25th Annual Meeting Abstracts - 2012
Hjalmar August Schiötz: His Life and Recently Rediscovered Ophthalmoscope
Daniel M. Albert, M.D., and Richard Keeler
Introduction or Purpose: We recently encountered an intriguing and largely incomplete Norwegian-made ophthalmoscope. Our quest to identify and restore it led us to reevaluate its place in the evolution of the modern day ophthalmoscope and also to reexamine the life and contributions of its inventor, the Norwegian ophthalmologist Hjalmar August Schiötz. Both the instrument and the man deserve to be better known.
Historical Approach, Methods, or Resources: Restoring the ophthalmoscope required finding and studying its original design and description. Schiötz's published papers and obituaries provided knowledge of his life.
Results or Summary of Paper: Although most ophthalmologists worldwide know about the Schiötz tonometer, other contributions and inventions by Schiötz have been largely forgotten outside of Norway. Most standard sources do not include his biography. Born in 1850, Schiötz received his medical education at the University of Oslo and subsequently studied with Arlt and then under Javal at the Sorbonne ophthalmological laboratory, becoming Directeur adjoint. He became head of a surgical section at the Government Hospital and later head of the Surgical Polyclinic, gaining great skill in ophthalmic and plastic surgery. He was named the first Norwegian professor of ophthalmology in 1901.
A gifted craftsman, Schiötz built a home workshop and there fashioned the prototype models of his inventions, including a self-registering perimeter, his famous tonometer, a lantern for testing color vision, and his ophthalmoscope. His contemporaries stated that with his keen intelligence, Schiötz could "absorb German thoroughness together with Gallic dexterity of thought." With Javal he designed the ophthalmometer for which Schiötz contributed most of the required mathematical calculations. Although the instrument bore both men's names, nearly everyone remembers it as the Javal ophthalmometer.
An austere, sensitive individual haunted by depression, Schiötz despised showmanship and publicity. Although he had limited interactions with international colleagues, his students and patients warmly regarded him, and he was an admired public figure in Norway. He remained professionally active until his death in 1927.
Searching journals, books, and instrument catalogues for an ophthalmoscope designed by Schiötz was unsuccessful. However, the engraved name of "A. Krogh" found on the incomplete instrument sample turned the search to Norway where it was confirmed by the present Krogh family of opticians that they made an instrument for Schiötz in the early 1880s.
The sample was found in the Technical Museum in Oslo and photographs taken. More importantly, details of the ophthalmoscope were found in a book on his life written in Norwegian by Schiötz himself. This established that Schiötz had introduced his design in 1882 claiming some original features. Studying photographs taken at the museum, reconstruction of the incomplete sample was undertaken by a skilled engineer using spare mirrors from contemporary instruments.
This paper will highlight the original features of Schiötz's ophthalmoscope and place it in the context of other instruments of that period.
Summary or Conclusions: Schiötz played a major role in modern ophthalmic history as the specialty evolved from its 19th century beginnings to 20th century modernity. Like his better-known tonometer, ophthalmometer, and perimeter, Schiötz and his ophthalmoscope, described here, are worthy of notice.
Emily Dickinson’s Ophthalmic Consultation With Henry Willard Williams, M.D.
Donald Blanchard, M.D.
Introduction or Purpose: Emily Dickinson is one of America ’s premier poets of the 19th century. Dr. Williams was one of the very first physicians to limit his practice to ophthalmology and was the established leader in his field in Boston . They met when Emily consulted him about a now obscure ophthalmic disorder. Photophobia and a restriction in her ability to work up close were her main symptoms. Iritis, exotropia, or an inverted Oedipus complex are the most frequent diagnoses offered to explain her difficulties. Rather than attempt a definitive conclusion, this paper will offer an additional possibility which Dr. Williams likely considered. That is “Hysterical Hyperesthesia of the Retina”. This was a common diagnosis at that time and stood in good regard along with vapours and neurasthenia.
Historical Approach, Methods, or Resources: The main sources for this investigation are works by Emily Dickinson, especially her letters, and Dr. Williams’ various textbooks. Biographies and vignettes by her relatives and associates were given special consideration too.
Results or Summary of Paper: Hysterical Hyperesthesia was felt to be a disease with few objective signs on examination. Symptoms were extreme photophobia, eye ache, persistence of retinal images, and difficulty with focusing up close. He presented “a masterly inactivity” and recommended a general diet, exercise, and a gradual reintroduction of light exposure along with his optimistic predictions of full recovery. This corresponds to the limited information about her course that we have. Emily’s symptoms began in 1863 and occasioned two prolonged stays in Boston for consultation in 1864 and 1865. In place of a follow up in 1866, she stayed home because her father was “in the habit of me”. In later reports her vision was normal and her symptoms basically resolved.
Summary or Conclusions: No records from Dr. Williams’ treatment of Emily Dickinson are known to exist. There is no documentation of a diagnosis in her lifetime. Her reported symptoms were extreme but vague and incomplete. Comments by people who knew her at the time were mostly sympathetic rather than informative. With that in mind no conclusion about her condition is being offered but from what we know, it is likely that Hysterical Hyperesthesia was considered in Dr. Williams’ differential diagnosis.
Paul A. Cibis, Pioneer of Modern Vitreo-Retinal Surgery. Part 2, Contribution to Vitreous Surgery
Christopher F. Blodi, M.D.
Introduction: Fifty years ago Paul Cibis, M.D., introduced the use of silicone oil and various intraocular instruments as methods for curing vitreo-retinal conditions felt to be virtually irreparable. Retinal detachments caused by giant retinal tears, proliferative vitreoretinopathy and vitreous hemorrhage were among these diseases.
Resources: Oral and written communications with primary participants. Review of primary and secondary written sources.
Results: By using intraocular silicone oil and innovative new instruments, Paul Cibis was able to repair certain heretofore virtually incurable conditions. After Cibis’ death further advances including John Scott’s surgical techniques in the United Kingdom and the introduction of pars plana vitrectomy allowed additional progress to be made in treating severe vitreo-retinal diseases.
Conclusion: Paul Cibis ushered in a new era of vitreo-retinal surgery using silicone oil and intraocular instruments in an attempt to repair severely detached retinas and other seemingly inoperable conditions.
To Trick the Eye: A Short History of a Famous Magical Optical Illusion: The Sphinx Head
George M. Bohigian, M.D.
Introduction or Purpose: Optical illusions are the mainstay of magic.
Historical Approach or Resources: References from magic books, and interviews with magicians.
Body of Paper: The psychologist William James said, “Part of what we perceive comes through our senses and the object before us, another part ‘which may be the great larger part’ always comes from out of our own mind.” Optical illusions are the mainstay of magic. The famous optical illusion of the talking Sphinx head without a body on a plain table is an example of one of the most famous optical illusions in history. This particular trick is based on properties of physics, optics, and more important the mind- eye connection. This famous trick from the 1800’s has now developed into large stage illusions such as the elephant in the cage which instantaneously changes into a beautiful woman before your “eyes”. The term “smoke and mirrors” will be explained.
Summary or Conclusions: History of famous magic tricks based on preconceived notion of the mind playing tricks on the eye. One such magic trick is performed with mirrors and has become a foundation of many of the magic acts of the 19th and 20th century.
The Final Days of the Armed Forces Institute of Pathology (AFIP)
J. Douglas Cameron, M.D.
Purpose: The AFIP closed on May 31, 2011. Many thought that closure was impossible given the standing and contributions of the Institute. The purpose of this paper is to describe some of the factors leading to closure based on personal observation as the last Chief of the Ophthalmic Pathology Division and on extensive interviews with key participants active during the past two decades.
Introduction: The predecessor of the AFIP, the Army Medical Museum (AMM), was founded in 1862 during the American Civil War for multiple purposes including analysis of medical specimens obtained at the time of war. The goal was to improve the effectiveness of military medicine. Beginning with the Registry of Ophthalmic Pathology in 1921 the mission of the AMM was broadened to include clinical research and collaboration was established with non-military pathologists. The model was extremely successful for approximately 60 years. The “disestablishment” process began with subtle changes in culture, administration, professional parity and financial climate.
Significant Factors: Military and civilian medical cultures have traditionally represented extremely different points of view. However, those differences were secondary to the combined culture at the AMM/AFIP in the early 20th century because of the rapid technical and professional development of pathology. The military was willing to provide financial support from Department of Defense funds. Everyone benefited from the arrangement. With the establishment of professional parity of AFIP pathologists with University Departments of Pathology and with private sector pathology the use of military funds to support civilian roles was questioned. Also, pathologists trained at the AFIP and civilian pathologists in general did not want to have to complete with a free, government sponsored, consultation service.
Attempts to develop business models which would allow sufficient financial support to continue the mission of the AFIP independent of government funding were not successful.
The process of closure was accomplished by applying the provisions of the Base Realignment and Closure Act (BRAC) to the Walter Reed Army Medical Center in 2005. The AFIP happened to be on that campus. Two of the three divisions of the AFIP were preserved: The Registry (slides and blocks) and National Museum of Health and Medicine. The civilian consultation sector of the AFIP was not preserved. The pathologists forming the core of the Consultation Service of the AFIP dispersed during 2007 to 2011. All medical equipment at the AFIP was transferred to other medical facilities, sold, or discarded. The majority of the books in the AFIP library were discarded. Some ophthalmic artifacts were transferred to the Smithsonian. A 20-pathologist consultation service (Joint Pathology Center) was established for military and Veteran Administration specimens.
Conclusions: The AFIP was extremely successful in meeting the demands of a specific medical market. It is not known if this medical market continues to exist or will return in the future making reformulation something like the AFIP necessary.
Ten Chairmen of the Ophthalmology Department at Peking Union Medical College (PUMC)
Chi-Chao Chan, M.D., and Daniel Ardeljan, M.D.
Introduction or Purpose: Peking Union Medical College (PUMC), founded by the China Medical Board in New York under the Rockefeller Foundation in 1921, is among the most selective medical colleges in China and the only medical school affiliated with the Chinese Academy of Medical Sciences. It is the most important medical institution in China and is directly managed by the Ministry of Health. Under the leadership of 10 Chairs from PUMC’s founding to the present day, the Ophthalmology Department has played an important role in training ophthalmologists, treating difficult ocular diseases and conducting ophthalmic research in China and the world. This presentation discusses the 10 Chairmen and their contributions.
Historical Approach, Methods, or Resources: Google search, PubMed search, PUMC visit in 12/2011
Results or Summary of Paper: Ten nationally and internationally renowned ophthalmologists comprise the list of the ten Chairmen of the PUMC Ophthalmology Department: Harvey Howard (1918-1927), Arnold Pillat (1928-1930, 1931-1933), Ludwig von Sallmann (1930-1931), Peter Kronfeld (1933-1939), Zongxian Luo (1948-1974), Zheng Hu (1974-1983), Chengfen Zhang (1983-1990), Weiye Li (1990-1999), Fangtianon Dong (1999-2002, 2005-present) and Jialiang Zhao (2002-2005). Prior to his time at PUMC, Harvey Howard (1880-1956), had been the EENT (Ophthalmology) Head (1910-1913) at Boji Medical School, the first Western medical school in China. After his time at PUMC, he became the first chairman (1927-1933) of the Ophthalmology Department at the Washington University School of Medicine in St. Louis. During his time at PUMC, he was the ophthalmologist (1921-1925) of Pu Yi, the last emperor of the Qing dynasty and was even kidnapped by Manchurian bandits and held captive for 10 weeks in 1926. Arnold Pillat (1891-1975), Ludwig von Sallmann (1892-1975) and Peter Kronfeld (1924-1980) were all Austrian-born Ophthalmologists educated in Vienna. During their careers, they made substantial contributions to the field of cornea, retina and experimental cataract, and glaucoma. Dr. Pillat eventually became the Director of the Graz Clinic (the First Eye Clinic of Vienna), Dr. von Sallmann the Chief of the Ophthalmology Branch of the National Institute of Neurological Diseases and Blindness, and Dr. Kronfeld the Head of Ophthalmology at the University of Illinois College of Medicine/University of Illinois Eye and Ear Infirmary. Zongxian Luo (1905-1974), a 1932 PUMC graduate who completed post-doctoral training at Harvard and Wilmer in 1940-1941, became the Vice President of the Chinese Ophthalmological Society (COS) in 1950 and the founder of journal Fundus Disease in China. Zheng Hu (1915-2003), who specialized in epidemiology and glaucoma, was the Chief editor and Associated Editor of the Chinese Journal of Ophthalmology (CJO) and the Chinese representative of the International Agency for Prevention of Blindness. Chengfen Zhang (1925- ), an expert in medical retina was an Associated Editor of CJO and named among the “Famous Physicians of PUMC”. Weiye Li (1946- ) is a Professor of Ophthalmology and director of both Ophthalmic Research and Retina Services at the Drexel University College of Medicine. He was the first Chinese investigator who received an R01 grant from the NEI. Jialiang Zhao (1944- ), a 1970 PUMC graduate who has since focused his research on epidemiology and glaucoma, was the President of COS (1999-2007) and a member of Academia Ophthalmologica Internationalis. With his effort, COS was finally accepted as a member by the International Federation of Ophthalmological Societies (IFOS) in 2004 and by the Asia Pacific Academy of Ophthalmology (APAO) in 2005. Fangtian Dong (1951- ), a vitreoretinal surgeon, did his post-doctoral training at Hong Kong Chinese University (1987-1988), Schepen (1992) and Washington University in St. Louis (1995-1996). In 1996, he successfully performed the first human embryo retinal pigment epithelium (RPE) transplantation in a patient with retinitis pigmentosa.
Summary or Conclusions: The 10 chairmen of PUMC are distinguished ophthalmologists and are responsible upholding the PUMC motto: “strict assiduousness, advancement, diligence and devotion.” Under their leadership, the Ophthalmology Department at PUMC, although small, has maintained its prestigious historical background and continues to do so, playing an important role in Chinese and world Ophthalmology.
Western Ophthalmologists and the PUMC (Peking Union Medical College) Connection
Ira Eliasoph, M.D., FACS
Peking Union Medical College is unique as an institution. There was a special connection there with Western ophthalmologists, although there had been an earlier Western ophthalmologist’s eye hospital in China. The Rockefeller Foundation through its China Medical Board, planned and built the campus in central Peking. The official opening, in1921, was a week-long celebration attended by notable people from near and far. The city name varied from Peking to Peiping to the current Beijing. The archeologists find of the “Peking Man” was studied at the college, and the state funeral of the great Chinese leader, (who had a medical degree), Sun Yat-sen, was held there (where he had died after a long struggle with cancer). I first knew about PUMC, in 1951, from Doctor Isadore Snapper, then Chief of Medicine at Mount Sinai Hospital, who had been Chief of Medicine there for close to a decade. His small book, ”Chinese Lessons to Western Medicine” is a gem. Connections to PUMC of the following will be presented: I. Snapper, Tsai Fan Yu, H. Howard, G. deSchweinitz, E Fuchs, A. Fuchs, P.Soudakoff, I. John, R. Daniel, and P. Kronfeld.
New York Academy of Medicine Library, Arlene Shaner, Archivist
Mount Sinai Hospital Library, Barbara Niss, Archivist
Rockefeller Foundation Archives, Monica Blank, Archivist
Benjamin Eliasoph, M.D., personal files
William Cain Ruffin, M.D. (and Some History of the Ruffin Family as It Pertains to the American Civil War)
Jay M. Enoch, Ph.D., Dr(s). Sci. (h.c.)
In the late 1970s, Prof. Herbert ("Herb") Kaufman, M.D., a fine ophthalmologist who had both developed and chaired the Department of Ophthalmology, College of Medicine, University of Florida, Gainesville, FL., chose to resign his appointment there. Prof. Kaufman had then accepted the Chair in Ophthalmology at Louisiana State U. in New Orleans. The writer was a member of the Department of Ophthalmology faculty in Gainesville, FL, at that time.
Following Herb Kaufman's resignation, Professor William C. Ruffin, M.D., a psychiatrist with academic credentials, was assigned to serve as the Interim Chairman of the Department of Ophthalmology at Gainesville for a few years by the then Dean of the Medical School at the U. Florida. Prof. / Dr. Ruffin managed to perform this none-to-easy role with some skill! So saying, during that extended time period, almost all faculty members in the then Department of Ophthalmology chose to leave Gainesville (including the writer). It was a period of great uncertainty. A successor to Prof. Kaufman was sought, and, finally, after a period of some time, an established senior ophthalmologist at the University of Florida at Gainesville, Prof. Melvin Rubin, was selected to replace Prof. Herbert Kaufman as Chairman. This paper addresses some interesting facts regarding Prof./Dr. Ruffin and his family history, particularly as that history relates to "The Civil War," or, as our Southern friends would term it, "The War Between the States."
Paul A. Cibis, Pioneer of Modern Vitreo-Retinal Surgery, Part 1, Biography
Robert M. Feibel, M.D.
Purpose: To review the life of one of the founders of modern vitreo-retinal surgery.
Historical Resources: This is the first biography of Cibis (1911-1965) based on primary documents and materials in the possession of his family and the reminiscences of many of his colleagues. The relevant primary and secondary ophthalmologic literature has also been reviewed.
Results: Cibis’ major ophthalmologic contribution was the intravitreal approach to treat complex retinal detachments, and his development of liquid silicone injection into the vitreous has stood the test of time. However, his contributions to vitreo-retinal surgery only occupied the last ten years (1955-1965) of his tragically short life. During the fifteen years (1940-1955) prior to his practice of retinal surgery, he made contributions to the physiology of color vision, local retinal adaptation, physiologic optics, the effect of ionizing radiation and atomic energy on the eye, and the pathologic effects of iron upon the globe. Some of his research on local retinal adaptation was instrumental in the later development of static visual perimetry. The importance of his basic research was recognized by the award of the von Graefe Prize from the German Ophthalmological Society in 1949.
Summary: The life and remarkable basic clinical research of Cibis is presented as a prelude to a second paper discussing his contributions to vitreo-retinal surgery.
Joseph Priestley's Book on Optics
Ronald Fishman, M.D.
Purpose: To briefly recall Priestley's eventful life and to evaluate his only foray into optics.
Summary and Conclusion: Priestley is usually recognized in the history of science as the co-discoverer of oxygen, but in 1772 he also published The History and Present State of Discoveries Relating to Vision, Light, and Colours. This was a serious 812 page treatise with index and attachments of many fold-out optical diagrams. It was probably intended as the first in a series of monographs encompassing the whole range of science, and to secure him some financial stability in an era when outside of academia there was no livelihood for a self-supporting scientist. The book can be taken as a fair survey of what was known in the field at the time.
Resources and Methods: The main references are:
Priestley, J: The History and Present State, etc. of 1772. Facsimile edition by Krause Reprint Co. Milwood, NY. 1978
Cantor, G: Optics after Newton. Theories of Light in Britain and Ireland, 1704-1840. Manchester University Press. 1983
Johnson, S: The Invention of Air. A Story of Science, Faith, Revolution and the Birth of America. Riverhead Books. New York. 2008
Keeping Things in Focus: A Brief History of Objective Refraction
Edmond J. FitzGibbon, M.D.
Introduction or Purpose: A brief review of objective refractive methods - from the 19th century invention of retinoscopy to iPhone apps.
Historical Approach or Resources: Primary sources, textbooks and medical literature, internet search.
Body of Paper: In 1859 Sir WIlliam Bowman noted that a candle-lit ophthalmoscope created a linear shadow when viewing an astigmatic eye. This developed into the "shadow test" which was later termed retinoscopy. Since that time there have been several refinements by Copeland and others in the retinoscope. Automation of refraction was developed by Guyton and other inventors using principles of retinoscopy, image quality analysis, or the Scheiner double pin hole refraction (The latter dates back to the 16th century). Developments in astronomy led to wavefront analysis and adaptive optics by deformable mirrors. Ophthalmology adapted this technology (aberrometry) to imaging individual rods and cones and correcting higher-order ocular distortions with lasik and aspheric intraocular lenses. Recently an iPhone app (netra) has been developed that uses inverse wavefront analysis to determine refraction.
Summary or Conclusions: We have come a long way in objective refraction from the first use of retinoscopy to sophisticated wave front analysis. Skillful non-automated retinoscopy is still a useful clinical technique and can give information unobtainable by other methods, especially in detecting irregular astigmatism.
The First Female Medical Students
Albert Franceschetti, M.D.
Introduction: The problem of the feminisation of medicine in Europe is a major one, as the social system and medical studies in particular do not take into account the fact that the majority of medical students nowadays are females. Women doctors face a very practical problem in that they have to take care both of their profession and of their family. They usually delay having children.
The purpose of this study is to review how it all began, in Zurich, in the second half of the 19th century. From there, we should be able to recommend changes in the Swiss medical studies so as to make it easier for our female colleagues to practice their profession and not eventually abandon it as most of them do. Ophthalmology was the first specialty after pediatrics, obstetrics and gynecology.
Historical Approach: The paper summarizes the lives of the first medical students and reveals the big difficulties they had to overcome to obtain recognition. Previous known papers on the subject were reviewed as well as the few new books that have appeared on some of these students. Data and pictures were found for nearly all them.
The Emperors of the time—Queen Victoria, Napoleon III and the Tsar of Russia—all showed a very modern attitude towards female students.
Conclusion: The extraordinary personalities of these women have set in motion a trend that has resulted in the most important change in modern medicine: the taking over of the profession by women. Therefore, if we can solve the very practical problems women doctors have to face, we shall have a high-quality medicine, all the more so as female students are usually highly motivated and less prone to be influenced by the business approach that we deprecate in some of our male colleagues.
The Blinding of King Zaleukos of Lokri on a 16th Century German Medal
Jay M. Galst, M.D.
Introduction or Purpose: To discuss the history, myth and symbolism of the blinding of King Zaleukos, and the reason for the production of this medal.
Historical Approach, Methods, or Resources: Review of historical, art & numismatic references; including early 20th c. European numismatic auction catalogues in the ANS library; the 1947 Art Bulletin; works of art at the Metropolitan Museum of Art, the Louvre, and Yale University; and On-line resources.
Results or Summary of Paper: King Zaleukos (c. 650 BCE) was known as one of the earliest Greek lawgivers, known for his severe, unalterable legislation. Among his laws he ordered that adulterers be punished with blinding. When his son was caught in flagranti, Zaleukos demanded that his son suffer the consequences. He ceded to the protests of his fellow citizens in so far that he ordered only one eye of his son to be enucleated, but insisted that one of his own eyes be removed to give the law the two eyes that it required. In 15th – 16th century central Europe, art representing Justice, often graphic examples from ancient times, were hung in court rooms and town halls. Thereby the lofty principles of law and justice were brought to the attention of the public in a most dramatic manner. Medallic art was also used to disseminate these ideas and ideals.
Summary or Conclusions: The Blinding of King Zaleukos on a 16th century medal was used as a graphic example to illustrate the lofty principles of law and justice to the public of that era.
Newton (Uyesugi) Wesley: Contact Lens Pioneer and Advocate
Alice (“Wendy”) Gasch, M.S., M.D.
Introduction or Purpose: To provide an overview of Newton Wesley, O.D., Sc.D., M.D., Ph.D., (1917-2011), whose keratoconus motivated him to develop practical contact lenses for improving vision impairment due to that disorder, and whose subsequent work stimulated widespread general use of contact lenses.
Historical Approach, Methods, or Resources: Sources of information about Newton Wesley are scarce. Various data bases were searched and Google proved most helpful. Sources of information included: obituaries in several publications; multiple web sites, including those of Oregon Encyclopedia and The International Society of Contact Lens Specialists; a reprint of a U.S. Supreme Court Case (1978, No. 78-886); the periodical Contact Lens Spectum; the books Contact Lenses: The Story by T.J. Bowden and Contacts – One Hundred Years Plus by N.K. Wesley, and personal communications by phone and e-mail with librarians and archivists at schools with which Wesley was affiliated.
Results or Summary of Paper: Newton (Uyesugi) Wesley, O.D., Sc.D., M.D., Ph.D., (1917-2011) was an icon, visionary, pioneer, inventor, educator, and author, who played a major role in making contact lenses a viable and widespread refractive option. He was born in Oregon to Japanese parents and earned an OD at North Pacific College of Optometry (Oregon), which he and a classmate bought soon after graduation. During World War II, Wesley and his family were sent to a war relocation center (Idaho), that he was allowed to leave, without his family, to study chemistry at Earlham College (Indiana). After the War, his family rejoined him and he taught at Monroe College of Optometry (Illinois). There, his deteriorating vision from keratoconus impelled him to work with George Jessen, O.D., to develop the first practical contact lenses for improving vision impairment due to keratoconus. Subsequently, Wesley and Jessen founded the Plastic Contact Lens Company that eventually was acquired by Ciba Vision. In addition, Wesley strongly promoted contact lenses both to practitioners, who often feared fitting contact lenses, and to consumers, who often believed contacts were painful -- and caused cancer! To further this effort, Wesley learned to pilot a plane, made television appearances, and spent $500,000 annually from 1952 through 1956 on a public awareness campaign. He also campaigned to get “contact lens” into the dictionary. Furthermore, Wesley founded the now-defunct National Eye Research Foundation, a leading institution in contact lens research and education during its heyday. Along the way, Dr. Wesley earned an honorary Sc.D. of ocular science, a M.D. degree, and an honorary, Ph.D.
Summary or Conclusions: Newton Wesley played a major role in making contact lenses a viable and widespread refractive option and thereby improved the quality of many lives, particularly those of keratoconus patients.
Justification: There is no comprehensive biography of Newton Wesley, yet he played a significant role both in the development of practical contact lenses, particularly for keratoconus patients, and in the adoption of their widespread use in the U.S. Considering Dr. Wesley’s Japanese heritage, Washington, DC, during the blossoming of its Japanese cherry trees, is a particularly appropriate setting in which to present the proposed paper.
Wilhelm Kühne and Optograms
John W. Gittinger, Jr., M.D.
Introduction or Purpose: The development of photography in the 19th century inevitably led to the comparison of the eye to a camera. The retina was the “film,” and there was serious speculation that images were recorded on it.
Historical Approach, Methods, or Resources: Wilhelm (Willy) Friedrich Kühne, who succeeded Helmholtz as professor of physiology at Heidelberg and who is credited with coining the word “enzyme,’ thought that he could see images on postmortem animal retinas in his laboratory and called these “optogramms.”
Results or Summary of Paper: He then set out to demonstrate an optogram in a human retina. He arranged for the left eye of a murderer executed by guillotine to be removed within ten minutes after death. What he interpreted as the resulting optogram was published in 1881. The concept that the last thing a dying person saw remained on the retina after death seized the popular imagination and was featured in several works of science fiction. Some actual murderers may have covered or destroyed eyes, thinking that this would prevent their use in identification, and Scotland Yard hoped that photographs of his victims’ eyes might solve the infamous Jack-the-Ripper murders in 1888.
Summary or Conclusions: Although current understanding of retinal physiology makes optograms an impossibility, the idea that images and other memories are stored in the brain after death remains a subject of interest to fiction writers.
Visual Axis, Blind Spot, Yellow Spot – Controversies Over 400 Years
Balder P. Gloor, M.D.
Introduction or Purpose: To illuminate the three great controversies provoked by the detection of the yellow spot: 1. Is there a hole? 2. If there is a hole, is Mariottes localisation of the blind spot correct and were begins the visual axis? 3. Does the yellow spot exist in the living eye?
Historical Approach, Methods, or Resources: Literature search regarding the theme from 16th century to the year 2011
Results or Summary of Paper: Fernando Buzzi’s detection of the yellow spot 1782 passed almost unrecognized, but when Theodor Soemmering became aware of the Macula lutea 1791 and pretended that there were a hole in the centre of it, he triggered off long lasting controversies. He called not only Edmé Marriottes explanation of the blind spot in question, but also predicted the collapse of the doctrine of Haller on the topography of the visual axis. This invites for a short review of the supposed position of the visual axis since the Arabs and the modern time with the histologic description of the fovea by H. Müller. The ophthalmoscope didn’t bring the clarification. Indeed, there was neither a hole nor any yellow colour in the macular region! Slowly the macular yellow got its rebirth with observations of Schmidt-Rimpler 1875 and of Dimmer 1894, but then Gullstrand started a controversy of homeric dimension, denying the existence of a yellow pigment in the retina, 1902 – 1908 against Schmidt-Rimpler and Dimmer, then 1918 against Vogt, stating that it is impossible to see the macular yellow with the light source Vogt had used for his investigations. J.W. Nordenson made an attempt to back up Gullstrand in 1949, but Wald had already proven the existence of Lutein in the Macula by spectroscopy 1945, what opened the way for the development of instruments and methods to measure Lutein content during live such as Raman-Spectroscopy, Ophthalmo-Spectrometry, heterochromic flicker photometry (HFP) to investigate correlations between Lutein content and senile Macular Degeneration in our time.
Conclusions: The approach to reality is a winding way full errors and of human comedy.
Boleslaw Wicherkiewicz: Interesting Contributor to European Ophthalmology
Andrzej Grzybowski, M.D., Ph.D., and Dieter Schmidt, M.D., Ph.D.
Introduction or Purpose: Boleslaw Wicherkiewicz (1847–1915) was the most prominent Polish ophthalmologist at the end of the 19th century and beginning of the 20th century living in Polish lands.
He was trained in ophthalmology under Richard Foerster’s in Breslau, Alexander Pagenstecher in Wiesbaden, William Bowman and George Crichett’s in London, Louis de Wecker and Photinos Panas in Paris. He also worked in Heidelberg, Leipzig and Halle. Finally, he returned to Poznan in 1877 to start his own ophthalmology practice. Between 1877 and 1895, he founded and developed the largest and internationally best known 19th century ophthalmic hospital in Poland. In 1895, the hospital had a total of 80 beds. One of his assistents at that time was Emil von Behring, who later received a Nobel Prize. In 1894 Wicherkiewicz was given the title of professor of ophthalmology by German authorities, a very rare distinction related to his great recognition. With his extensive experience gained abroad, Wicherkiewicz was well prepared to become in 1895 the head of the most important university ophthalmology centre in Poland – the Department of Ophthalmology at the Jagiellonian University in Cracow. In 1899, Wicherkiewicz founded the first Polish ophthalmic journal ‘Postep okulistyczny’ (Progress in Ophthalmology). He was an active contributor to majority of international ophthalmic congresses, and co-editor of many international ophthalmic journals. He published about 300 scientific reports in Polish, German, English and French, however both his interesting life and his scientific achievements were never studied in detail. The aim of this study is to fulfill this gap.
Historical Approach, Methods, or Resources: The study is based on analysis of all papers written by Wicherkiewicz, mainly in Polish and German. The biographical details were verified in National Archives in Poznan and Cracow, cities where he lived and worked. The secondary sources, including review articles and other reports about his life and activities, were also collected and analyzed.
Results or Summary of Paper: Original contributions on oculoplastic surgery (epicanthus, lid coloboma, ectropion and enctropion, trichiasis, distichiasis, lid replacement, free skin transplantation), cornea transplants (first in Poland), glaucoma surgery (sclerotomia cruciata posterior superficialis), cataract surgery (cataract irrigation technique), clear lens surgery in myopia (before Fukala) and many reports on new ophthalmic medications (pilocarpine, cocaine, novocaine, pyoktanin, dyonin, aspirin, antipirin, etc.).
Wicherkiewicz hospitals were also training centers for many ophthalmologists, some of renowned reputation, including Boleslaw Kapuscinski, later professor of ophthalmology in Poznan, Franciszek Sroczynski, later associate professor of ophthalmology at Jagiellonian University, Adam Szulislawski, later professor of ophthalmology at Lviv University, Adam Bednarski, later professor of ophthalmology at Lviv University, and Barbara Burdo, the first Polish female ophthalmologist. Summary or Conclusions: Wicherkiewicz played a crucial role in the development of Polish ophthalmology. He was internationally recognized due to his many surgery innovations and scientific activities. He was a member of majority of ophthalmic European societies (including many honorary memberships), and he was given honorary doctorate by Leuven University in 1909.
The Several Discoveries of the Ciliary Muscle
David G. Harper, M.D.
Introduction: Several investigators independently discovered the ciliary muscle during the first half of the 19th century. This paper reviews their efforts and results.
Resources: Original ophthalmic literature from the 19th century.
Summary of Paper: This presentation gives an account of the multiple independent discoveries of the ciliary muscle during the first half of the 19th century. Credit has generally been given to Ernst Brücke (1846) and Sir William Bowman (1847), who presented their work on this muscle independently. Each acknowledged as a precursor Sir Philip Crampton, who in 1813 observed that the so-called ciliary circle must be muscular in nature. Brücke went so far as to refer to the “Musculus Cramptonianus” in the title of his German language paper of 1846. Crampton thought that the muscle flattened the cornea to enhance distant focus and referred to it as a depressor of the cornea. Brücke expanded the anatomical knowledge of this structure by describing it in a broader range of animals and added his work on the radial part of the muscle, which he referred to as a tensor of the choroid. But it was in fact Robert Knox, MD, working in Scotland in 1823, who established that what had been called the ciliary ligament for at least two hundred years was actually a muscle, which he named, for the first time, the “ciliary muscle.” Knox noted that many investigators had thought that the ciliary ligament was a muscle, but that none had actually identified it as muscle anatomically. He and his work, which makes no mention of Crampton’s paper from a decade earlier, were largely forgotten after 1830. Presumably this was due to Knox’s suspected involvement in the purchase of human cadavers for his anatomy laboratory that had been murdered for that express purpose. It was never proved that he was directly involved, but the scandal nonetheless destroyed his career. Another investigator, the American William C. Wallace, MD, published his own work on the ciliary muscle in 1836, giving credit to Dr. Knox for his discovery while apparently knowing nothing of Crampton’s earlier work. Wallace, too, has been largely forgotten. Each of these investigators thought they understood the action of the ciliary muscle relative to accommodation and gave their opinions, however incorrect, on the subject.
Conclusions: Although the discovery that the structure previously called the ciliary ligament was in fact a muscle is normally credited to the independent observations of Ernst Brücke and William Bowman in the 1840s, several earlier investigators were also aware of this fact. It was in fact Robert Knox who, two decades earlier, had named it the ciliary muscle, a name that has been adopted by everyone even as its source has been largely forgotten.
Relja Živojnovic – Daring, Creative Vitreoretinal Surgeon of the “Inoperable Retinal Detachment”
Danny H.-K. Jokl, M.D.
Introduction or Purpose: The intent is to present a time when Dr .Živojnovic, with the close help of a few loyal supporters, confronted retinal complicated detachments that a worldwide consensus of his peers viewed as inoperable and to show how he succeeded.
Historical Approach: In April 1970, Dr. Robert Machemer introduced a pars plana approach for mechanized vitrectomy. Complex retinal detachments though still required, in addition, traditional large external buckles to close retinal breaks. At the same time, Mr. John Scott in Cambridge, England revived Okun’s abandoned use of silicone oil dissection of surface retinal membranes for such cases. Dr. Relja Živojnovic, a general surgeon before a Rotterdam Eye Hospital residency, visited Scott and others and, as the chief of the fledgling vitreoretinal surgery team of Dr. Diana Mertens and Dr. Ed Peperkamp at Rotterdam Eye Hospital began with brilliant intuition, daring and courage to combine Machemer/Scott surgical concepts into an innovative internal vitrectomy technique that with novel instrumentation and creative techniques permitted “inoperable” cases to be solved internally without massive buckles to achieve complete surgical reattachment. Their first paper (Klin M A 1981;179:17-22) reported results in 90 such complicated cases was followed in one tear by a further 280 cases of such complexity as to make repair appear miraculous. Visitors worldwide, including Dr. Machemer who was quick to recognize and hail a fellow innovator, were quick to come to Rotterdam to witness the miracle of surgical possibilities firsthand.
Summary: Through interviews with former residents, team members and Dr. Živojnovic , the uncertain initial times will be revisited and the surgical cases shown will demonstrate the courage of this undertaking.
Tobiah and the Fish; Medicine or Magic?
Linda Lawrence, M.D., and Robert House
Introduction or Purpose: To examine the Historical basis and mythology for the treatment of Tobit's blindness in the Apocryphal Old Testament Book of Tobit.
Historical Approach, Methods, or Resources: The use of fish gall in ancient medicine as a treatment for leukoma to 700 BC was described in the Book of Tobit will be reviewed, as well as the medicinal/pharmacological properties of fish gall for curing eye disease, including possible antisepsis for trachoma versus the use for self couching. This review will discuss the mythology that evolved in renaissance art and literature including Rembrandt's interpretation of Tobiah curing his father's blindness, and references in Milton's “Paradise Lost”.
Results or Summary of Paper: The Apocryphal Book of Tobit in the Old Testament contained fragments reported from the Dead Sea Scrolls dating to 612 BC. Included is a detailed description of the blindness of Tobit that occurred when sparrow dung “whitened his eyes”. According to the text Tobiah, son of Tobit, was on a journey to retrieve his father's fortune. Tobiah was directed by the disguised Archangel Raphael to remove the heart, liver and gall bladder from a large fish of the Tigris river. The fish bile was then used to cure Tobit's leukoma, restoring his sight. The white film may have been purulent conjunctivitis associated with trachoma, or a “cataract”. While various theories have been proposed, the use of fish bile has been documented for treating trachoma in this time period. Another theory is that the irritant effect of fish bile could cause rubbing of the eye, and since it includes chymotrypsin like substance as part of the chemical makeup, this could facilitate “self couching”. These various theories will be explored, and the possible medicinal properties of fish gall reviewed.
Summary or Conclusions: The use of fish gall as an ophthalmic medication demonstrates one of the oldest and most interesting examples of fish bile use to cure disease.
Marshall M. Parks, M.D.: Before Pediatric Ophthalmology
John C. Lee, M.D.
Purpose: Marshall M. Parks, the founder of modern pediatric ophthalmology and the American Association of Pediatric Ophthalmology and Strabismus, was a great, generous, and productive man. The purpose of this paper is to depict who and what in Parks’ life contributed to him to become one of the world’s leading ophthalmologists.
Historical Approach or Resources: Local and State of Illinois Library, video-taped personal interview, historical records, internet.
Body of Paper: Marshall M. Parks (1918-2005), son of a farmer/salesman and school teacher, was born in a small town in northern Michigan, Old Mission. His work ethics and efficiency were clearly the result of his heritage and environmental influences. Three major influences in his life were his maternal grandfather John Marshall Miller, his twin brother Elvin Parks (who died at a young age), and his U.S. Navy experience in World War II. Also, his education pathway and association with Frank Costenbader, M.D. had a direct impact on his professional life. As a result of these influences, Dr. Parks developed a remarkable self-discipline which resulted in his life’s accomplishments. Dr. Parks, an outstanding clinician and teacher, was pivotal in establishing Pediatric Ophthalmology as a sub-specialty and the professional organization, American Association of Pediatric Ophthalmology and Strabismus. This sub-specialty has influenced the lives of many children throughout the world.
Summary: The heritage and environmental influences (by choice or chance) of Dr. Marshall M. Parks played a major role in shaping his character. Because of his strong character, Dr. Parks made huge contributions to pediatric ophthalmology as an outstanding teacher, clinician, and researcher.
Richard G. Scobee, M.D., The Ultimate Ocular Motility Man
Donelson R. Manley, M.D.
Purpose: To call attention to an individual, Richard G. Scobee, M.D., who in the short span of ten years organized the understanding of strabismus.
Methods: Interviews with his widow, Philip Knapp, M.D. (an early fellow), Stanley Thruhlsen, M.D., Benjamin Milder, M.D, and Philip Skroska, Archivist of the Bernard Becker Medical library at Washington University.
Results: Richard Scobee finished his residency in 1942 and entered military service at the beginning of WWII. He had the opportunity to perform ocular motility examinations on thousands of pilots and studied the effects of motility abnormalities on pilot performance. After his military service he joined the Ophthalmology Department of Washington University and continued his studies in strabismus. Shortly thereafter the first edition of his popular book "The Oculorotary Muscles" was published. He revised the Academy's strabismus manual and began a popular orthoptic program. A fellowship in Strabismus with him was sought after by young ophthalmologists.
Conclusion: Sadly, he died at the age of 38 so we will never know what he might have accomplished. As a friend said of him:" He accomplished more in ten years than many men accomplish in a lifetime".
Diderot’s Letter on the Blind for the Use of Those Who Can See. Perspectives on Its Contribution to Science
Curtis E. Margo, M.D., M.P.H., and Lynn E. Harman, M.D.
Introduction or Purpose: Interpretation of the impact that Diderot’s essay had on social attitudes toward the blind, and to examine the role that his argument about sensory adaptation and sensory integration on consciousness had on the development of neurophysiology.
Historical Approach, Methods, or Resources: Translation of Diderot’s Letter, review of related historical material and critiques on the subject.
Results or Summary of Paper: Diderot’s essay on blindness landed him in prison in 1749. Although not subversive by current standards, philosophical essays of this type were threatening to the French monarchy. Diderot used a thought experiment to resolve the controversy of Cartesian dualism and Lockean empiricism. His approach was to challenge the primacy of visual input to the development of consciousness. Using the accomplishments of Nicholas Saunderson, a blind mathematician of Cambridge University, Diderot showed that other senses could promote abstract thinking of the highest order, and that all sensory input was integrated into consciousness in the brain. Because Saunderson could “see” with his fingers, it highlighted how little was known about the translation of sensory input into consciousness.
Conclusions: Diderot’s essay on blindness was read throughout Europe, gradually dispelling misconceptions and myths about the blind. For those natural philosophers who preceded modern physiologists, the work begged for a better model of neural function. The physiological mechanisms through which the central nervous systemic integrates input from peripheral nerves and sensory organs into consciousness are still incompletely understood, but Diderot’s allegorical Letter highlighted weaknesses in Descartes’ model of the soul that overly relied on the sense of vision. As a pivotal document in the Age of Enlightenment, the Letter may not have resolved any neurophysiological riddle, but it energized the dialogue about the workings of the brain and the power of reason.
Raft of the “Medusa”, Phosphenes, and Potential Vision
Harry H. Mark, M.D.
After the French monarchy was restored following Napoleon’s loss in the battle of Waterloo the newly throned king Luis XVIII sent the frigate ”Medusa” to reclaim the French colonies in West Africa. The ship foundered off the coast and 150 of its passengers drifted for thirteen days on a raft without food or water, resorting to cannibalism. Only five finally survived the ordeal, one being J.B.H. Savigny (1793-1843), the ship’s second surgeon. Back in Paris he published (1818) the event, causing a public outcry and political storm against the corrupt royalist regime. It was imaginatively painted (1818-19) by Theodore Gericault (1791-1824) on a huge canvas (16’ x 24’) inaugurating the Romantic era in painting. Savigny also submitted the narrative as his MD thesis. In an 1838 ophthalmic publication he coined the name “phosphene” to visual phenomena elicited by pressure on the globe. Ten years later Serre d’Uzes (1802-1870), practicing in a small town, inadvertently claimed to have introduced the same name (A claim repeated in the Am. Encyclop. Oph. XII: 9692), and for the first time advocated its use to detect visual potential prior to cataract extraction. In addition to a book on phosphenes, Serre published several ophthalmic papers, invented an instrument to measure vision and accommodation (“Opsiometer”), as well as pinhole spectacles as a diagnostic tool and a visual aide. In modern times the phosphene is used in a tonometer (‘Proview’ B & L Comp.) to measure intraocular pressure, while several instruments are available to measure potential visual acuity prior to cataract extraction.
Did Degas’ Maculopathy Affect his Sculpture?
Michael F. Marmor, M.D.
Purpose: Degas had a chronic progressive maculopathy which affected not only his ability to draw in later years, but his ability to judge the impact upon his work as viewed by others. This new study, with visual simulations, explores the effect of Degas’ maculopathy on his sculpture.
Method: Computer simulations of Degas’ vision were produced by inducing Gaussian blur in Photoshop, in accordance with correction for optical blur, object size and viewing distance. Images of Degas’ sculptures were created to show how he would have seen the works at different times in his career. Degas did not date his sculptures himself, but art historians have proposed dates on grounds of comparison with pastels and other works. The simulated images will be used to analyze the effects of his visual loss on his technique, and on the dating of the works.
Results: Sculpture differs from pastel drawing in that some features can be created by feel rather than sight, whereas others such as shading are no longer relevant. Taking this into account, one can see the degree to which maculopathy reduced Degas’ ability to sculpt fine details later in his life, although it did not prevent him from demonstrating form and posture. The simulations show that certain works with finer detail were probably done in years in which Degas had suitable visual acuity.
Conclusions: Degas continued to sculpt late in his life, concentrating on shape and stance more than facial or other details. While his blurred vision smoothed over the coarse shading of his late pastels, (which may have encouraged him to keep painting) his late sculptures simply lack details that could not be constructed or appreciated with failing vision. Analysis of an artist’s vision can be an aid to art historians, in dating works and in understanding aspects of their style – but it does not explain the artistic judgments that create the style.
R. Townley Paton, Father of Modern Eye Banking: A Portrait of His Own Times in His Own Words
Mark J. Mannis, M.D.
Introduction or Purpose: This presentation will review the professional history and personality of R. Townley Paton, widely considered the father of modern organized eye banking. The emergence of organized eye banking with the founding the Eye-Bank for Sight Restoration in New York City is largely attributed to Paton’s dedication and leadership.
Historical Approach, Methods, or Resources: The presentation is based on a series of remarkable films presented by Dr. Paton to the Houston Ophthalmological Society as the 8th Everett Goar Lecturer in 1974 in which Paton reviews both the founding of organized eye banking and the state of anterior segment surgery during his professional career. The information is based on films narrated by Paton himself as well as on written historical accounts and documents related to the founding of the Eye-Bank for Sight Restoration in 1948.
Summary and Conclusions of Paper: Paton mirrored his times in the era of nascent corneal transplantation in the United States. His education under William Holland Wilmer at Johns Hopkins was followed by his move to New York and the founding of the first eye bank in the country. His “self portrait” reflects the beginning of organized eye banking in our country and the world over.
G. Venkataswamy: A Man With a Heart and a McDonald’s Type Business Plan
Marilyn Miller, M.D.
Purpose: To describe the man behind one of the largest ophthalmic health care delivery systems in the world: his vision and his accomplishments.
Body of Paper: After mandatory retirement from Government Service in 1976, Dr. G. Venketaswamy left the Madurai Medical College where he had been head of the Department of Ophthalmology and Vice-Dean to establish the Goval Trust under which the Aravind Hospitals were founded. It began in a house with 11 beds. At present there are about 4000 beds spread around 6 eye hospitals all located in Tamilnadu, India. In a recent one year period over 300,000 surgeries were performed in the Aravind system which accounted for about 5% of the countries surgical output with about 1% of the ophthalmic manpower. This represented about 75% free or heavily subsidized procedures. This monumental achievement was strongly influenced by Dr. V. and his family and a shared goal of humantarism and a productive business plan.
Resources: Multiple articles, a few books and personal knowledge of Dr. Venketaswamy and the Aravind Hospitals.
Conclusion: A dedicated remarkable man driven by a philosophy, a vision and good business decisions was able to make a major contribution to the reduction of blindness.
Julia Bell, MRCS, LRCP, FRCP (1879-1979)—A Legendary Female Pioneer in Human Genetics
Sayoko E. Moroi, M.D., Ph.D., and Gale Oren, MILS, AHIP
Introduction or Purpose: Our purpose is to review the life and accomplishments of Dr. Julia Bell and the impact of her observations and calculations as a clinician-scientist on ophthalmic genetics.
Historical Approach, Methods, or Resources: Our method was a review of her publications and biographies.
Results or Summary of Paper: One of 14 children, Julia Bell had enlightened parents, who valued equal education for their children. Although she and female contemporaries successfully achieved the requirements at Girton College (for women) and University of Cambridge (1901), she was not awarded a degree. The faculty senate of Trinity College, Dublin, Ireland, provided an “academic refuge” for these women, who were educated at Girton College and Universities of Oxford and of Cambridge. After satisfying Trinity College examinations, these women were awarded Dublin degrees. The fees collected from these women were used to build Trinity Hall, a female residence hall. With her father’s encouragement, Julia obtained both BA and MA degrees (1907) from Dublin. Under Karl Pearson, who devised what is now known as the Pearson product-moment correlation, Julia used statistics to understand light fluctuation of stars, relationships between wasps and their queens, and quantitative traits of diverse biological systems. However, given her passion of applying statistics to biology, Dr. Pearson recognized the value of a medical degree for Julia Bell in assisting his “science of heredity” project documenting accurate pedigrees of inherited conditions. She earned her MRCS and LRCP degrees from the Royal Free Medical School in 1921. With her credentials, mentors, and colleagues, she was instrumental in completing the five volume series, The Treasury of Human Inheritance. The first volume was initiated in 1909 by Dr. Pearson with many co-authors, and the final volume was completed in 1958. Of particular interest for ophthalmic genetics, volume II focused on “Anomalies and Diseases of the Eye.” She and Dr. Haldane are credited with the first human linkage study between red-green color blindness and hemophilia, which was originally published by the Royal Society and republished in the Annals of Human Genetics. The diversity of her ophthalmic descriptions include cataract, aniridia, coloboma, microphthalmia, nanophthalmos, retinitis pigmentosa, color blindness, osteogenesis imperfecta, Leber’s disease, and glaucoma. As a testament to her scientific rigor and integrity, she respectfully issued a “warning” about the validity of a pedigree on aniridia. She could not validate this pedigree with the family, and her suspicion was shared by Dr. Lucien Howe who stated that this particular pedigree should not be accepted without verification. After learning that this incredulous pedigree was presented to the Prevention of Blindness Committee, she issued a letter restating the concerns regarding the accuracy of this pedigree of aniridia, which was published in Nature.
Summary or Conclusions: Dr. Bell was a humble feminist and a pioneer of human genetics. She was an astute observer, was passionate about her work, and was extremely respectful of her mentors and colleagues. With clear recognition of human physiology and organ systems, she was prescient on the impact of genetics for medicine and public health.
Disclosure: Both Gale Oren and Sayoko Moroi have no disclosures relevant to the content of this abstract in accordance with guidelines outlined by the American Academy of Ophthalmology. We take full responsibility about the accuracy of the content of our talk given the resources and materials that were used for our research methods. We will obtain appropriate permission to reproduce photographs or other copyrighted materials.
Adolph Barkan and His Diary
J. Fraser Muirhead, M.D., CM, FRCS(C)
Introduction or Purpose: To present some interesting aspects of a post US Civil War West Coast immigrant ophthalmologist’s life.
Historical Approach, Methods, or Resources: Archival documents in Lane Library, Stanford University, family reminiscences, public library collections, internet information.
Results or Summary of Paper: Arriving in San Francisco in 1869, Dr. Adolph Barkan, a Hungarian Jew trained in Vienna under Arlt, began a very successful West Coast career. He established a large practice, became the first professor of Ophthalmology and Otology at the Cooper Medical College in 1872, and later was named Professor of Structure and Disease of the Eye, Ear, and Larynx at Stanford University School of Medicine. He was awarded an honorary LLD at the University of Glasgow in 1901, and honored as Ehrenbürger of the University of Munich the same year. His publications ranged from the ocular embryology of amphibians to such medical subjects as magnetic removal of intraocular foreign bodies (7 articles) and cocaine as an anesthetic to brain abscess induced by purulent otitis media and use of the burr in mastoid surgery. After retirement in 1912 he returned to Europe. With his wife and children he was interned in Germany during part of WWI. He is remembered for the strenuous efforts and generous financing he provided when he was in his eighties to establish and enlarge the medical history collections of the Lane Medical Library at Stanford University.
His non-professional activities were also numerous. He was a very popular lecturer beginning with one in 1887 followed by almost annual ones in the 1890’s. Subjects varied but the delivery must have been very entertaining to judge from the flavor of his opening sentences. His musical talent and interests served him well on the Board of the San Francisco Symphony Orchestra.
In an unpublished diary in the the Lane Library at Stanford University, Dr. Barkan recounts much of his early life. In it he writes of the reason he left a very promising career in the center of the Austro-Hungarian Empire to come to San Francisco. San Francisco was then a young and tumultuous city, far from the established civilizations of the eastern United States and Europe. Anti-semitism in the Austro-Hungarian Empire, familial inducements, financial considerations, or simply a sense of adventure might possibly have been the reason. But the reality was different; it was a magazine article about the Committee of Vigilantes he read as a ten year old boy.
Summary or Conclusions: Dr. Adolph Barkan migrated to San Francisco in the late 1860‘s. His excellent training in Vienna and Zürich, and his personality and abilities aided him in becoming a dominant figure in the Bay Area medical world as well as being highly regarded in Europe. He is probably best remembered for his extensive efforts to establish and expand the historical medical collections of the Lane Library at Stanford University. Reading a magazine article at age nine or ten about the San Francisco Vigilantes as a ten year old boy initiated his desire to live in San Francisco, California.
Mementos From Dr. Cogan’s Closet
Steven A. Newman, M.D.
Introduction or Purpose: When interviewed in the late 1980s, one of Dr. Cogan’s proudest accomplishments was forming the American Ophthalmic History Society. Clearly this and his previous incorporation of our Ophthalmic Heritage in the Archives of Ophthalmology indicate his interest in history. David Cogan was truly a Renaissance Man. Review of his published papers, access to his notations and stored photographs indicates how wide his range of interest, from cornea to cataracts, to vascular circulation to central nervous system neuro-ophthalmic manifestations, to the development of new techniques. Underneath it all, Dr. Cogan considered himself very much a pathologist. This is born out by his extensive collection of slides.
Historical Approach, Methods, or Resources: Review of some of the over 12, 000 stereo glass slides from Dr. Cogan’s collection plus material stored from his personal case studies and papers.
Results or Summary of Paper: Dr. Cogan was an inveterate collector and cataloger of cases that he saw. Glass mounted stereo slides of anterior segment, adnexal, retinal, and orbital pathology indicates the breath of his clinical interests.
Summary or Conclusions: David Cogan, first and foremost an educator and mentor. He was also an outstanding clinician and observer who early on felt the need for documentation, use, and access to Donaldson’s stereo cameras provides a unique insight into the extent of his experience.
Ophthalmology in Iran: Then and Now
Introduction or Purpose: To report on ophthalmic practice in Ancient Persia & present day Iran
Historical Approach, Methods, or Resources: The author visited Iran on invitation of Iranian Society of Ophthalmology annual meeting in November 2011.
Results or Summary of Paper: Ancient Persian physicians made remarkable observations and have written in Arabic language. The glimpses of their achievements will be presented as well as the present day ophthalmology in Iran.
Summary or Conclusions: Persians are not Arabians. The authors experiences will be presented in a historical context.
The Magician With a Meningioma
James G. Ravin, M.D.
Purpose: To describe the index case of the report by Harvey Cushing and Louise Eisenhardt of meningiomas arising from the tuberculum sellae (Arch Ophthalmol 1929; 1 (1) new series; 1-41, 168-206). The key findings were optic atrophy, bitemporal visual field defects, and a normal appearing sella turcica.
Resources: Medical records of the eminent neurosurgeon Harvey Cushing (1869-1939) about the illustrious magician Karl Germain (1878-1959). The records include photographs, the operative note, as well as the radiology and pathology findings. Postoperative correspondence between the two men has been preserved.
Summary: Landmark case of a magician most famous for his Egyptian water jar act in which empty jars were miraculously filled with water and then poured into an aquarium. His neurosurgeon is often considered the most important 20th century American physician or surgeon. Cushing was a member of the American Ophthalmological Society and he created the word meningioma. The patient outlived his surgeon.
Conclusions: The classic findings of tuberculum sellae meningiomas remain relevant today. Germain and Cushing were outstanding in their fields of expertise.
Justification: Landmark paper (volume 1, issue 1, page 1, Arch Ophthalmol, new series). Highly important individuals. The diagnosis should not be missed.
New York Eye Infirmary and the Flowering of Ophthalmology in America
Richard B. Rosen, M.D. and Joseph B. Walsh, M.D.
Introduction or Purpose: To review the 192 year history of the New York Eye and Ear Infirmary our nation’s first specialty hospital and it impact on American Ophthalmology.
Historical Approach, Methods, or Resources: Primary historical documents, review of literature, and oral and written communications with secondary sources.
Results or Summary of Paper: Inspired by experiences of its founders, Edward Delafield and John Kearney Rogers, at the recently established Royal London Dispensary for Curing Diseases of the Eye and Ear, the Infirmary’s immediate success as a community facility and teaching institution, served as a model for a multitude of eye and ear institutions that sprouted up around the country as news of its success spread.
Summary or Conclusions: Created to fill the need for specialty care which was considered too trivial for real hospital attention at the time of its conception, the Infirmary introduced a critical community service which helped working men and women to continue to function in society. Its success lead to the way to a generation of similar institutes, many of which continue to flourish to this day.
Salus University: Both the Oldest and Newest Nonprofit, Independent, Optometric Higher Educational Institution in the United States
Joseph W. Sassani, M.D., and Marianne E. Boltz, O.D.
Introduction or Purpose: This paper traces the History of Salus University from its origins in the Pennsylvania College of Optometry to its present status as a fully accredited academic institution offering professional and graduate degree programs in Optometry, Audiology, Physician Assistant studies, Public Health, and Education and Rehabilitation for the Blind and Visually Impaired. The paper includes placing the narrative in the context of the history of American optometry and optometric education.
Historical Approach, Methods, or Resources: Electronic and print media search and evaluation.
Body of Abstract: In 1914, a Pennsylvania court declared that “the practice of Optometry was separate and distinct from the practice of Medicine”, and therefore, not subject to regulation by the State Medical Board of Licensure. Shortly thereafter, the Pennsylvania College of Optometry was established in 1919 through the efforts of Dr. Albert Fitch, and resources of $300 in cash, and $10,000 worth of bonds. Specific landmarks in the history of the College include:
1919 First non-profit, independent college of optometry.
1923 First to confer Doctor of Optometry degree.
1935 First to require four-year optometric educational program.
1948 First contact lens course for practitioners.
1954 First independent health profession institution to receive regional accreditation.
1975 First school or college of optometry to develop a comprehensive, off-campus Externship Program.
1978 First to develop a comprehensive inter-disciplinary clinical facility, The Eye Institute, for education and patient care.
1988 First independent college of optometry to affiliate with a medical school, Hahnemann University.
1990 First school or college of optometry to conduct research and training using an excimer laser.
1998 College moves to the present location at the intersection of Routes 73 and 611 in Elkins Park.
2001 New four year optometry curriculum launched, which has become a model for other schools and colleges of optometry, offers a completely redesigned optometric curriculum with interdisciplinary integration of basic and clinical courses using a module approach.
On July 1, 2008 the College of Optometry became the first school or college of optometry to establish a university (Salus University). The name of the university represents the Latin meaning “health and well-being”, and is said to emphasize a “holistic” approach to its multiple missions. Presently, there are 1,800 students involved in its programs including professional and graduate degree programs in Optometry, Audiology, Physician Assistant studies, Public Health, and Education and Rehabilitation for the Blind and Visually Impaired.
Relevant historical context of the profession of optometry discussed in this paper includes the 1922 meeting establishing standards for optometric curricula. Among other historical topics discussed is Dr. Edmund Richardson’s “triangle of progress”, which delineated a strategy for the advancement of the optometric profession, and included the three complementary sides (parameters) of professional education, legislation, and public education, and came to include also community service to this strategy.
This paper is dedicated to the memory of Shahane T. Kirman, O.D., who died on November 10, 2011 at the age of 80 after a courageous battle with prostate cancer. He is a 1954 graduate of the Pennsylvania College of Optometry, and for over 50 years, while practicing optometry in Central Pennsylvania, he exemplified professional character and ability reflecting favorably on that institution.
Summary: The history of the Pennsylvania College of Optometry and Salus University are discussed in the context of the progress of the profession of Optometry, in general, and optometric education, in particular.
David Cogan and the National Eye Institute
Paul Sieving, M.D.
David Glendenning Cogan (1908-1993) had a seminal influence on all aspects of ophthalmology from research to teaching. One of his roles was his help in shaping the early history of the National Eye Institute. After an illustrious career at Harvard, including serving as director of the Howe Laboratory, he came to the NEI somewhat reluctantly for a three-month sabbatical in 1973. He found the environment stimulating and remained until his death in 1993. During this time, he helped to set the course for the NEI excellence in ophthalmic research.
The Optic Nerve Is Still Hollow?
David Taylor, M.D.
Introduction or Purpose: The hollow optic nerve as an anatomical and physiological concept was maintained in Western medicine from about 300 BCE to the 19th century.
Historical Approach, Methods, or Resources: As part of a wider study of the history of the optic nerve and vision, I visited the libraries of the Topkapi and Sulimaniye in Istanbul to view the original mss of the early Arabian ophthalmic writers and from this I have studied the Humoral physicians and their view of how sight was generated.
Results or Summary of Paper:
The early period- Greece
The Arabian era
William of Conches 1090-1154
Georg Bartisch’s Ophthalmodouleia
Gemma, Descartes, Briggs and van Leeuwenhoek
The last doubters
Summary or Conclusions: In terms of deeply embedded traditions in many cultures of the world, the optic nerve is still hollow!
Georg Bartisch and His “Augendienst”
Lilla Vekerdy, M.A., M.L.S.
Introduction or Purpose: The paper introduces and analyses the life and work of a 16th century eye surgeon, Georg Bartisch (1535-ca. 1607).
Historical Approach, Methods, or Resources: The analysis is primarily based on Bartisch’s 1583 main work, “Ophthalmodouleia, das ist Augendienst” (The Service of the Eyes). Other resources include Julius Hirschberg’s “History of Ophthalmology” and numerous scholarly articles from the RLIN, PubMed, and OCLC/WorldCat databases.
Results or Summary of Paper: Georg Bartisch is known by two extant works: one on kidney stones and the other on eye diseases. The latter is titled “Ophthalmodouleia, das ist Augendienst” (The Service of the Eyes). The “Augendienst” is remarkable in its size, details, and illustrations in the early literature of ophthalmology. The large folio volume covers 616 pages and is profusely illustrated with images of eye diseases, treatments, surgical instruments, and scenes of eye surgery.
The work was repeatedly considered the first medical book in the German vernacular language but this statement is erroneous. However, the “Augendienst” is the first significant German-language monograph in this particular field of medicine, in ophthalmology. And it is important that the work is a non-Latin text, because it shows that its author did not belong to the contemporary medical establishment but to the less erudite group of surgeons and barber surgeons. The paper will argue about this distinction and how it determined Bartisch’s life. It will also emphasize the professional achievements of the “Augendienst” and of its author. The second part of the paper will highlight advances of eye surgery from the numerous examples described and illustrated in the “Augendienst.” However, it will also point out other, “less advanced” features of the book that lined up with certain aspects of 16th century medicine, like the humoral theory and astrological considerations. These aspects were often regarded as plain superstition by later secondary literature, but recent scholarly analysis looks at them as contemporary trends in the medical literature of 1500s, that should be scrutinized as representatives of their age.
Summary or Conclusions: Georg Bartisch and his “Ophthalmodouleia” played a significant role in the development of 16th century ophthalmology. While many aspects of the book clearly refer to an early understanding of medical and surgical problems others had lasting impact in the field of ophthalmology and especially ophthalmic surgery.