Cogan Ophthalmic History Society

35th Annual Meeting 2023

Sacramento, California

Titles marked with a P* are available in the Proceedings volume for the year of presentation.  Contact Jenny Benjamin at the Truhlsen-Marmor Museum of the Eye (jbenjamin@aao.org) for further information.

Papers noted as being “Published as…” may not be identical to the Cogan Society presentation or the content in the Proceedings volumes.

Snyder Lecture

Christopher Blodi

The Whole Eye Transplant of 1969: The Whole Story and Insights into Experimental Surgery Then and Now

Purpose: The controversial whole-eye transplant (WET) of 1969 performed by Baylor College of Medicine/ Texas Medical Center (TMC) eye surgeon Conard Moore, MD, is examined to determine whether he performed a WET or a different operation.  Moore claimed that he performed the world’s first WET, then retracted his claim amid criticism.  Medical and ethical factors are explored. The parameters for experimental surgery of that era are compared to current policies.

Design: Retrospective study.

Methods: This is a retrospective analysis of a single patient’s ophthalmic operations performed in April, 1969 and the controversial claim of the world’s first WET.  Oral and written interviews with witnesses were performed.  Primary and secondary literature sources were reviewed.  Ocular illustrations provided by the surgeon in 1969 were reviewed and compared to verbal reports.

Results: A newly uncovered book chapter by Moore’s department chairman Louis Girard, MD, supports the initial claim of a WET, as do recent interviews with medical journalist Miriam Kass, JD.  Ophthalmic pathologist Milton Boniuk, MD, states that he did not receive the whole eye for examination.  Gerald Ramsey, MD, then an ophthalmic resident at Baylor, recalls a more nuanced account reported to him at that time by co-resident Dan Sigband, MD, who assisted Moore.  Moore made his claim of a WET amid the intense attention to TMC’s aggressive heart transplantation operations.  Moore retracted his claim after professional criticism. Current limitations on experimental surgery are markedly different when juxtaposed with those utilized at the time of the WET.

Conclusions:  While some new evidence supports Moore’s initial claim, other scenarios are plausible.  This case highlights the boundary between accepted and experimental operations and underscores the need for modern bioethics oversight to provide safeguards for novel surgical procedures. P*

Barbara J. Arnold

Ophthalmia Neonatorum 19th Century – A Chronicle of America’s First Woman Doctor from Losing her Eye with this Hospital Acquired infection to Her Founding The Woman’s Medical College in 1868

Elizabeth Blackwell MD had dreamed of becoming a surgeon.  After graduating first in her class at Geneva Medical College in 1849, she traveled to Paris. She hoped to be admitted as a graduate student in surgery at one of the better Parisian hospitals.   None of the French hospitals would recognize her American diploma.  She found a way to observe and study with the recognized gynecological surgeons in Paris by entering the La Maternite as an apprentice mid-wife student.  She kept quiet about her American medical credential and worked diligently to attend the Maternite patients and their gynecological surgeries. She was on-call for mothers and babies with problems in the night.  What is described as a “slight accident” in her biography is really the onset of acquiring the infection which penetrated her cornea, cause systemic infection and some scaring in the fellow eye. This was the end of her hopes of becoming a surgeon, but her drive to help women and children and to gain access to medical education for other women was only kindled by her deep determination.  Her biographer, in 1941, published this detailed story of Dr Blackwell’s treatment of her ocular infection, the application of leeches to the temples, ointment of belladonna to the eyes, opium and cold compresses to the forehead. The day after a little squirt of fluid from the infected infant hit her eye, she was bedridden with a systemic infection.  She recognized that she may have been sleepy and careless in attending the infected infant with an attempt to irrigate the infected eye with a syringe.  This effort of care in the late-night caused her to forfeit her intended career as a surgeon, but it did not dampen her passion to help often neglected indigent women and children. 

After leaving her apprentice position at the maternity hospital she sought care in the famous hospitals of Europe only to end up back in Paris where the noted ophthalmologist Louis – Auguste Desmarres operated to remove what remained of her left eye and fitted her with a glass prosthesis.

In 1880 Dr Carl Crede, a German gynecologist, introduced the use of silver nitrate preparations in the eyes of newborn infants forever changing the preventive measures for ophthalmia. This prophylaxis for gonorrhea remained standard of care evolving to the application of erythromycin    when this antibiotic became available in the 1950s. P*

 M. Tariq Bhatti

Theodor Leber: A Man Ahead of His Time and the Story of Gene Therapy for His Optic Neuropathy

Born in 1840 Germany, Theodor Karl Gustav von Leber received his medical degree at Heidelberg University at 22 years of age. His first clinical job was at an ophthalmic hospital under the direction of Dr. Hermann Josef Knapp. A year later, while working in the Department of Physiology at the Josephinian Military Academy of Surgery in Vienna under the direction of Dr. Carl Ludwig, he described in detail the vascular anatomy of the eye. From Vienna he moved to Paris, but then returned to Germany at the invitation of Dr. Albrecht von Graefe (University of Berlin) in 1867 at 27 years old. Eventually he became Professor of Ophthalmology at Goettingin University; ending his career at Heidelberg University, the same institution in which he earned his medical degree.

Dr. Leber’s lifetime of professional achievements can be traced back to his teachers and colleagues that included von Graefe, Knapp, Ludwig, and Helmholtz. His contributions to ophthalmology began very early in his career, when at the age of 24 years he presented his research on the vascular anatomy of the eye at the Heidelberg Ophthalmology Congress. His drive to not only be a clinician but a researcher led to the understanding of the production and circulation of aqueous humor, the role of the corneal endothelium and the development of ocular inflammation. Curiously, he even studied the genesis of dental caries. Many ophthalmic diseases were initially described by Dr. Leber such as a severe form of a congenital retinal dystrophy (a.k.a. Leber congenital amaurosis), idiopathic neuroretinitis (a.k.a. Leber stellate neuroretinitis), primary retinal telangiectasia (a.k.a. Leber miliary aneurysm), and lymphangiectasia hemorrhagica conjunctiva. Arguably however, his greatest contribution is describing an optic neuropathy that now bears his name: Leber hereditary optic neuropathy (LHON).

It is not an exaggeration to state that Theodor Leber was a man “ahead of his time”, in fact it is very apropos. But why was Theodor Leber “ahead of his time”? The answer being that he was the first to clinically describe and recognize the subtle characteristics of a unique form of a hereditary optic neuropathy (i.e. LHON) that over a century later was the first mitochondrial disease to be attributed to a mitochondrial DNA point mutation. After decades of basic science research, LHON is also the first mitochondrial disease to undergo clinical trials of gene therapy and serves as the quintessential model of translational research progressing from bedside to bench and back again to bedside.

James Brandt

Orbis International at 40 - A Brief History

Orbis (www.orbis.org) was the brainchild in the late 1960s of David Paton, M.D., then a member of the faculty at the Wilmer Eye Institute. Recognizing the lack of eye care and ophthalmic training in the developing world, he proposed bringing training to where the need existed. With assistance from contacts in both the medical and aviation industry, a grant from USAID and a donated DC-8 narrow-body plane from United Airlines, the world’s first fully functional Flying Eye Hospital (FEH) was launched in 1982. 
The first FEH program took place in Panama in March 1982 – volunteer instructors from the United States introduced local ophthalmologists to current surgical techniques and state-of-the-art surgical equipment. The early programs consisted primarily of surgical demonstration projects with little follow-through, and these early initiatives were often criticized for more ‘showing off’ than ‘showing how’. 
Over the next 4 decades Orbis grew and morphed to become what it is now – a global NGO focused on capacity-building and partnerships with training programs and health systems around the world. The FEH (now in its 3rd generation on a FedEx-donated MD-10 aircraft) serves an iconic role in advocating for eye care to local Ministries of Health in host countries. Though high visibility, the FEH is a small proportion of Orbis’ footprint. Hospital-based trainings (HBTs) consist of a small group of volunteers who work with local programs to boost nursing, anesthesia and biomedical engineering to support the delivery of care.
The COVID pandemic disrupted Orbis to its core – donations dropped off precipitously, and travel ground to a halt. During the pandemic Orbis focused its efforts to expand the Cybersight platform (www.cybersight.org) to include online lectures, consultations, mentorship, surgical videos and even AI grading of fundus photographs. In 2021, nearly 17,000 ophthalmologists from 184 countries accessed Cybersight, with >4 million views of the video library. Ninety live lectures were given, attended by 9,303 eye care providers.
In 2023 the Orbis FEH is again in the air, traveling first to Vietnam and then Zambia in the fall. 
In my talk I’ll review Orbis’ 40 year history and how it grew from a ‘showing off’ technology showcase to a ‘showing how’ global platform focused on capacity building around the world.

Edward De Sutter

Anophthalmia, Depleted Uranium and the Rest is History

Perhaps we still remember the first Gulf War in 1991 and the subsequent reports and pictures from Iraq that reached us during the embargo. For this reason alone, there were discussions about the influence of depleted uranium and its effects on newborns, such as the development of malformations, cancer, or cataracts.

In May 1999, we received a call from the Iraqi Embassy after sending them a letter regarding a message from the Iraqi News Agency about the consequences of depleted uranium and anophthalmia.

In 2000, we received an invitation from the then government to travel to Baghdad and investigate the causes of various malformations, especially cases of anophthalmia, in newborns in the country.

We made our first trip to Iraq in April 2000 to assess if there was a connection with the use of ammunition containing depleted uranium or if there were other factors involved.

In April 2001, we made a second trip to Iraq. During this time, we examined patients with eye malformations at the El Ibn Al Haitham Eye Teaching Hospital in Baghdad. These patients came from various regions of Iraq, and we were able to collect blood samples from them.

For various reasons, we kept the data confidential, even after receiving a call from a reporter at the Sunday Times. We chose not to discuss or publish our findings at that time.

Now, after twenty years, we are attempting to revisit these results and assess the significance of our findings to reach any meaningful conclusions. P*

Alice (“Wendy”) Gasch

Gerhard Rudolph Edmund Meyer-Schwickerath (1920-92):  Propagator of the Use of Light as a Non-invasive Therapeutic Tool

Gerhard Rudolph Edmund Meyer-Schwickerath provided an extraordinary gift to the world: the dissemination (not the origination) of the use of light as a non-invasive therapeutic tool (the importance of which will be presented). Yet there is little information available about Meyer-Schwickerath – certainly no comprehensive biography, which he definitely merits and which would be intriguing to read.

When 25 years old, Meyer-Schwickerath was experimenting with rabbits to create a device for trans-scleral diathermy treatment of retinal detachments, and he noticed that the morphology of the macular solar burn of a young man who had viewed a solar eclipse was similar to that of burns resulting from his diathermy experiments. Subsequently, one sleepless night, he had the revelation that light, like that from the sun, could be used to treat retinal detachments and small intraocular tumors. This revelation led to his development of a device using the sun to photocoagulate those problems in patients.

Frustrated with the dependence of sunlight coagulation on weather and season, he developed a photocoagulation device using a high-intensity carbon arc lamp, which could perform iris and ocular surface coagulation, as well as retinal coagulation. Later, he created a xenon-arc photocoagulator that could perform the same tasks. He then pioneered combining radiation and xenon-arc coagulation to reduce effective irradiation doses sufficiently to prevent radiation retinopathy and optic neuropathy. He also pioneered pan-retinal xenon-arc coagulation of the retina to treat diabetic retinopathy. Xenon-arc coagulation was used worldwide until supplanted by laser coagulation -- for which Meyer-Schwickerath had helped lay the foundation.

In addition to the above, Meyer-Schwickerath provided the field of ophthalmology with other procedures and instruments of importance today. Also, he was the first to describe in detail oculodentodigital syndrome, also known as Meyer-Schwickerath syndrome.

Meyer-Schwickerath received numerous awards, as well as several honorary doctorates. Furthermore, he was proposed unsuccessfully for the Nobel Prize three times. In 2002, he was inducted into the Ophthalmology Hall of Fame. His legacy lives on in every ophthalmologist who performs ocular photocoagulation and in the current multitude of patients who are benefitting from it. Among his patients was Leonard Bernstein. P*

John Gittinger

Fever Therapy in Ophthalmology

Hippocrates wrote, “Give me the power to create a fever and I will cure any illness.” This idea was widely translated into clinical practice in the first half of the 20th century. Julius Wagner-Jauregg, a psychiatrist, infected patients who had tertiary syphilis with malaria to cause fever and noted improvement in their mental status. This work led to him receiving the Nobel Prize in Medicine and Physiology in 1927. Encourage by these results, Willis R. Whitney, Director of the General Electric Research Laboratory, and Charles F. Kettering, Director of the Research Laboratory of the General Motors Corporation, developed devices to raise body temperature. The resulting Kettering Hypertherm was used by ophthalmologists primarily for the treatment of uveitis. Raising body temperature using this device and other methods, including injections of typhoid vaccine and other foreign proteins, resulted in the death of several otherwise healthy young patients at major medical centers, including Johns Hopkins and the University of California. With the advent of antibiotics and corticosteroids in the 1940s, the use of fever therapy for uveitis had been largely abandoned in the United States by midcentury. In Europe there are still centers that use hyperthermia in the treatment of cancer with uncertain benefits. P*

Alison Hong

Dr. Patricia Bath (1942-2019): A Life’s Work Dedicated to Serving the Visually Impaired

Known for her invention of the Laserphaco Probe in 1981 and as the first female chair of ophthalmology in the United Stated at Drew-UCLA in 1983, Dr. Bath was a pioneer in the field of ophthalmology. In addition to her numerous academic achievements, she is remembered for her dedication to serving the patients in her community and role in creating the field of community ophthalmology. Dr. Bath used her platform as one of the first African American female ophthalmologists on the West Coast to bring about awareness on matters of racial and socioeconomic health disparities that specifically impacted the visual health of African Americans. She dedicated her career to the cause of improving their access to ophthalmologic care. 

Dr. Bath defines community ophthalmology as “the discipline of blindness prevention utilizing the methodologies of public health, community medicine and clinical ophthalmology (Bath, 1978).” In an article written by Dr. Bath in 1978, she identifies the major worldwide causes of blindness as trachoma, xerophthalmia, onchocerciasis, and cataract. She clarifies that while senile cataracts are not preventable, “community health workers would be trained to educate the elders as to the treatment of cataract.” With community education, she argues that “blindness due to cataract could become significantly reduced (Bath, 1978).” Her goals with community ophthalmology were to establish screening projects with trained community members to detect eye diseases at early stages and provide health education programs to those in need. She also encouraged physicians to provide mobile surgical clinics for cataract extractions to provide for “continuity of care.” After learning that African Americans had twice the risk of blindness compared to white Americans, she co-founded the American Institute for the Prevention of Blindness (AIPB) in 1977 with the hopes to “protect, preserve, and restore the gift of sight,” as she believed that “eyesight is a basic human right (NIH, 2015).” With these community interventions, Dr. Bath embodied what it meant to be a humanitarian physician by understanding how she could better serve those around her. She also expanded the professional duties of an ophthalmologist by incorporating local community activism and service into her career. A true trailblazer for women in surgery, Dr. Bath has left behind a profound societal legacy that has inspired future generations of physicians to advocate for the less fortunate and to use their privilege to heal those in need.

Benjamin Jastrzembski

Dr. Elmer Carleton of the Dartmouth Eye Institute

A prominent figure at the Dartmouth Eye Institute, Elmer H. Carleton MD was also an ophthalmologist of extraordinary intellect and character. Born in rural Maine in 1868, he graduated from Bowdoin College and Dartmouth Medical School. He subsequently studied otolaryngology and ophthalmology for a year in Europe before returning to Dartmouth in Hanover, New Hampshire to practice. He was respected by his patients for his skills as a physician as well as his generosity. It was said that no patient went without glasses from his clinic as Dr. Carleton would pay for the spectacles himself if necessary. At the age of fifty, he suffered the nightmare of any surgeon: he developed a disastrous gangrenous infection on his dominant, right hand after performing a surgery. This ultimately required amputation of his right arm and months of painful recuperation. Astonishingly, Carleton not only survived, but had decades of productive practice after the amputation. He reportedly learned to perform surgical operations with his single, non-dominant hand. Later, from 1932 to 1945, he was a member of the Dartmouth Eye Institute alongside such luminaries as Alfred Bielschowsky and Walter Lancaster, contributing to seminal work on aniseikonia. Carleton passed away in June 1952 at the age of 83, a role model of a physician in his kindness, intellect, and courage.

Jace (Jason) Jo and Krish Sharma

From Cornea to Choroid, cornū to χόριον: the Latin and Greek Etymology of the Eye

From the cornea to the choroid, the anatomical terminology of the eye is rife with Latin and Greek influence. This project uncovers the etymologies, associations, and references of interest to five of these terms, from the anterior to the posterior of the eye.

Cornea (LATIN: cornū, -ūs n. — “horn”): In Book XI of The Natural History, Pliny the Elder (ca. 23 – 79 AD) describes the cornea as the “horn” that hosts the pupil, writing that “in the middle of the eye’s horned structure, Nature has established the pupil as a window, the narrowness of which disallows its sharp edge to wander without certainty” (media eorum cornua fenestravit pupilla, cuius angustiae non sinunt vagari incertam aciem…). It is uncertain, however, whether Pliny fully understood the utility of the cornea’s “horned” shape, to refract light.

Iris (GREEK: Ἶρις, -ιδος, ἡ — “the goddess Iris” or “rainbow”): The goddess of the rainbow, Iris was a messenger of Olympus who served as the bridge between mortals and immortals. While often as diverse in color as a rainbow, our iris too serves as a messenger, between the outside visual world and our brain.

Pupil (LATIN: pūpa, -ae f. — “doll”): When you look into someone’s eyes, what might you see in their pupils? A minuscule reflection of yourself. This appears to be what the Romans believed too, when they identified the pupil as a “doll” or “little girl”. In Deuteronomy 32.10 of the Vulgate Bible (ca. 382 AD), pūpa is used in a doting manner — “He protected him as if he were the pupil of his eye” (custodivit quasi pupillam oculi sui).

Retina (LATIN: rēte, -is n. — “net”): In a historical drama entitled Octavia, Seneca the Younger (ca. 4 BC – 65 AD) uses the word rēte to describe a fishing net (gravi extrahere pisces rete). With a fundoscopic examination, we may also observe a net-like structure in the branches of the retinal vessels.

Choroid (GREEK: χόριον + εἶδος — “membrane enclosing the fetus” and “shape” respectively): From etymological, anatomical, and functional perspectives, the choroid and chorion share similarities. In History of Animals, Aristotle (ca. 384 – 322 BC) underscores the significance of the chorion, writing “All animals are stripped after birth; just as the chorion in those born breathing…” (πάντα δὲ μετὰ τὴν γένεσιν ἐκδύεται· ὥσπερ γὰρ τοῖς ζωοτοκουμένοις τὸ χόριον…). Certainly, the significance of the choroid to the eye also cannot be understated. P*

 Nivan Lakshman

Howard Venable and the Desegregation of American Medicine

Throughout his life and career, Dr. Howard Venable demonstrated remarkable resilience to reach prominent heights in ophthalmology few Black physicians could attain in segregationist America. Born in Canada and raised in Detroit in 1913, Venable earned his undergraduate and medical degrees from Wayne State University. To fund his education, he spent his summers playing trumpet with Duke Ellington and his band. In 1939, Venable moved to St. Louis to complete his ophthalmology training at Homer G. Phillips Hospital, one of a few institutions in the country that offered specialty training to Black physicians. Venable described Homer Phillips as “the most tangible accomplishment of St. Louis’s black community,” serving as an economic anchor for jobs and a source of pride for a community that experienced segregation in the education of their doctors and treatment of their patients. Meanwhile, other hospitals in St. Louis, including Barnes Hospital affiliated with Washington University, routinely treated Black physicians as inferior and diverted Black patients into dimly lit basements.

 In 1943, Venable became director of the Department of Ophthalmology at Homer Phillips, focusing his practice on glaucoma and eliminating the discrepancies in treatment between White and Black patients, as well as the first Black instructor at St. Louis University School of Medicine. Venable’s seminal work, “Glaucoma in the Negro,” astonished ophthalmologists all over the world by suggesting racial differences due to differing levels of pain and inconsistent monitoring and checkups in Black patients. He formed a close relationship with renowned ophthalmologist Bernard Becker, who recruited Venable as an assistant professor at Washington University.

 Venable’s advocacy for racial justice also stretched to housing equality when he fought the wealthy suburb of Creve Coeur from taking his property. Employing eminent domain, the city successfully seized property from Venable and other Black families for a paltry sum and turned the land into a park. Venable passed away in 1998, but in 2021, the city passed an ordinance renaming the park in his honor. Though he shouldered decades of outright racism and hate, Dr. Howard Venable blazed a trail within a system designed to prevent him from succeeding, inspiring physicians and advocates alike to carry forth and build upon his legacy.

John Lee

Fyodorov: the Russian ophthalmologist, Inventor, Politician, and Professor

In 2017, Dr. William Tasman’s abstract, Fyodorov, his IOL, and the Berlin Wall, was accepted for presentation at the 30th Annual Meeting of the Cogan Ophthalmic History Society, March 24 through 26, 2017. Sadly, Dr. Tasman was ill and passed away on March 28, 2017, without the opportunity to present. Six years later, I wish to honor Dr. Tasman’s plan and present, Fyodorov: the Russian ophthalmologist, inventor, politician, and professor.
Svyatoslav Nikolayevich Fyodorov, (1927-2000) was born in Ukraine, the son of a Red Army Division Commander. His first choice was to become a pilot. However, after an aircraft accident when he lost his left foot, he changed his career direction to medicine and subsequently ophthalmology.
Fyodorov developed surgeries for cataracts, scleroplasty for glaucoma, and methods of microsurgery. In 1960, he developed and implanted the first intraocular lens in the Soviet Union. By 1974, he began performing keratotomia surgery (later called radial keratotomy) to treat and correct myopia. 
A known innovator, Fyodorov developed the “conveyor-belt” technique to move the operating beds in a conveyor fashion while the surgeon and assistants perform specific duties of surgery. He also established clinics and hospitals in many Russian cities and cities in Italy, Poland, Germany, Spain, and Yemen. He voyaged a clinic aboard the ship, Peter the First, to sail throughout the Mediterranean and Indian Ocean. 
Fyodorov was a political capitalist and member of Parliament. He created his own party, the Party of Workers’ Self-government, and campaigned for the President of Russia in 1996. Although he was not successful in the election, Fyodorov had a direct influence on the ophthalmic fraternity and the outside world.
While returning from a ceremony celebrating the anniversary of one of his microsurgery eye clinics, Fyodorov and three colleagues were killed in a helicopter crash near Moscow. Fyodorov (age 72) was not piloting the helicopter during the crash of June 3, 2000. P*

Christopher T. Leffler, B. Frits Hogewind, and Stephen G. Schwartz

The First Planned Cataract Extraction from the Posterior Chamber by Delivery of the Lens Which Jacques Daviel Documented was Performed on September 18, 1750

Background: Jacques Daviel (1696-1762) of France has been credited with presenting, in 1752, the first cataract extractions by delivery of the lens from the posterior chamber. However, when he actually performed the first such case has been unknown.

Methods:  Newspapers, publications, books and handwritten manuscripts from the 18thcentury related to Jacques Daviel and Natale Pallucci were analyzed.

Results: From 1747 onward, both Daviel and Pallucci performed or assisted in cataract couchings at the Hôtel Royal des Invalides in Paris with surgeon Sauveur Francois Morand (1697-1773).  In the spring of 1750, Daviel intended to take a grand tour of Europe, as far as London and St. Petersburg.  On July 3, 1750, Pallucci made a corneal incision to remove cataract fragments from the posterior chamber following a couching.  On July 7, 1750, Daviel, while in Leuven, performed the first of what became 4 months of animal experiments on cataract extraction.  Reports from Daviel’s 1750 stops in Cambrai in the Spring and Liège in the summer provide no hint that he had performed a revolutionary new technique in patients.  However, on Sep. 18, 1750, while in Cologne, Daviel extracted the cataract of Gilles Noupres, a Franciscan father, and handed the cataract, which was as soft as jelly, to the observing doctors.  The patient was able to see well enough to preach to his congregation 15 days postoperatively.  Daviel’s technique was hailed in the newspaper as his new method “seiner neuen Art”.  Daviel cancelled his planned European tour, and remained in France to defend his new method.  In 1751, Pallucci claimed that his July 3, 1750 surgery established his priority.  Daviel responded in 1752 that he had been occasionally performing cataract extractions since 1745 without telling anyone, but Daviel’s claims about his earlier ophthalmic practice were internally inconsistent.

Conclusions:  Planned cataract extraction from the posterior chamber by delivery of the lens was first documented by Jacques Daviel in Cologne on Sep. 18, 1750.  Only in 1752, after Daviel’s priority was challenged, did he begin claiming that he had performed planned primary cataract extractions before Pallucci’s July 1747 arrival in Paris.  It is conceivable that Jacques Daviel, Natale Pallucci, John Taylor, or others had performed the procedure before the fall of 1750, but none of them left supporting evidence. P*

Mark J. Mannis

The Vision of Esperanto: Ludwik Zamenhof's Dream

Ludvik Lejzer Zamenhof (1859-1917) was a visionary, who began his drive to create a universal language to foster worldwide communication and world peace as a young man. A dedicated ophthalmologist, who created a language that he envisioned as a universal common tongue that would bring diverse cultures together, Zamenhof worked in an era of divisiveness, national aggression, and imminent war.

Inspired to be an ophthalmologist because he felt it was a medical specialty that truly changed people’s lives, Zamenhof spent his non-medical life promoting Esperanto. Among the almost 500 “artificial” languages that have been created, Esperanto is the only of these that has enjoyed a degree of success and is still spoken by over two million people around the world.

Zamenhof’s contributions as a linguist in the context of practicing ophthalmology should be both a source of interest and pride to our specialty in medicine.

Curtis Margo and Lynn Harman

 Helen Keller, Ophthalmia Neonatorum, and the Social Dimensions of Eye Disease

Purpose: To describe, critique, and place in historical context an editorial written by Helen Keller in the 1909 Ladies’ Home Journal about the prevention of blindness from neonatal conjunctivitis.  

Results: Though blind, deaf, and nulliparous, Helen Keller at the age of 29 sensed that the newborn children of many American women were denied preventative treatment for ophthalmia neonatorum. Acknowledging that venereal disease may be an improper subject for respectable women to discuss, she nevertheless urged women to become proactive in matters of personal and family health care.    

Conclusions: Helen Keller viewed blindness from ophthalmia neonatorum as a failure of the American health care system. She wanted to provide women with essential knowledge so they would seek care from educated medical professionals The observation that many women and their children were receiving substandard medical care reflected a fundamental problem with disparities in its delivery. Her insights related to social disparities are as relevant in medicine today as they were in 1909. P*

Norman Medow

 Kenneth C. Swan M.D. …. The Man…. His Incision….and much…much…more!!

Ken Swan is best known to those of us that perform Strabismus Surgery, by having learned about the SWAN CONJUNCTIVAL INCISION APPROACH to a muscle. But… Dr. Swan made other significant contributions to Ophthalmology.

He opened up the upper west coast to Ophthalmic Education and laid the foundation to what is now the OHSU Casey Eye Institute, one of America’s finest Educational Institutions.

Along the way, he showed us how to perform a Peripheral Iridectomy in angle closure glaucoma, based on anatomical considerations, so that the iridectomy could be done ab externo, without having to search for the iris within the eye and often times lead to damage the lens, iris or cornea. This technique and his article about the anatomy of the eye, were REQUIRED reading by myself and ALL of my co residents when we were in training. This was all before the advent of lasers were introduced to perform a Peripheral Iridotomy.

The Swan Incision was developed by him to be a most direct approach to a muscle, fulfilling a most important tenet in Surgery…EXPOSURE>>>EXPOSURE>>>>>EXPOSURE.

Dr. Swan’s legacy has been greatly expanded in that when he began his Ophthalmology practice in Oregon, he was one of only 3 Board Certified Ophthalmologists in the state….by 2006 there had been 205 Board Certified Ophthalmologists that had practiced in the state… Many of whom had been trained by Dr. Swan.

His Leadership in developing Ophthalmic Education in the state as well as his great ability of fostering philanthropy, led to the development of the OHSU Casey Eye Institute. From it’s humble beginning as having been the sole teacher of Ophthalmology, in a yet to be developed Department of Ophthalmology, to the pinnacle of ophthalmic education that it has today. Tune in for more about the achievements of Dr. Swan.

Frances Meier-Gibbons and Thierry Zeyen

Ophthalmology in Stamps: From Ancient Times to the Present

Introduction: Since Sir Rowland Hill (1795-1879), also called the “father of stamps” invented the first stamp in 1840, many different themes painted on stamps have subsequently followed. These events have been nicely encapsulated by Thierry Zeyen, Professor Emeritus of the University of Leuven, Belgium, through his collection of over 900 stamps with different themes in the context “Ophthalmology”. This abstract will focus on a selection of these stamps, presenting the Ophthalmologist along with the historic occasions. 

Forerunners:

·      It is said that Pallas Athene, daughter of Zeus, was the first ophthalmologists because she could treat ophthalmological diseases and was called the goddess of protection for ophthalmologists.

·      Nicholas of Cusa (1401-1464) is said to be the inventor of the first concave eyeglasses for myopia.

·      John Pope XXl (1215-1277) was the only Portuguese Pope in addition to being the only ophthalmologist in this clerical position.

·      Benjamin Franklin (1706-1790), one of the founding fathers of the US, is credited for inventing the first bifocal glasses.

Famous ophthalmologists:

·      Albrecht von Graefe (1828-1870), famous German ophthalmologist who introduced the ophthalmoscope of Von Helmholtz into Ophthalmology. He conducted the first glaucoma operation, an iridectomy, in 1856.

·      Ferdinand Ritter von Arlt (1812-1887) working in Vienna, Austria, discovered the reasons for amblyopia and invented many ophthalmological operations.

·      Harold Ridley (1907-2001) saw that aircraft pilots in the Second World War could tolerate fragments of plastic (from airplane canopies) in their eyes. He was the first ophthalmologist to implant an intraocular implant made of polymethylmetacrylate (PMMA) after a cataract operation.

Ophthalmology congresses: Since the 15th International Congress of Ophthalmology in Egypt (1937), many ophthalmological congresses had their own stamps created for them.

Summary: Ophthalmology, one of the oldest fields of medicine, has been the source for hundreds of unique stamps since their first introduction in 1840.

References:

Zeyen, T., History of Ophthalmology told by postage stamps, Laboratoire Théa, 2019

Dietrich, HH., Augenärzte auf Briefmarken, Klin Mbl Augenheilk 194 (1989); 133-138

P*

Sayoko E. Moroi and Alan D. Letson

The History of Ophthalmology at The Ohio State University

The Ohio State University (OSU) started under President Lincoln’s 1862 Morrill Act “An Act donating Public Lands to the several State and Territories which may provide Colleges for the Benefit of Agriculture and the Mechanic Arts”. In 1870, the “Ohio Agricultural and Mechanical College” was established and renamed OSU in 1878. Willoughby Medical College of Columbus (established 1847) and Starling Medical College (1848) merged to Ohio Medical University (OMU) in 1890. In 1914, OMU merged with OSU as the College of Medicine. The Department of Ophthalmology and Otolaryngology was led by Dr. John Edwin Brown (1914–1923), who trained at University of Michigan, Medical College of Ohio, NY Post Graduate Medical School, and University of Vienna, Austria. Dr. Hugh Beatty (1923-1929) helped found the American Board of Plastic Surgery and recognized the need to separate the specialties. The Department of Ophthalmology was formalized under Dr. Albert Frost (1929-1945). Dr. Arthur Culler, who studied medicine and ophthalmology at Michigan, was acting chairman and chairman (1945-1953). He organized a residency program, partnered with optometry for the Institute for Research in Vision, developed an ocular pathology lab with Dr. Torrence A. Makely, prosthetics laboratory, photography, and bacteriology and immunology lab. Dr. Makely (1953-1959) convinced impressive understudy Michigan chief resident Dr. William Havener, who substituted for Michigan chairman Dr. Bruce Fralick’s talk at the 1954 Columbus EENT Society, to join OSU as the first full-time faculty. Dr. Havener, 35 years old, became the youngest chairman in 1959, stepped down in 1961, and Dr. Makely resumed leadership (1961-1972). Dr. Havener resumed duties (1972-1988) with a legacy of prioritized teaching medical students, re-structured residency, established the Annual Postgraduate Symposium, obtained research funding, taught AAO courses, introduced specialization, and pivoted from community ophthalmologists to full-time faculty. Dr. Paul Weber (1988-2004) transitioned the business model of private practices into a single not-for-profit corporation, brought OSU as the last program into Accreditation Council for Graduate Medical Education, contributed to glaucoma clinical trials, and raised a higher bar for medical student education. Dr. Thomas Mauger (2004-2018) led the department into the University Group Practice, started the free clinic, partnered with Columbus VA, implemented EPIC, and moved into the Havener Eye Institute. Dr. Matthew Ohr was interim chairman (2018-2020), implemented teleophthalmology, and segued into a new compensation plan. Dr. Sayoko Moroi retired from Michigan and returned to serve at her alma mater as the first woman chairperson on January 6, 2020.

Ala Moshiri and Tim Stout

Macular Star Retinopathy

Macular star retinopathy was originally described by Leber in 1916 as “stellate maculopathy.” Subsequently Gass associated this pathology with optic disc swelling in 1977 and suggested the term “neuroretinitis.” A macular star appearance, though perhaps most commonly seen in the context of infectious neuroretinitis, can occur in numerous conditions. These include hypertensive retinopathy, papilledema, anterior ischemic optic neuropathy, diabetic papillopathy, and retinal vasculitis among others. This presentation will review the history of macular star retinopathy, its differential diagnosis, and pathobiology. Additional insights based on recent experiments will also be presented.

Gary Novack

Regulation of Ophthalmic Ocular Hypotensive Drug Approval in the US over the Past 140 Years

Ophthalmologists and their patients have experienced multiple paradigm shifts over the past 140 years in topical ocular treatment of elevated intraocular pressure in patients with glaucoma and ocular hypertension. In the 19th century, pilocarpine was introduced. In the 20th century, epinephrine, its pro-drug dipivefrin, timolol, dorzolamide, and latanoprost were introduced (as well as other agents in those drug classes). In the 21st century, netarsudil was introduced. The author will review the magnitude and quality of the clinical data used to support the adoption of these now sterile and stable drug products into our therapeutic pharmacopeia, concomitant with federal congressional laws, and public events driving those laws. P*

James Ravin

Flavel Tiffany's Sojourn Among the Oculists of Europe, 1896

Flavel B. Tiffany, MA, MD, an ophthalmologist who practiced in Kansas City, MO, authored several books and made two lengthy European tours. He was a Civil War veteran and received his MD degree from the Univeristy of Michigan.
His Sojourn among the Oculists of Europe (Hudson-Kimmerly Pub. Co., Kansas City, MO, 1896) is half travelogue, half a chatty view of prominent European ophthalmologists. Tourism took him from Blarney and Killarney to the continent. His longest discussion of ocular topics is given to cataract, but glaucoma, lid problems, and sympathetic ophthalmia are also addressed.
Physicians, not only ophthalmologists, are described by location: Dublin (Jacob, Fitzgerald, Swanzy, Maxwell, Story, Benson); Belfast (Nelson); Edinburgh (Argyll Robertson, Berry); Liverpool (Browne); Birmingham (Priestley Smith); London (Schaffer, Nettleship, Carnow, Cross, Fay, Lang, Cilcox, Juler, Power, Lister); Paris (Abadie, Panas, Landolt, De Wecker, Meyer, Galezowski, Charcot); Brussels (Coppez); Utrecht (Donders); Copenhagen (Hansen); Berlin (Hirschberg, Schweigger, Schoeler); Halle (Alfred Graefe); Leipzig (Schwartz); Prague (Sattler); Vienna (Fuchs, Gruber, Konigstein); Heidelberg (Becker); Strassburg (Stilling). P*

Ivan Schwab

Ocular Vestiges, Atavisms, and Remnants

Introduction: Evolution has gradually developed multicellular life though unfathomable lengths of time and random tinkering using various genetic tools. As those 3.75 billion years passed, some of the genetic tissues and organs became unnecessary, or even counterproductive, for new species. Most of those evolutionary developments were discarded, but occasionally, genetic effluvia remained in the dust bin of many genomes only to rise again unexpectedly in later progeny. Hence, ancestral anatomical tissues and ancient forms that were long ago meant for other animals can and do appear randomly across the human body. The genetic tools for these inborn surprises still reside in the human genome. The eye is no exception to these novel bits of unneeded, useless, and sometimes harmful anatomic changes. We will explore a few of these including the implications for ocular anatomy and ocular health.
Methods: Literature review of PubMed, Scopus, Google Scholar,  for vestiges (remaining traces of previous tissue or organ), atavisms (ancestral tissues occurring in subsequent generations after being lost evolutionarily), and remnants (remaining fragment of tissue used for other purposes.) Review of ocular anatomy chapters and books of mammalian, piscine, canine and murine species. Limited human cadaveric dissection and histologic inspection. 
Results: Multiple ocular vestiges, atavisms, and remnants have been discovered. These include the nictitans, the retractor bulbi, cartilaginous shell, scleral ossicles, Mueller orbitalis muscle, the pupillary membrane, Mittendorf dot, Cloquet canal, ocular coloboma, and perhaps cone distribution. Remnants include but are not limited to the caruncle and atrophic globes.
Conclusions: There is a surprising number of ocular vestiges, atavisms, and remnants. In most cases, these are novelties but can occasionally result in serious visual symptoms, signs and consequences. P*

Daniel Whitfield and Robert Enzenauer

An Overview of Eye Surgeons Knighted by the British Monarch

Sir Arthur Conan Doyle once said, “There's no need for fiction in medicine…for the facts will always beat anything you fancy.” As an ophthalmologist by training, he knew this firsthand. There is also no need for fiction in describing the history of his compatriots. At least 32 ophthalmologists have been knighted by the British monarch. Too numerous for one presentation, I have broken the list down into a few categories: those knighted for extraordinary advances within ophthalmology, for medical advances outside of ophthalmology, and for other reasons.

First, I highlight those knighted for ophthalmological advances. Many are familiar names, including Sir Harold Ridley, inventor of the intraocular lens. However, I will focus on Dame Ida Mann, who pioneered surgical technique and greatly advanced knowledge of embryology, eye development, and genetic/social impacts on eye health. Among her accolades are becoming the first woman appointed a professor at Oxford and being appointed a Dame Commander of the Order of the British Empire (DBE). 

Next are those knighted for medical advances outside of ophthalmology. For instance, Sir Jonathan Hutchinson was the first to describe the triad for congenital syphilis, and Sir Norman Gregg established the symptoms of congenital rubella. Sir William Bowman, 1st Baronet, developed advanced microscopy techniques that revolutionized anatomy and physiology. I will focus on Sir James Mackenzie Davidson, the first in Scotland to use mysterious “rays” to image tissue. His work with X-rays earned him the unofficial title of “founding father of British radiology.”

I will then analyze those knighted for other reasons. Many of these are political feats, such as Sir William Read, a ‘quack’ ophthalmologist who became a knighted oculist to Queen Elizabeth. Regrettably, Sir Arthur Conan Doyle was knighted for his literature supporting British colonial atrocities. I highlight Sir William Lawrence, 1st Baronet, who wrote a pre-Darwinian book outlining the theory of evolution. After being labeled “blasphemous” and heretical by the Lord Chancellor, he withdrew the book, and went on to a successful career as President of the Royal College of Surgeons and Serjeant General to the Queen.

In summary, one might mistake this presentation for a fictional novel due to the drama and intrigue of each knight’s story. There are numerous ophthalmologists who earned a knighthood, whether from their advances within ophthalmology, for medical advances outside of ophthalmology, or for other reasons.

Page last updated January 4, 2024