X-shaped brain structure where optic nerves from the eyes cross over. This crossing allows visual information to be transmitted from both areas to the appropriate regions of the brain for processing, ultimately enabling binocular vision.

The meningioma was also causing brain herniation, a serious medical condition where the brain tissue is pushed out of its normal position inside the skull due to increased pressure.

As with most meningiomas, Blackwell’s was benign. However, not having it removed would mean it would continue to exert pressure on her brain. Eventually, she could lose her vision completely, as well as her ability to walk and speak.

A few days after the diagnosis, Spiros Blackburn, MD, associate professor in the Vivian L. Smith Department of Neurosurgery at McGovern Medical School, operated on Blackwell for eight hours to remove the tumor.

“Meningiomas are quite common. But Verna’s case is atypical because the tumor was so large,” Blackburn said. “The pressure from the tumor was so high that it was causing her brain to shift, in turn impacting her vision.”

Thankfully for Blackwell, no radiation was needed; however, she will need to undergo follow-up MRIs over the coming years to ensure no regrowth.

“Recovery after surgery took time, but each day brought progress,” she said. “At first, I needed a cane to walk, and my vision was blurry, especially in my left eye, where the tumor had been pressing on my brain. But I’ve noticed gradual improvement over time, which gives me hope.”

Treviño and the rest of her care team collaborate closely with Blackburn to ensure she can continue her daily activities and maintain as much independence as possible. In addition to regular appointments with Treviño, Blackwell is also doing occupational therapy so that she can carry on with her daily routine.

“Verna’s story should serve as a reminder that a thorough eye exam can uncover life-threatening conditions. Something you might think is related to vision could be something much more serious,” Treviño said.

Thanks to the UTHealth Houston team, Blackwell can plan to start a new chapter of her life as she prepares to move to Idaho to be closer to family.

“I’m so grateful to Drs. Treviño and Blackburn for properly diagnosing and treating the root cause of my issues,” Blackwell said. “Because of them, I can look forward to the future with clearer vision and begin living life again.”