18th Annual Meeting Abstracts - 2005
Little Lord Fauntleroy’s Father: Swan Moses Burnett
Daniel M Albert
Swan Moses Burnett (1847-1906), a distinguished ophthalmologist at Georgetown University, introduced the teachings of Donders into the United States. Born into an established family in Tennessee, he married his childhood sweetheart, Frances Hodgson. She became one of the most successful writers of the late 19th century, authoring The Secret Garden and also Little Lord Fauntleroy, for which their son, Vivian Burnett, was the model. Failing in general practice in Knoxville, Swan studied ophthalmology in Paris and London. Returning to Washington, he flourished professionally but his marriage floundered spectacularly and became the focus of gossip columns nationwide. Remembered now only as the spouse of Frances, Swan Burnett deserves better.
Spitfires and Hurricanes
David J Apple
For years many have assumed that Harold Ridley's idea for the IOL was based on his experiences treating injured pilots in World War II. This is a nice story, but is it true? This paper will present newly discovered information to address what actually happened. In addition, a perusal of the documentation now available gives answers to two other longstanding questions related to the cataract-IOL operation: 1) Why was there extreme animosity between Ridley and Sir Stewart Duke-Elder? 2) Why was there an unfortunate delay in widespread acceptance and dissemination of this surgical procedure -- as long as 30 years, thus depriving an entire generation of the benefits of this operation?
Now You See It, Now You Don’t
Since antiquity men and women have stood in awe of the optical phenomena occurring in the heavens. Whether an aurora borealis, a comet, the changing size of the moon or a rainbow, these spectacles have begged for explanations and have led to poems, stories and songs if not superstitions and hopes for a pot of gold. The optical cause of rainbows have elicited explanations from the ancient Greeks, the Bible, Bacon, Descartes, Snell, Kepler and Newton. Here is help in explaining with aplomb to ourselves, our children and our grandchildren just "why" we see a rainbow and an appreciation for the optical nuances and past explanations.
L. Webster Fox
Dr. L. Webster Fox was one of our country's greatest ophthalmologists. He was schooled by some of the finest physicians of his day and immortalized their teachings in his own practice. Upon earning his M.D. in America, he traveled through Europe to harvest the knowledge he hungered for in the field of ophthalmology. Along the way he made friends, and even met the love of his life. Dr. Fox also worked with the Black foot Indians to eradicate trachoma. His enthusiasm and views on ophthalmology and health in general are inspiring and timeless.
Honey: The Pharaoh’s Magic Eye Potion
George M Bohigian
The use of honey for medicinal purposes has taken place since antiquity. This presentation describes the history of the use of honey for treatment of eye diseases in ancient Egypt. Honey’s therapeutic properties, and methods of compounding will be discussed. A brief description of the Edwin Smith papyrus, one of the oldest medical books in the world dating from at least 1700 B.C., will be discussed along with the hieroglyphics system of writing. In spite of advancements in ocular therapy the use of honey for eye diseases continues in the modern world.
The Man Behind the Forceps – N. Bishop Harman
and A Controversial Ophthalmologist - Charles McCormick
Most eye surgeons know the Bishop Harman forceps and find it useful, but usually spell the name wrong. His irrigation cannula can also still be purchased. His double bladed or twin scissors for sclerotomy was the forerunner of a more modern scleral punch. The Harman photometer was used to measure illumination. In a book titled " The Minor Horrors of War" there is a brief contribution from him dealing with body lice. Charles McCormick wrote about "Optical Truths", but wasn't always so truthful. His opinions were grandly expressed in his writings, and he stated that his McCormick Neurological College, in Chicago, was the first non-sectarian Medical School. "No other school teaches what we do, although many imitations have been launched..." He was against vaccination and wrote that the "doctor who advocates it is either an Ignoramus or a Scoundrel".
Filling in Some of the Gaps: The World's Oldest Mirrors II
Jay M Enoch
Prior to use of spectacles, mirrors were employed for refractive corrections and magnification over a long span of years. The Spanish-born Roman citizen, Seneca (the Younger), addresses this issue in his books titled Natural Questions, written about the time of Christ. Last year, I spoke of the World's earliest mirrors; here, I fill in some gaps. A superb color image obtained by utilizing an 8000 year-old Anatolian polished convex mirror is included. Ancient Chavin (Peruvian) anthracite (coal) mirrors are presented, and a later Moché (Peruvian) copper mirror frame. The first depiction of spectacles is in frescos by Tomaso da Modena at Treviso, Italy, in ca 1352 AD, but sometimes overlooked are two mirror arrangements already in general use(!), as well as a lens magnifier.
Edgar Derry Tillyer: The Man and His Career
Gerald A Fishman
The name Edgar Tillyer does not engender immediate name recognition in most ophthalmic circles. Nevertheless, this innovative man devised and improved upon many devices which had a major impact on ophthalmic practice as well as in other venues. These included, among others, inventions such as a retinoscope, the Calobar lens, a lensometer, phoropter, trial set lenses, and the Polaroid lens (CoolRay) for eyeglasses. The number of idiosyncrasies almost paralleled the number of his inventions. He left a legacy of accomplishments for which we are all the beneficiaries.
The Rise and Fall of Coal Miners' Nystagmus
Ronald S Fishman
CMN became one of the first occupational diseases recognized as a direct result of exposure to a hazardous working environment. CMN became a significant financial problem in particular for the British compensation program, and the British medical literature became a forum of speculation as to the etiology of the condition. British physicians were adamant in denying malingering in all but rare cases. Although new cases of CMN became rare after World War II, it continued to be discussed in the literature through the 1970’s, after which it abruptly disappeared from textbooks and journals without any authoritative summing-up. What was going on here?
The Gonin Medal - The Nobel Prize of Ophthalmology
Jay M Galst
Of all award medals in ophthalmology, there is no other medal as prestigious as the Gonin Medal. It is awarded only every four years by the International Council of Ophthalmology to the ophthalmologist, who in its opinion, has done the most for the specialty of ophthalmology. This award was established to honor the memory of Jules Gonin, known as the father of retinal detachment surgery. A brief biography of Gonin will be presented, along with a note about each of the recipients to date.
Argyrol and Dr. Barnes
John W Gittinger, Jr
Albert C. Barnes (1872-1951) graduated from the University of Pensylvania Medical School, but never practiced medicine. Instead he marketed Argyrol, a colloidal silver eye drop still available, and made a fortune. Childless, he spent most of his fortune collecting modern art. The effectiveness of both Argyrol and of the Barnes Foundation in accomplishing their stated purposes has been the subject of continuing controversy.
Charles Bonnet Syndrome
Thomas R Hedges, Jr
The Charles Bonnet Syndrome, a syndrome of formed visual hallucinations, was described by Charles Bonnet (1720-1792) of Geneva Switzerland in 1759. This presentation details the life and contributions of this noteworthy naturalist and philosopher who contributed the first scientific observation of an important clinical phenomena in neuro-ophthalmology. Discussion of Bonnet's life and times demonstrates his scientific interest and how he observed a single case, that of his Grandfather, in order to achieve this discovery. His investigation of this not uncommon visual phenomena illustrates how early ophthalmological findings and syndromes were discovered and described.
Early Use of Contact Lenses for Keratoconus Treatment in the USA
Robert F Heitz
Interest in contact lens treatment of keratoconus began in October 1928, when Donald Hunter O’Rourke of Denver and Robert Von der Heydt of Chicago, almost simultaneously described the successful fitting of keratoconus patients. In the following months, George S Derby and Dewey Katz, both of Chicago, described several cases of patients with bilateral keratoconus who could wear “contact glasses”. In the years that followed, these successes encouraged other ophthalmologists to try keratoconus correction. Until the mid 1930s, the use of contact lenses was limited to the correction of severe keratoconus only and it already had a reputation for producing regression of this disease.
The Eye Disease of Jefferson Davis (1808-1889)
Confederate States President 1861-1865
Richard W Hertle and Bobby Spellman
The only Confederate President Jefferson Davis led a long and eventful life. He was a Mississippi planter, a husband, a father, West Point graduate, war hero, Congressman, Senator, Secretary of War, and finally President of the Confederate States of America. He was a study of contrast with northern counterpart, Abraham Lincoln. Davis was a rich, educated, war hero who did not understand the political process or have the personal skills to work with others. Davis' health was a constant problem. In the winter of 1858 he became so seriously run down that he “caught cold” which “went into laryngitis then neuralgia of left side of face and badly inflamed his left eye.” “He lay for weeks in a darkened room unable to speak or see with the pupil of his left eye actually so painfully swollen that his own doctor thought it would burst.” This paper will propose a discrete differential diagnosis of his ocular condition.
History of Concepts of Extraocular Muscles Function
Robert S Jampel
The functions of individual skeletal muscles of the limbs, torso and head are predictable from their origins and insertions. These muscles are encased in connective sheaths, exist in compartments and do not side-slip. Their rotational axes are fixed for any given movement. But, there is still no consensus concerning the functions of the EOMs and the location of their rotational axes. I will trace concepts of EOM function from al-Kindi (?800-866 AD) to the present active pulley hypothesis of Demer and Miller. I will include the concepts of Willis (1621-1675), Porterfield (18th Century) Helmholtz(1821-1894), and Donders (1818-1889) et al. I will show a brief video of the micromovements of the eye.
Exploring the Fundus: a 19th century view
Early users of the ophthalmoscope not only had to master a new optical instrument but had to contend with indifferent illumination. They also had to learn from scratch how to differentiate between the normal fundus and a diseased one. For teaching the fundus various types of ophthalmoscope were used including demonstration, auto, and second observer ones. Books, artificial eyes and fundus atlases also played a role. Liebreich's use of a Camera Lucida for his drawings may well explain the accuracy of his 1863 atlas. Early attempts at fundus photography produced nothing that could be used for teaching in the 19th century.
Pathology and Pathologists in Neuro Ophthalmology
David L Knox
This presentation will include a brief history of pathology. Personalities and evolving ideas will be illuminated by describing different pathologists, their thoughts and contributions. Glaucoma, optic nerve ischemia optic nerve pits and diabetic papillopathy will be featured
The Historical Development of the Diagnosis of Cyclovertical Muscle Palsies
After the existence of extra ocular muscles in humans was confirmed it would be many centuries before the exact number was determined. It was then necessary to study the nerve supply and finally the actions of these muscles. Then some confusion occurred as to which muscle was weak. Within short period of time both Alfred Bielschowsky and Francis Adler unraveled the mystery and allowed the development of the three steps which today are used to confirm the diagnosis.
Arnold Sorsby, MD – 20th-Century Clinician-Scientist
Sayoko E Moroi and Soojie Yu
Arnold Sorsby (1900-1980), son of Jacob Sourasky and Elka Slomiansky, was a twentieth-century clinician-scientist with diverse expertise in infectious disease, epidemiology, refractive errors, and genetics. Born in Poland, he completed his education at Leeds University (1928), and became a naturalized British citizen in 1929. He married Charmaine V. Guiness in 1943. His career spanned four decades with appointments ranging from medical school dean (1934-38), editor of Journal of Medical Genetics (1964-70), and expert advisory panel on trachoma for the World Health Organization (1954-69). The impact of his studies on our current early 21st-century ophthalmology will be discussed.
Homonymous Hemianopsia: The Localizing Value of Incongruity
Steven A Newman and Valerie Biousse
One of the earliest and most critical localizing intracranial signs has been the presence of visual field defects, and certain rules have become part of the mantra of perimetry education. One of the prominent ones was the concept that homonymous hemianopsias involving the occipital lobe produced congruous homonymous defects while lesions affecting the more anterior pathways (radiations, geniculate, and tract) produced incongruous defects. Trying to trace the origin of this critical “rule” in analyzing visual fields turns out to be much more complicated than we might expect. Strong opinions were expressed and the publication of localizing concepts within a frequently used text probably underlay the classical assumption present for the last half century. Review of the history of perimetry from Hirshberg and Cushing through Traquair, Lyle, Kestenbaum, Walsh and Harrington suggest this rule may be more variable than previously expressed.
The Cogan Society Website
Patrick J Saine
We will share the new version of the Cogan Ophthalmic Historical Society Web Page. The goals of this World Wide Web site include guiding members to other relevant Web locations as well as archiving and transmitting historical facts and events relating to the COHS specifically and Ophthalmic History in general. We feel that embracing this new communication technology will improve our ability to pursue our history together. We will pose questions relevant to this Society’s use of this medium.
Paul A. Cox, M.D. Historic Historian
Joseph W Sassani
Until his death at the age of 95 on October 16, 2003, Paul A. Cox, M.D. was a vital member of the Central Pennsylvania medical community. Dr. Cox was many things to many people; including Past-President and former Legislative Chairman of the Pennsylvania Academy of Ophthalmology and Otolaryngology. Most importantly, he was known and respected for his incredible, patience, kindness, and generosity. During his 69 year medical career, Dr. Cox demonstrated excellence in the areas of Family Medicine, Obstetrics and Gynecology, Otolaryngology and Ophthalmology. He wrote the “History of the Pennsylvania Academy of Ophthalmology and Laryngology 1943 – 1990”. He embodied the best qualities of the medical profession.
When the Cure is Worse than the Disease: A Brief History of Ocular Immunopathology
Arthur M Silverstein
Between 1880 and 1900, Louis Pasteur, Ilya Metchnikoff, Emil Behring, and Paul Ehrlich showed that a set of protective mechanisms had evolved to defend against dangerous pathogens and toxins -- the adaptive immune response. Shortly thereafter workers in the field were perplexed to learn that this same response could be mounted against benign substances, causing anaphylaxis, hay fever and asthma, and even autoimmune diseases. Ophthalmic researchers played an important part in developing an understanding of these processes, while defining the pathogenesis of a variety of ocular inflammatory diseases.
The Influence of Phacoemulsification on IOL's and Vice Versa
Robert M Sinskey
Phacoemulsification, in my opinion, was the most dramatic invention in cataract surgery in the past century. The ups and downs of phaco and the influence of phaco and intraocular lenses and visa versa will be discussed.
Jorge Luis Borges: A Man of Metaphors and Myopia
Pamela C Sieving and Johnny Tang
Jorge Luis Borges (August 24, 1899 June 14, 1986) was one of Latin America's most original and influential writers. Despite suffering from progressive visual loss, his imaginative work sparked a generation of devotees to his art. Blindness and visual loss became central themes in both his creative writing and in his references to himself. What can ophthalmology learn from his illness and his integration of it into his life and writing?
Otto Lowenstein, Persistent Pupillographer
H Stanley Thompson
Otto Lowenstein was a German-trained academic neuropsychiatrist with an interest in experimental psychology. While still in Bonn he worked hard at recording and understanding pupillary movements. In 1933 he fled the Nazis and continued to take motion pictures of the pupils in Switzerland. From 1939 to 1964 he lived and worked in New York. During these 25 years Irene Loewenfeld was his assistant and then colleague.They published many papers together, introducing pupillography in America and encouraging the clinical use of pupillary signs. I had the good fortune to work in their lab in 1962.
History of Vitrectomy Surgery by Robert Machemer
Cynthia A Toth
Advances in surgery often arise from novel insights in anatomy and physiology and with the aid of pharmacology or technology to exploit such insights. The first pars plana vitrectomy, performed in 1970 by Robert Machemer, was a delightful example. From his research experience in the owl monkey eye, Machemer recognized the pars plana was an alternate entry site for vitrectomy surgery, an advance over the open sky maneuver. His development of inflow and outflow technology, with means to cut the vitreous, started from simple drill bits and benefited from numerous permutations. This talk will review 20 years of vitreoretinal surgical advances introduced by Robert Machemer.
The Diversion Club
In the 1920s and 1930s the American Academy of Ophthalmology and Otolaryngology was a relatively small, national medical society composed of ophthalmologists, otolaryngologists and some who combined both specialties. The membership totaled less that 2000 and because of its size many of the members developed close friendships. Often, at the time of the annual meeting, some of the members and officers of the Academy took advantage of the opportunity and enjoyed a game of golf. These games grew into an annual tournament and an Academy Golf Club was formed which was eventually administered by the Academy offices. This unique golf club grew in membership and was given a name, The Diversion Club, which was active until the late 1970s.