2026 Meeting Abstracts

Zara Ahmed, Esther Kang, Eric Wan, Kishan Avaiya, and Alice T. Gasch

Dr. Thomas D. Duane: Shaping Modern Ophthalmology Through Education, Research, and Leadership

Background: Dr. Thomas D. Duane (1917-1993) was a leading figure in twentieth-century American ophthalmology and founding editor of Duane's Clinical Ophthalmology. This project explores Duane's influence on the academic and educational foundations of ophthalmology and his role in advancing the field's national prominence.
Methods: We analyzed primary sources from Duane's UC Berkeley oral history interviews, research publications, textbooks, obituaries, and newspaper articles.
Results: Dr. Duane shaped ophthalmology education by emphasizing clinical rigor and humanistic patient care. As Chairman of the Department of Ophthalmology at Jefferson Medical College (1962-1981), Duane rebuilt the department by creating a structured training program for the residents focused on comprehensive eye examinations, while emphasizing thoroughness, honesty, and patient-centered care. Not only did he serve as a personable mentor, he also increased resident supervision to foster a supportive learning environment and advocated for a balanced, clinically relevant medical curriculum that prioritized educational need over departmental prestige.
Duane drove the affiliation between Wills Eye Hospital and Thomas Jefferson University and made major contributions to the design of the current facility, which has shaped it into a premier ophthalmic training institution.
His research spanned diverse areas, most notably blackout studies in NASA pilots. He also published studies on Valsalva hemorrhagic retinopathy, pseudo-Duane's retraction syndrome, and white-centered hemorrhages.
Duane’s love of literature, particularly the works of William Shakespeare, informed his proudest achievement: founding and editing Duane's Clinical Ophthalmology. This continuously updated loose-leaf textbook was geared towards residents and physicians and shifted ophthalmic education from encyclopedic teaching to clinically relevant, case-based learning. Together with Biomedical Foundations of Ophthalmology, these resources shaped modern ophthalmology academic texts.
His work with Research to Prevent Blindness produced Ophthalmic Research: USA, in which he published his findings from surveys assessing ophthalmic research needs. His work and advocacy played a central role in establishing the National Eye Institute, which was instrumental in securing national funding and institutional support for ophthalmic research.
Conclusions: Through humanistic mentorship, educational innovation, research contributions, and editorial leadership, Duane transformed ophthalmology training and practice. Beyond his departmental revitalization at Jefferson, Duane shaped the national infrastructure and academic legitimacy that the ophthalmology field holds today.

Mohammad Javed Ali

Three Stories Intertwined with Lacrimal History

Purpose: This presentation aims to bring to light three interesting stories and lessons intertwined with the history of lacrimal science.
Design/Methods: Review of lacrimal literature to obtain primary and secondary written material on these three stories.
Results: The first story is about Dominique Anel (1679-1730), whose innovations and work on lacrimal fistulas form a cornerstone in the development of lacrimal science. I would focus on the aspects of the story when he was tormented by several peers with scathing, personal criticisms, and his fightback to regain his footing in the lacrimal world. The second story is about the meeting point where, on two occasions, lacrimal surgeons met with immortal music. The third story is about the public duel between Eric Nordenson and Eric Widmark (known for the earliest impactful work in lacrimal sac microbiology) for the Chair of Ophthalmology at the Karolinska Institute, and how it changed the course of the Nobel Prize. 
Conclusion: Each of these stories is fascinating and has several morals for all of us to learn, and how certain individual actions can change the face of history.

Barbara Arnold and Mildred Olivier

Women in Ophthalmology – Over Four Decades of Vibrant Growth

The founding of Women in Ophthalmology was initiated by Dr. Marjorie Mosier. She reflected that women in academic medicine needed to have meaningful conversations about gender bias, wage equity, and opportunities to secure tenured positions. Beginning in 1979, Dr. Mosier mailed invitations to women members of the AAO with academic affiliations for lunchtime discussions on this topic. The following year, those in private practice were included as well; it was apparent that many AAO committees had no women, and few women were seen on the podium. Dr. Bernice Brown was integral in convening women in this early effort, securing off-site venues near the AAO meetings. Conversations evolved about how we could be included in AAO affairs. To move beyond a luncheon discussion group, an organizational structure was essential. Dr. Penny Asbell was asked to be the presiding officer of this newly formed group. WIO organizational bylaws were drafted. WIO was incorporated in the state of New York. Under Asbell’s leadership in 1989, we had the valid documents to qualify us to apply for a seat on the AAO Council. A board of directors was elected. Dr. Bernice Brown, vice-president, served a four-year term with Dr. Asbell.

As a board member, Dr. Barbara Arnold was appointed to be the alternate councilor and served in the Council seat representing WIO as an “observing” organization. For three years in a row, 1989 – 1991, Dr. Asbell and Dr. Arnold wrote letters asking for voting privileges and spoke at the microphones during the AAO Council meetings with the compelling message that our members had leadership skills and could make major contributions to serve AAO. Dr. Bronwyn Bateman, a seated Councilor for the Pan-American Association of Ophthalmology, argued on behalf of WIO as well. Arguments for inclusion emphasized the potential talent pool of skilled women physicians who could make major contributions. On October 15, 1991, WIO became a voting member of the Council. Annual WIO/AAO co-sponsored educational symposia began in 1997. The Summer Symposium, initiated by President Barbara Arnold in 1998, is a family-friendly four-day meeting for scientific presentations, mentorship, negotiation, and communication skills. Medical students and residents are important participants. Enthusiasm for the summer meeting grew quickly, and attendance (including a virtual component) reached 1600. Surpassing the founders’ vision, WIO creates a collaborative, win-win environment that actively supports the success of every participant.

Surbhi Bansal

The Political Eye: Ophthalmic Trauma as Statecraft in the Timurid-Mughal Dynasty

In the Timurid-Mughal tradition, the blinding of dynastic rivals was not merely an act of mutilation, but a specific form of political statecraft. Governed by the Chaghatai legal code which dictated that a blind man could not rule, blinding served as a "humane" alternative to execution—a method of disqualifying a rival from the throne without ending his life. This presentation analyzes the evolution of this practice across three centuries of Mughal rule in India, arguing that the medical sophistication of the blinding method mirrored the political stability of the empire itself. We identify a distinct "trajectory of trauma" through three pivotal case studies, reconstructing the specific surgical and crude techniques employed in each era. We begin with the zenith of imperial order: the 1553 blinding of Prince Kamran Mirza by his brother, Emperor Humayun. Recorded in the Humayun-nama, this procedure was conducted with "sterile intent" by a royal phlebotomist using a lancet to pierce the limbus, followed by the application of lemon juice and salt to chemically induce permanent corneal opacity. We contrast this surgical precision with the 1719 blinding of Emperor Farrukhsiyar at the hands of the Sayyid Brothers. Imprisoned in the Tripolia gates, the deposed emperor was subjected to hot needles and wire—a technique that lacked the anatomical finesse of the lancet, representing the fraying of imperial norms. Finally, we examine the total collapse of the state in 1788, illustrated by the blinding of Shah Alam II by the Afghan warlord Ghulam Qadir. This event devolved into brutal enucleation via dagger, lacking any pretense of medical procedure. By tracing this shift from the "surgical" to the "savage," we demonstrate that the devolution of ophthalmic technique was a symptom of the empire's fragmentation. As centralized authority eroded amidst the rise of regional factions and colonial powers, the regulated statecraft of the court gave way to the unchecked brutality of a fracturing state.

George Bartley

My Dinner with Jack (Mustardé)

John Clark (“Jack”) Mustardé was among the most influential plastic surgeons of the past century and has been honored by several eponymous operations. Early in my career, I was invited to host Professor Mustardé for a private dinner. Our conversation was wide-ranging and an extraordinary learning experience. This presentation will highlight our subsequent correspondence about surgical technique in addition to lesser-known chapters of Mustardé’s life including his early training in ophthalmology, his experiences as a prisoner of war during World War II, and his post-retirement establishment of a reconstructive plastic surgery hospital in Ghana. 

Bronwyn Bateman

Institutional Integrity: The History of the Rocky Mountain Lions Eye Institute at the University of Colorado

In 1991, eight men met at the Denver Country Club, and each put $100 on the table after breakfast to start the process of building the Rocky Mountain Lions Eye Institute. Later that year, this group signed an agreement between the Lions Clubs of Colorado and the University of Colorado to create and build an eye institute, guaranteeing $6 million. They created a non-profit business for fund-raising.

In 1995, a new Chair of Ophthalmology, Bronwyn Bateman, arrived in Denver from UCLA to take the position of Chair of Ophthalmology, the first woman in any department in the School of Medicine. She brought her National Institutes of Health molecular biology grant, studying the bases of hereditary cataracts, with her as well as her double board certification in both ophthalmology and medical genetics. She also brought knowledge of UCLA infrastructure.

Despite four years of fundraising, only a few thousand dollars had been raised by the Lions of Colorado, the Rocky Mountain Lions Eye Institute Foundation and the University of Colorado Foundation; the Department of Ophthalmology did not participate. No acknowledgements were sent as the amounts were ‘small.’ Per one of the original eight, Robert Sweeney, the project was ‘dead in the water’ when the new chair arrived.  Bateman’s challenges were: clinical activities, departmental infrastructure, education, faculty, fiscal stability of the department, fund-raising, national and international activities, and research.  Bateman raised money from several members of Lions Clubs in Colorado and Wyoming as well as from many individual supporters of the project who were not affiliated with Lions Clubs. She received major support from Sweeney, President of the Kenneth Kendal King Foundation. She wrote multiple grants to Lions Club International and to foundations that were not affiliated with Lions Clubs.  The Rocky Mountain Lions Institute began functioning with teaching, clinical services and research in 1995 when Bateman arrived. The building to house the Institute was inaugurated in 2001. The Rocky Mountain Lions Eye Institute was ultimately lost after 2010.

Christopher Blodi and Danny H.-Kauffmann Jokl

Jay Galst, MD and the Medals of the Cogan Ophthalmic History Society

Purpose: This presentation reviews the life of Jay Galst, MD (1950 -2020) and how the combination of his concurrent careers as an ophthalmologist and numismatist led to the development of the Cogan Ophthalmic History Society medals.
Methods: Oral and written interviews were completed with people directly involved with the creation of the medals. Secondary written material was reviewed.
Results: Galst’s knowledge of ophthalmic history and his vast experience in numismatics, including in the production of medals, allowed for the creation of the Charles Snyder Lecturer medal and the Meritorious Service medal.
Conclusions: Expertise in both ophthalmology and numismatics allowed Jay Galst, MD to visualize and create the two medals of the Cogan Ophthalmic History Society: the Charles Snyder Lecturer Medal and the Meritorious Service Medal

John Bullock

Ocular-Related Iatrogenic Disorders (Snyder Lecture)

Iatrogenic causes are defined as diverse factors arising from any medical activity, intervention, treatment, or advice that result in an unintended and adverse outcome for the patient, such as a new illness, injury, recurrence, or complication. A disorder signifies a deviation from the usual or healthy state.

The therapeutic use of bloodletting had been a common medical practice since antiquity, first appearing in Egypt, as described by the Ebers papyrus circa 1550 BCE. The concept that illness resulted from an imbalance of the four bodily humors is traditionally attributed to Hippocrates (c. 460-c.370 BCE) who recommended therapeutic phlebotomy for the treatment of various systemic conditions including apoplexy, headaches, pneumonia, seizures, and others. Overzealous blood loss, however, can result in blindness. Hippocrates has been credited with the admonition “First, Do No Harm”.

Paracelsus (1493-1541), the Swiss physician and alchemist who pioneered the therapeutic use of chemicals in medicine, objected to excessive bloodletting, believing that the process disturbed the harmony of the body’s system and that blood could not be purified by merely decreasing its volume. Paracelsus recommended the administration of highly specific medicines and he treated a variety of diseases with orally administered chemicals, including mercury, arsenic, and lead; all three of these elements are now well-known to cause toxic oculopathies. Paracelsus stated: “Solely the dose (of a medication) determines that a thing is not a poison”.

The Athenian scholar and Hippocratic contemporary, Socrates (469-399 BCE), was the earliest philosopher who recognized error as something he himself actively caused; he made that recognition a core of his philosophical method.

During my 2026 Snyder lecture, I will propose that Hippocrates and Paracelsus were the first physicians to recognize ocular-related iatrogenic disorders (ORIDs) because they, most likely, had caused or observed them. I will also elaborate my 57-year ophthalmological experience involving numerous other instances of ORID’s with which I am highly familiar. These ORID’s encompass those resulting from systemic or ocular treatments/procedures/advice as well as systemic disorders resulting from ocular therapies or procedures. They include disorders associated with ophthalmic and non-ophthalmic surgery, dental procedures, blood transfusions, local and general anesthesia, radiation therapy, medications (including eye drops), diagnostic testing, and medical advice, among others. It is hoped that a knowledge of this topic will prevent or mitigate future disabilities associated with ocular and medical treatments and procedures.

Du Cheng and Christopher T. Leffler

The Invention of the Silicone Intraocular Lens in China in 1978

Introduction: Little has been written in the West regarding the invention and early development of the silicone intraocular lens (IOL). It is often written that Zhou Kaiyi in China is the inventor of the silicone intraocular lens. We explore the early development and clinical application of soft silicone IOLs in China during the late 1970s by two independent groups.
Methods: By reviewing the original medical literature and more recent media from the 1970s to today, as well as direct interviews of some of the original co-authors on the research teams, we were able to construct a timeline and obtain details of the development of intraocular lenses in the two groups.
Results: Driven by a lack of resources for intraocular lenses, there were two groups which started working on developing silicone intraocular lenses in China in 1978: Zhou Kaiyi’s group in Chengdu, and Zheng Yiren’s group in Shanghai. Both groups claimed that they started their work in early 1978. Both groups presented their work for the first time at the Second National Ophthalmology Meeting in February 1979 in Chengdu. By 1981, Zhou’s group published 67 cases of clinical application of silicone IOLs and Zheng’s group published 20 cases. These silicone IOLs pre-date Mazzocco’s folded silicone lenses and were implanted through a large incision without folding. Zhou continued to make improvements in silicone IOLs and the Shuguang biomedical engineering technology research institute was formed to mass produce the silicone IOLs. Zhou ran a training program from 1984 to 1997 and trained a total of 1200 ophthalmologists and technicians. While Zheng’s IOL implant was successful, he shifted his attention to develop silicone corneal prosthetics for use in penetrating corneal keratoplasty. Zhou presented their work and gave out samples at international conferences.
Conclusion: While we credit both groups for their initial effort inventing the silicone IOLs, Zhou’s group carried on the work with meaningful clinical and industrial volume, and laid the foundation internationally for the silicone IOL landscape.

Rupert Congmon

From Sight to Certification: Driver Vision Standards and the Transformation of Ophthalmic Authority, 1900–1970

At the beginning of the automobile era, licensing did not initially test eyesight. Early operators instead attested to their “physical condition,” placing the body under administrative scrutiny rather than clinical care. As automobiles spread, this logic hardened. The 1934 Uniform Vehicle Code required applicants to demonstrate knowledge, driving ability, and particularly, eyesight. Vision was no longer merely a biological attribute; it became a credential required to use public infrastructure.
This development reflected a new social problem. Automobility required preserving personal independence while limiting danger to others. Vision proved uniquely suited to negotiation between these aims: it was measurable, rapidly testable, and correctable. A driver might fail a visual threshold yet immediately regain eligibility with lenses, making participation contingent on managed functional capacity rather than diagnosis.
By mid-century the shift was explicit. Federal motor-carrier regulations in 1952 mandated physician certification and defined measurable thresholds such as 20/40 Snellen acuity, including eligibility conditional upon corrective lenses. The physician increasingly acted not in response to complaint but as an evaluator of capability. Vision specialists were soon recruited as consultants to traffic authorities, expanding concern from acuity to glare, adaptation, and visual fields as predictors of driving performance.
State statutes completed the transition. Laws such as Virginia’s 1968 requirements granted specialist reports administrative precedence and created graded licenses, such as daylight restrictions or corrective-lens requirements, based on measured sensory performance. Clinical measurements now determined lawful participation in ordinary mobility.
Driver licensing therefore reveals a change in the public function of ophthalmology. Rather than only restoring vision, ophthalmic examination came to mediate between individual capacity and participation in a technological society.

Mary Daly, Yonwook J. Kim, and Abhishek R. Payal

Tears as Tactics: An Ophthalmic History of Tear Gas

The use of chemical agents to incapacitate through ocular irritation is recorded as early as the 5th century B.C. during the Peloponnesian War. Tear gases, also known as lacrimators, cause significant eye pain, tearing, and blepharospasm, disabling the person who is exposed. They have been used in war, law enforcement, military training, crowd-control, and civilian self-defense. We will discuss the use of tear gas throughout human history, short- and long-term risks, and controversies surrounding its continued use in society today.

Edward De Sutter

Waardenburg, von Verschuer, and Ophthalmic Genetics at the Deutsche Ophthalmologische Gesellschaft (D.O.G.) Meeting, Heidelberg, 1936.

This presentation examines how the prevailing scientific and social climate shaped ophthalmic genetics between 1900 and 1945, using the Deutsche Ophthalmologische Gesellschaft meeting of 19 July 1936 as a historical focal point. At this meeting, both Petrus Johannes Waardenburg and Otmar Freiherr von Verschuer presented on hereditary aspects of eye disease.

The analysis traces how research on inherited ocular disorders—initially a legitimate and internationally respected scientific endeavor—became ethically compromised through ideological alignment and institutional acquiescence in the 1930s and early 1940s. Particular attention is given to the erosion of professional responsibility, the failure of ethical oversight, and the susceptibility of scientific authority to political misuse.

The presentation concludes by addressing the loss of patient autonomy in this period and reflects on the continuing obligation of ophthalmologists to uphold informed consent and individual dignity in the contemporary era of genetic testing and reproductive medicine.

Sophie Gorup, Eric L. Wan, Kishan Avaiya, and Alice Wendy True Gasch

History of Aniridia: A Window Into Ocular Genetics

Introduction:
Aniridia – the partial or complete absence of the iris – remains rare. However, its discovery and scientific underpinnings remain critical to the history of ocular genetics and genetic syndromes. We provide a unique chronology of aniridia, beginning with Giovanni Baratta's original description in 1818, which ultimately paved the way for a genetic reckoning in the 20th century.
Methods:
To better understand the history of aniridia, its identification, and its pathophysiology, we consulted original manuscripts, including Baratta’s text, and primary scientific literature. To contextualize our findings, we performed a literature review and interviewed historians and scientific experts on the condition. We sought insight into the history of aniridia, its association with known genetic syndromes, and societal perceptions and implications.
Results:
In 1818, Giovanni Baratta published “Osservazioni Pratiche Sulle Principali Malattie Degli Occhi” (Practical Observations of the Principal Maladies of the Eyes), which includes the first known description of aniridia. The title of “Osservazione XCV” (Observation 95) translates to “Two Eyes lacking irises with complete cataracts, and the subject seeing excellently.” Much of the known basics of aniridia can be gleaned from Baratta’s original description – aniridia is rare, impairs vision, and predisposes to cataracts.
One hundred years later, scientists and physicians studied the genetics of aniridia. In 1964, Robert W. Miller discovered the association between aniridia, Wilm’s tumor (nephroblastoma), and other congenital abnormalities, which led to the term WAGR (Wilms Tumor, Aniridia, Genitourinary Anomalies, and Range of Developmental Delays) Syndrome. In 1965, Dr. Frederick D. Gillespie introduced a new syndrome characterized by aniridia, oligophrenia, and cerebellar ataxia – Gillespie Syndrome. Both of these syndromes reflect a common theme in ophthalmology, where an external, visible ocular anomaly or pathology clinically guides a physician to explore other systemic and, in this case, genetic pathology.

Alison Hong

Early Ophthalmology Graduates of the Woman’s Medical College of Pennsylvania

At the beginning of the 19th century, formal medical education for women in the United States was nonexistent. In 1850, the founding of the Woman’s Medical College of Pennsylvania in Philadelphia provided the first opportunity in the world for women to earn a medical doctor (M.D.) degree. The program allowed both domestic and international female students to study, train, and research in a variety of medical specialties. Two of the early graduates of the school included trailblazing ophthalmologists, Dr. Amy Barton and Dr. Romania Penrose.
Dr. Amy Barton graduated from the Medical College in 1874 and subsequently spent over a decade training with Dr. George Strawbridge at Wills Eye Hospital. She then returned to the Medical College to become a professor of ophthalmology. Among her achievements in ophthalmology, Dr. Barton opened a medical dispensary clinic in the underserved area of South Philadelphia in order to provide a training opportunity for graduates of the College and to serve a community with extremely limited access to health care.
Dr. Romania Penrose of Utah attended the College with funds raised by members of the Church of Latter-Day Saints. She graduated from the College in 1877 as the first Mormon woman from Utah to graduate with a medical degree. She studied both ophthalmology and otolaryngology, spending time at Wills Eye Hospital learning from Dr. Strawbridge, and at the New York Eye and Ear Infirmary. She then returned to Utah to start her own medical practice. It is reported that she was the first surgeon in Utah to perform cataract surgery. She later taught obstetrics at the Deseret Hospital in Utah.
Although there are likely other 19th-century female graduates of the Woman’s Medical College of Pennsylvania who contributed to the field of ophthalmology, published research on these physicians is limited. The documented career trajectories of both Dr. Amy Barton and Dr. Romania Penrose demonstrate how the founding of the Woman’s Medical College of Pennsylvania provided the opportunity for some of the first formally educated female physicians to train in the field of ophthalmology. Their legacies also highlight how many of the female physicians of the 19th century were multidisciplinary physicians.

Arslon Humayun, Andrea I. Copland and Pradeep Y. Ramulu

Aida de Acosta Root Breckinridge: The Catalyst Behind 100 Years of Wilmer

Introduction:
In 2025, the Wilmer Eye Institute marked its 100th anniversary. To celebrate, the Wilmer Centennial initiative was created to spotlight decades of progress at the intersections of clinical care, research, and public health within the field of ophthalmology. In addition to medical milestones, it is important to acknowledge the catalytic forces that allowed an institute like Wilmer to exist in the first place. Perhaps no one is more important to this legacy of innovation than Aida de Acosta Root Breckinridge, the founding donor at the Wilmer Eye Institute. In this presentation, we will discuss the life and philanthropy of Breckinridge, and how a glaucoma diagnosis led to the foundation of one of the most esteemed ophthalmological institutes in the world.
Methods: To understand the motivations and contributions of Breckinridge in the establishment of the Wilmer Eye Institute, we consulted institutional papers including letters of correspondence, photographs, and magazine articles from the Friedenwald-Romano Library at the Wilmer Eye Institute. To frame these findings, we conducted a literature review of news articles and manuscripts from the Johns Hopkins Libraries and ProQuest Historical Newspapers databases. We sought to explore: the life of Breckinridge, her glaucoma diagnosis and its impact on her career, factors leading to her seeking care under Dr. Wilmer, and her philanthropic efforts that led to the founding of the Wilmer Eye Institute.
Results: Breckinridge was a pioneering aviator, prominent socialite, and dedicated philanthropist. Deteriorating vision and a suggestion from a British statesman at a dinner party led her to seek the care of Dr. William Holland Wilmer, a prominent ophthalmologist in Washington, D.C., who diagnosed her with glaucoma and performed vision-saving surgery. Amazed by his care – but not afraid to go against his wishes – Breckinridge began a philanthropic campaign that would raise over $3 million toward the founding of the Wilmer Eye Institute. Without Breckinridge, there would be no Wilmer Eye Institute.
Conclusion:  The contributions of Breckinridge to the founding of the Wilmer Eye Institute cannot be overstated. She was committed to establishing an institute that would train future leaders in ophthalmology to provide the same standard of care that she had received from Dr. Wilmer. Breckinridge embodied the virtues celebrated by the Wilmer Centennial: Imagination, Innovation, and Impact. As we look toward the next 100 years of Wilmer, it is important to remind ourselves of this rich history and the lasting legacy of Breckinridge.

Hadi Joud and Curtis Margo

Cataract Surgery and the History of Patenting Surgical Procedures

The development of modern cataract surgery serves as a powerful example of the pace and impact of innovation in surgical methods. The development of an artificial intraocular lens by Harold Ridley and the invention of phacoemulsification by Charles Kelman revolutionized cataract surgery, bringing it into the modern era of safe and effective intraocular surgery. In parallel, extracapsular cataract extraction continued to modernize, transitioning from the large corneal limbal incisions employed by Jacques Daviel to the self-sealing sclerocorneal tunnel incisions employed in manual small incision cataract surgery (MSICS). Many ophthalmologists filed patents for their new techniques, including Kelman in 1967 for his phacoemulsification system. In the 1990s, ophthalmology stood at the forefront of the national discussion over whether surgical procedures should be patented.

In 1993, Samuel Pallin patented a self-sealing episcleral “chevron” incision for extracapsular cataract surgery, aiming to reduce suture-induced corneal astigmatism. Pallin sought to collect royalties by licensing this incision to other cataract surgeons, including Jack Singer. When Pallin sued Singer for using a similar incision, Singer refused to pay the royalties, which initiated a political movement that lobbied Congress to reform US patent law. While the movement did not achieve its goal of banning medical procedure patents, their advocacy resulted in the passage of 35 U.S. Code § 287, which rendered medical procedure patents unenforceable. This case raised complex ethical issues in medicine, which will be placed in historical context. 

By exploring the history of modern cataract surgery evolution, the Pallin v. Singer case, and the ethical-legal controversy surrounding surgical procedure patents, this presentation highlights ophthalmology’s role in the changing landscape of medical ethics and the profession’s commitment to the open exchange of surgical knowledge.

Talia Korobkin, Eric L. Wan, Chau Nguyen, Kiah McSwain, Sonia Catalina Francone, Brian Do, and Alice Wendy True Gasch

Disney History for the Ophthalmologist

Background
For over a century, the Walt Disney Company has entertained children and adults alike. We sought to understand how Disney has intersected with ophthalmology throughout the history in media, theme parks, research, and charity.Methods
We collected primary and secondary sources and contextualized these with expert interviews. We also consulted archivists and art experts to validate and refine our findings.
Results
Walt Disney’s personal ophthalmologist, Dr A. Ray Irvine of the Doheny Institute, is honored on Disneyland’s Main Street. The Irvines enlisted Disney’s engineers to conduct experimental ophthalmic pathology projects on inflammation, specifically to shoot time-lapse photography. It is possible that the Irvines’ relationship with Walt yielded a niche JAMA paper in 1926. Furthermore, the famed Dr. Jules Stein had a close friendship with Walt Disney that enabled the financing of Disneyland. Astute COHS members may speculate if Walt Disney was secretly an ophthalmologist-in-training. Indeed, many of Walt’s creations required a great understanding of how vision works. To celebrate the opening of the Jules Stein Eye Institute in 1966, Walt commissioned his favorite artist, Mary Blair, to create the “It’s a Small World” mural, now hanging in the children’s waiting area.

Mary Blair contributed to iconic Disney films, including the 1951 film adaptation of Alice in Wonderland. Very little is known about her eyes, despite her astonishing accomplishments as a mid-century woman artist. We hypothesize that her visual impairments influenced the distinctive animation style seen in her work. We briefly discuss her symptoms and history to make the case for possible diagnoses. In an interactive component of our talk, we invite the audience to explore these possibilities with differently-colored lenses and copies of her original artwork.
Furthermore, we describe the evolving portrayal of ophthalmic conditions (i.e., strabismus, blindness, and myopia) from the first Disney films to the present day. We also discuss how Disney’s Imagineering research projects about the eye and vision have shaped and continue to influence visual effects. Imagineering is Disney’s highly secretive ‘research and development’ arm responsible for the design of all storytelling elements in Disney, from their movies and theme parks to cruise ships and hotels.
Conclusion
Disney’s connections to ophthalmology are diverse and have had a profound and lasting impact on film and media arts. We hope ophthalmologists and historians at COHS will appreciate this exploration of how the entertainment industry has unexpected overlaps with our specialty.

Christopher Leffler, William Banko, and Stephen G. Schwartz

The Development of Small-Incision Cataract Surgery by Charles Kelman and Anton Banko: Insights Based on Newly Identified Documents

Purpose. To describe the development of small-incision cataract surgery by ophthalmologist Charles Kelman and engineer Anton Banko in the 1960s, which occurred when they modified an ultrasonic dental scaler (Cavitron, NY) to emulsify cataracts. 
Design. Review of primary source materials discovered from 2023 to 2025, scholarly literature, and interviews.
Methods. We reviewed the John A. Hartford Foundation files related to Kelman, and a newly discovered memo from Cavitron engineer Anton Banko, dated Jan. 13, 1966. We interviewed people who knew Kelman and his coworkers.
Results. Kelman was interested in reducing the need for hospitalization after cataract surgery when he was a resident at Wills Eye Hospital from 1958 to 1960. Kelman began working on cryoextraction in the fall of 1962, and believed freezing could shrink the lens. In the fall of 1963, he began performing research at the Manhattan Eye Ear and Throat Hospital. Richard C. Troutman of that hospital served as a consultant on his first research grant. Troutman used a “two-way syringe” (with irrigation and aspiration) to remove congenital cataracts. Kelman’s first grant, which became active in Jan. 1964, proposed using both cryoextraction and either a “two-way syringe” or a plastic encapsulating bag to enable small-incision cataract surgery. During the first half of 1965, Kelman had a visiting dentist working in his lab, and was investigating for cataract surgery a rotary cutting tool with concentric irrigation and aspiration elements. By mid-1965, Kelman had begun investigating the Cavitron ultrasonic dental scaler as a tool to emulsify cataracts. On July 13, 1965, Cavitron engineer Anton Banko met with Kelman at his hospital, and they began a program to add ultrasonic energy to the cutting tool with irrigation and aspiration, using longitudinal vibration to reduce iris disinsertion and a titanium tip to reduce flaking. On Aug. 27, 1965, Kelman first experimentally tested a custom ophthalmic ultrasonic phacoemulsifier. The phacoemulsification instrument was first able to successfully remove a cataract in a cat’s eye on March 23, 1966. The first two phacoemulsifications in human patients took place between April and June of 1967. 
Conclusions. Kelman was focused on small-incision cataract surgery from early in his career. He modified a number of existing pre-existing technologies (cryoextraction, irrigation-aspiration devices, rotary cutting instruments, dental ultrasonic devices) in his pursuit of this end, and was ultimately successful by 1967.

Eric Lien, Christopher T. Leffler, and Stephen G. Schwartz

Jefferson Davis and His Ophthalmologists

Background. Jefferson Davis, the president of the Confederate States of America, is known to have had a chronic eye ailment, but many details of his ophthalmic care have been uncertain.
Methods. Review of historical documents.
Results. Historical accounts as early as 1851 described “great irritability in the nerve of the eye” and what appears to be corneal edema that “entirely covered the pupil”. While this appeared to have self-resolved, the etiology of Davis’ ailment remains uncertain.  However, there is a high suspicion that the former Confederate president was afflicted with herpes simplex keratouveitis. Davis suffered again from inflammation of his left eye in early 1858, at the same time that he sustained a cough and sore throat. Of note, one of Davis’ children was in isolation in one of the upstairs rooms with symptoms of scarlet fever. This recurrent ocular inflammation, including a keratitis, likely led to iris prolapse in Jefferson Davis. Davis was diagnosed by Isaac Hays of Philadelphia with a “procidentia iridis” (iris prolapse) during the American Medical Association meeting held in Washington DC in early May 1858, by which time Davis had already been examined by local ophthalmologist Robert K. Stone. Davis had eye surgery performed in June 1859. Another eye operation was performed on Davis by Stone in March 1860. The concept of iridectomy for (angle-closure) glaucoma was known in Germany but had not yet come to the United States. Stone had written about performing an “artificial pupil” in similar cases. Hays had recommended against resection of iris tissue in “procidentia iridis”. Specifically, for “procidentia iridis”, both Stone and Hays recommended chemical cautery with silver nitrate. Surgical enucleation was practiced during the period, but we did not find evidence that Davis’ doctors considered enucleating this blind, painful eye. Davis’ ophthalmologist, Robert K. Stone, would go on to become the family physician of Abraham Lincoln during his White House years.  A search of the account book from the Civil War years of James Bolton, the premier ophthalmologist in Richmond, turned up entries for cataract surgeries and artificial pupils, but did not mention Jefferson Davis.
Conclusions. Based on the recommendations of his ophthalmologists, we consider it likely that the iris prolapse of Jefferson Davis was treated by applying chemical cautery, as with silver nitrate, to the iris tissue.

Trevor Lin, Lynn E. Harman, and Curtis E. Margo

Exploring Innovation in Intraocular Lens Through Patents Issued in the United States and Internationally from 1950 Through 2000

We explored how individuals, universities, and corporate manufacturers contributed to the design of artificial intraocular lenses (IOLs) during the second half of the 20th century through analyzing annual patent activity in the United States and internationally. 

Information on IOL patents was obtained from PATENTSCOPE, a global patent database maintained by the World Intellectual Property Organization (WIPO), an agency of the United Nations. The search focused on IOLs using the Cooperative Patent Classification (CPC) code A61F 2/16 from January 1, 1950 through December 31, 2000. 

A total of 855 patents were granted for IOLs in the US compared to 316 issued internationally between 1950 and 2000. In the U.S., 404 patents (47.2%) were granted to individuals, 430 (50.3%) to companies or corporations, and 21 (2.5%) to universities, whereas internationally 64 (20.2%) patents named individuals and 249 (78.8%) named companies. Throughout most of the 1960s to 1980s, U.S. individuals surpassed companies in patent ownership, but after 1989 corporate assignees exceeded those to individuals by 92%. 

To place these trends in context, we also reviewed U.S. Food and Drug Administration (FDA) regulatory milestones and the list of FDA‑approved IOLs from 1978 through 2000. The initial uptick in IOL patenting coincided with federal hearings that led to the FDA classifying IOLs as Class III medical devices in 1978. If patents are considered a surrogate measure for creativity in IOL development, the US played a leading role in the evolution of artificial lens design. They may also be a surrogate measure for entrepreneurship. The small but notable share of patents granted to universities in the U.S. likely reflects opportunities created by the Bayh‑Dole Act of 1980. 

Part 2 of this study will review the types of technological novelties that justified these IOL patents.

Vicky Yuan Lin and Christopher T. Leffler

Will the Pellier Brother Who Performed the First Glass Keratoprosthesis (Artificial Cornea) Please Stand Up?

Objective: To review the proposal of 1789 proposal of a glass keratoprosthesis by Guillaume Pellier, and to determine which Pellier brother actually conducted the glass keratoprosthesis.
Methods: A historical review of primary and contemporary sources, including the 1789 treatise of Guillaume Pellier and the 1802 account of Guillaume Lefébure de Saint-Ildephont, was conducted to clarify which Pellier brother performed the attempted glass keratoprosthesis.
Results: Guillaume Pellier (1751-1835) of Montpellier proposed placing a glass keratoprosthesis for corneal opacities in his ophthalmic treatise of 1789. Several of his brothers also treated patients with eye ailments. According to the 1802 treatise of Guillaume Lefébure de Saint-Ildephont (1744-1809), Guillaume Pellier was the brother who actually had performed the glass keratoprosthesis by about 1792. Although the history of oculist Jean-François Pellier (the brother of Guillaume) was not worked out until recently, Jean-François returned from the British Isles to the Continent in April 1786, and was
appointed a professor at Erlangen on Sep. 15, 1788. Another brother, Denis-Nicolas Louis
Pellier, was a physician who died in Metz in 1796.
Conclusions: Guillaume Pellier was the brother who proposed a glass keratoprosthesis by
1789, and actually unsuccessfully performed the surgery by about 1792.

Raziyeh Mahmoudzadeh

The History of Autofluorescence Imaging Development

The history of autofluorescence imaging develops gradually from basic observations of natural fluorescence to a clinically important ophthalmic technique. In 1970, investigators described a phenomenon seen in black-and-white photographs obtained during fluorescein angiography of the fundus. Lightly colored structures such as the optic disc, areas of pigment epithelial defects, and chorioretinal scars appeared to become increasingly white in the late phases of the angiogram. At that time, it was not clear if this whitening represented true staining of tissue by fluorescein or if it was an artifact. Through in vitro experiments using different fluorescein concentrations, and in vivo experiments in an owl monkey eye with a white metallic foreign body in the vitreous, the authors demonstrated that “pseudofluorescence” could occur. This was an important early step, because it raised awareness that not all visible fluorescence during angiography was due to dye leakage or staining.
In the following decades, especially during the 1970s and 1980s, technical progress in fundus cameras and optical filters improved the separation between excitation and emission light. At the same time, research identified lipofuscin accumulation within retinal pigment epithelium (RPE) cells as the main source of intrinsic fundus autofluorescence. This recognition represented a conceptual change. Instead of depending only on injected fluorescein dye, clinicians realized that the eye itself contains naturally fluorescent molecules. Fundus autofluorescence therefore became a non-invasive way to evaluate metabolic status and health of the RPE, information that could not be appreciated on standard color fundus photography.
A major technological advancement occurred in the 1990s with the development of confocal scanning laser ophthalmoscopy (cSLO). The confocal system reduced scattered light and improved image contrast, allowing more precise visualization of lipofuscin distribution . With this improvement, autofluorescence imaging changed from an experimental observation into a reproducible clinical modality. Characteristic autofluorescence patterns were described in age-related macular degeneration, Stargardt disease, and other inherited retinal disorders.
By the early 2000s, fundus autofluorescence imaging became more standardized and integrated into clinical retinal practice. As summarized in the 2008 review by Spaide , autofluorescence imaging evolved into an important component of multimodal imaging. It allowed documentation of RPE integrity, monitoring of geographic atrophy enlargement, and better understanding of degenerative retinal diseases.
In conclusion, autofluorescence imaging developed chronologically from early observations of pseudofluorescence during angiography, to identification of lipofuscin as the intrinsic fluorophore, and finally to advanced confocal imaging systems.

Curtis Margo and Lynn E. Harman

Foster Kennedy, State-Sanctioned Euthanasia, and the Role of Eponyms

Robert Foster Kennedy was an Irish-born neurologist who described the association of frontal lobe tumor with unilateral optic atrophy and contralateral papilledema in 1911. After immigrating to America he became a respected neurologist who at the height of his career became President of the American Neurological Association in 1940. He is less known for his views on eugenics and advocacy of euthanasia for children with birth defects. His public support for state-sanctioned euthanasia first appeared in Collier’s magazine in 1939. He later presented his philosophy on the subject at a national medical meeting when credible reports about German laws on euthanasia and racial hygiene were circulating in Europe and the United States. This presentation reviews how opinion changed towards eugenics after World War II, and discusses the roles that eponyms play in medicine, and when some should be replaced.

Evan Mason, Trevor Lin, and Curtis E. Margo

Trends in Intraocular Lens Innovation; Historical Analysis of Patents 1972 Through 2000

We characterized trends in intraocular lens (IOL) innovation using United States patents issued from 1972 through 2000 as a surrogate measure. Information on IOL patents was obtained from PATENTSCOPE, a global patent database maintained by the World Intellectual Property Organization. Patents issued for IOLs were identified through Cooperative Patent Classification codes. Only those issued in the United States were included. The names of individuals and agents of companies granted patents were anonymized. Of the 855 IOL patents identified, 583 were included in the analysis. Novel innovations were placed into eight categories. The single largest was lens design (264 [45.3%]), of which 197 (74.6%) were related to haptics. The next largest categories were novel biomaterials (111 [19.0%]) and novel means of optical correction (111 [19.0%]). The category with the fewest patents was phakic IOL (13 [2.2%]). Time trends in some categories overlapped the growth of phacoemulsification surgery. Only 156 patents (30.7%) were maintained through the full 20-year term, indicating a high rate of abandonment. 
During the last quarter of the 20th century, innovations in IOLs occurred in large numbers, indicating the practical utilization of optical and material engineering. These results were likely achievable because of constructive interaction between ophthalmic surgeons and the manufacturing industry. The authors speculate that the high rate of patent abandonment reflects the high rate of competing innovations.

Carolyn May and Christopher Leffler

Matters of the Angle: Otto Barkan (1887–1958) and the Definition of Open-Angle Glaucoma

Before the twentieth century, the term “glaucoma” generally referred to cases which we would classify as angle-closure glaucoma today, and were characterized by pain, redness, a firm globe, and an excavated optic neuropathy. The anterior chamber angle could not be directly visualized, but obstruction of outflow channels in the angle by the iris was presumed to explain most cases.

Otto Barkan emerged from a family closely tied to the development of ophthalmology in the United States. His father Adolph Barkan was born in Hungary and emigrated to San Francisco in 1869, where he became one of the earliest professors of ophthalmology on the West Coast. Adolph introduced new surgical techniques and collaborated with optical instrument makers, helping to shape early ophthalmic practice in California. His son Otto received medical training in Europe before returning to California to join the family practice, bringing contemporary technology including slit-lamp biomicroscopy and contact gonioscopy into his clinical practice.

In the 1930s, Otto Barkan systematically examined the anterior chamber angle in patients with “chronic simple” glaucoma and made the novel observation that many had angles that were completely open. He noted pigment deposition and sclerosis of the trabecular meshwork obstructing aqueous outflow. In 1939, he proposed a new classification of glaucoma based on angle anatomy, distinguishing narrow-angle from open-angle disease, and he coined the term open-angle glaucoma.

Barkan extended this anatomical understanding to treatment. By modifying the Koeppe lens, he performed goniotomy under direct visualization and applied the technique to congenital glaucoma beginning in 1936. Barkan was the first to use a microscope to perform intraocular surgery, which he termed “micro-surgery”. His work transformed a frequently blinding pediatric condition into a surgically treatable disease and established angle surgery as a central therapeutic principle. Goniotomy can still be used today for congenital glaucoma.

This presentation traces the Barkan family’s contributions to ophthalmology and outlines Otto Barkan’s role in defining and treating open-angle glaucoma. Modern gonioscopy and angle-based procedures are rooted in Otto Barkan’s contributions.

Norman Medow

Ocular Eponymy Associated with Hyperthyroidism

The thyroid gland is located in the neck, just under the skin.....It is shaped like a bow tie, with two lobes, that are about 2 inches wide, connected by an isthmus. Although it is not very large, its association with ocular eponyms is! I have found some 13 ocular names associated with Hyperthyroidism. Many of them, I am sure most, if not all of you, are aware of others...many of you, if not most of you, are unaware of others!
The thyroid Gland was given its name in 1656 by Thomas Wharton who named it after a famous ancient Greek "shield"..the thyreos..which to him looked like the gland.
Robert Graves in 1835 and Karl Von Basedow in 1840 are given credit for 1st describing Hyperthyroidism, although goiters...from Latin, gutturia for throat.. were noted in Hindu texts in around 300 B.C.
Surgery was the most common treatment for Hyperthyroidism until radioiodine and thyroid drugs took over mid century (1941-present). Immunotherapy has now developed a significant role in our therapeutic armamentarium.
Exophthalmos, proptosis or Graves ophthalmopathy are commonly used names, occurring in about 1/3 of thyroid patients, mostly women, are names familiar to most,..names like Rosenbach, Kocher, Gifford and Joffroy who have signs attached to them, are not.....stay tuned....to find out who they were and what they and others, described.

Frances Meier-Gibbons

The Recent Developments of Ophthalmology in Colombia and Its Famous Ophthalmologists

In earlier times, ophthalmology and otorhinolaryngology had a combined expression as “organos de los sentidos”.  In the 1950s, two ophthalmologists were practicing in Bogota, Colombia: Jorge Diaz Guerrero and Alejandro Posada Fonseca. Both were trained in Colombia and abroad and were joined in 1957 by Alvaro Rodriguez Gonzalez (1923-2017), the later founder of the Fundación Oftalmológica Nacional (Fundonal), an important ophthalmolological institution in Bogota, founded in 1976.  The interesting life of Alvaro Rodriguez Gonzalez and the development of Fundonal will be described in detail during the presentation.  On Nov 29. 1961, the Colombian Ophthalmological Society was founded with Alfonso Tribin Piedrahita (1921-2004) as first president and the two divisions separated into an ophthalmological and an otorhinolaryngological part.  The fourth important ophthalmologist of this time was Jose Ignacio Barraquer Moner (1916-1998), a third-generation descendant of the famous Barraquer family of Spain, who lived in Bogota first in 1949 and then again from 1953 on.  Another renowned Colombian ophthalmologist who is mentioned in the Truhlsen-Marmour-Museum of the Eye is Luis E.Uribe (1924-1999), who was born in Colombia and lived after studies in France in the US. He helped to establish the Castroviejo Cornea Society in 1975 and was a colleague of Alvaro Rodriguez Gonzalez.  Does a connection between ophthalmology and the very interesting street art of modern Colombia exist?
Street art has been recognized as an important artform in Colombia. Many paintings show faces and especially eyes and the artists express their interest in vision with their graffitti. During the lecture we will discuss some examples of Colombian street art. 
Colombia has a fascinating history and a connection to many famous ophthalmologists, whose influence can still be seen in modern-day Colombia.

Yannis Paulus

History and Evolution of Retinal Laser Therapies

Even before the advent of lasers, in 1949 Gerhard Meyer-Schwickerath performed the first intentional retinal photocoagulation by focusing sunlight through a heliostat to treat retinal tears. The commercial Xenon Arc Photocoagulator followed in 1956. Following Theodore Maiman’s invention of the laser, the Ruby laser was quickly adapted for eye surgery in 1961. The discovery of the argon laser in 1964 revolutionized the field because it was highly absorbed by melanin and hemoglobin. Retinal laser therapy became the mainstay for treating proliferative diabetic retinopathy, retinal vascular disease, diabetic macular edema, central serous chorioretinopathy, choroidal neovascularization, tumors, polypoidal choroidal vasculopathy, and retinal breaks through landmark studies like the Diabetic Retinopathy Study and the Early Treatment Diabetic Retinopathy Study. 

However, conventional millisecond photocoagulation can cause permanent scarring and procedure discomfort, leading to decreased peripheral visual field and night vision, motivating the development of damage-sparing approaches that preserve the neurosensory retina. To minimize retinal damage without compromising the therapeutic effect, new technologies with refined laser parameters including pulse duration, laser wavelength, laser beam size, and novel laser delivery systems have been developed to modify retinal laser therapy. Pattern scanning laser (PASCAL) in 2006 allowed a semi-automated system to apply dozens of laser spots in a single rapid sequence, reducing treatment time and patient pain. Navilas combines imaging with eye-tracking technology, allowing doctors to plan the treatment area using imaging. Subthreshold Micropulse Laser uses microsecond duration pulses to treat the retina without creating visible scars or permanent tissue damage. Selective Retina Therapy and 2RT were designed to selectively target the retinal pigment epithelium to trigger cellular rejuvenation without damaging the photoreceptors. Combination therapies using short pulse duration laser concurrently with synchronized ultrasound, termed photo-mediated ultrasound (PUT), along with image and AI-guided laser therapies also were developed. 

Classically, retinal laser therapeutic approaches are based on the photocoagulation of retinal tissue. The biological mechanism of retinal laser photocoagulation remains an area of active investigation. A leading hypothesis of the mechanism is that the destruction of specific retinal cells, such as the most metabolically active photoreceptor cells, could result in a reduced oxygen demand with down-regulation of angiogenic factors. Recent evidence suggests that reduced intensity and pulse duration retinal lesions might not lead to permanent retinal scarring, and that the outer retina can fill damaged areas. This talk summarizes the history and evolution of retinal laser modalities and their clinical applications.

Sadie Pichelmann and Christopher Blodi

Pioneering Women in Academic Retina

Purpose: This presentation reviews the lives and accomplishments of academic retina specialists Mary Lou Lewis, MD (1942-), Ingrid Kreissig, MD (1935-) and Alice McPherson, MD (1926–2013). These women were among the first in their field and greatly contributed to the advancement of ophthalmology. 
Methods: Written interviews were conducted with Dr. Kreissig, as well as with individuals who have personally known Drs. Lewis, Kreissig and McPherson. Secondary written materials were reviewed. 
Results: Drs. Lewis, Kreissig and McPherson’s achievements in patient care and research are a source of inspiration for all and have impacted countless lives through their work. Each woman earned recognition in her own way, including through mentorship, academic publication, research and technical innovations, and leadership in professional societies. 
Conclusions: The successful careers of these early female retinal surgeons illustrate how they adapted to a male-dominated medical specialty and reshaped professional identity in ophthalmology. Recognizing these trailblazers offers a deeper understanding of the history of retinal surgery and informs efforts toward equity in ophthalmic training.

Vadrevu K. Raju, Leela V. Raju, and Swapnika Y

From Retrolental Fibroplasia to Retinopathy of Prematurity History: Prevention and Continuing Global Mission

This talk traces the evolution of retrolental fibroplasia into retinopathy of prematurity from early discoveries and oxygen-related lessons to modern screening and treatment. It also highlights the Eye Foundation of America and Goutami Eye Institute's work screening 35,000 premature infants (Andhra Pradesh, India).

James Ravin

Rudolph Leopold MD

Rudolph Leopold MD was an ophthalmologist who went to medical school at the University of Vienna and trained in ophthalmology there as well. He and his future wife, Elisabeth Schmid Leopold, were in the medical school class of 1953 and trained in ophthalmology together. She developed a large practice in central Vienna while he practiced in the outskirts of the Austrian capital. During his university days he was introduced to the great works of art in the Kunsthistorisches Museum and was overwhelmed. Earlier he was a collector of butterflies and rare postage stamps, but the exposure to great paintings transformed him to being a collector of art. He amassed thousands of works, most notably early 20th century works by Schiele and Klimt. The Republic of Austria and the Austrian National Bank acquired the collection and opened the Rudolph Leopold Museum in the Museum Quarter of Vienna in 2001, paying him about $500 million, roughly 1/3 its market value. He was made a director for life and his wife was also given a lifetime position. He was also made a professor at the University. His Schiele collection is the greatest worldwide, but has always been controversial as many of the works are sexually provocative. Other curious aspects of Schiele’s work include the seizure of his 1912 Portrait of Wally by the NY DA. After legal battles lasting about 13 years the Leopold Museum agreed to pay $19 million to have it returned to Vienna. This year the Schiele portrait of Dr Erwin von Graff will be on display at the Neue Galerie in NY.
Klimt is best known for his portrait of Adele Bloch-Bauer, also known as the woman in gold, in the Neue Galerie in NY. His portrait of Elizabeth Lederer sold for $236 million last year at Sotheby’s, the second most expensive painting ever sold at auction.
The Rudolph Leopold Museum is one of only two museums in the world founded by an ophthalmologist and the other, in Switzerland, will also be described at this meeting.

Tracy Ravin

Arthur Hahnloser, Swiss Ophthalmologist and Art Collector

Arthur Hahnloser (1870-1936) was a Swiss ophthalmologist who practiced in Winterthur, Switzerland. He trained in Zurich, Vienna, London and Utrecht. He married an artist, Hedy Buhler, in 1898. The couple amassed a large collection of 19th and 20th century Swiss and French art. They became friends of many contemporary artists, particularly the Fauves and Nabis. Hahnloser's ophthalmology practice was initially based in his home, Villa Flora, in Winterthur, which has now been converted into a museum. The Hahnlosers had an outsized influence in popularizing modern art in Switzerland and expanding the reach of French artists.

Manisha Reddy and Christopher T. Leffler

The History of Enucleation for Sympathetic Ophthalmia in the United States During the Civil War (1861–1865)

Background: Sympathetic ophthalmia is a condition in which an injury to one eye can cause blindness to the other eye due to an autoimmune response. During the 1800s, enucleation of a traumatized eye for prevention or treatment of sympathetic ophthalmia became established, but the degree to which this procedure was performed during the U.S. Civil War has been poorly documented.
Methods: We reviewed descriptions of enucleation of traumatized eyes during the United States Civil War.
Results: Union soldiers sustained 1199 gunshot wounds to the eyes. Among the 825 soldiers with severe unilateral ocular injury, it is recorded that 91 (11%) sustained sympathetic ophthalmia. Diagnostic criteria were poorly specified in that era, and this rate is undoubtedly an overestimate. As we are informed of only one enucleation among a Union soldier who had a “sympathizing” eye, it cannot be established that wartime enucleation was a standard treatment for established sympathetic ophthalmia during the Civil War, though it may have occurred on occasion. Boston surgeon Hasket Derby performed an enucleation of an eye with a fish hook injury to prevent sympathetic ophthalmia in October 1863, but published the case too late to influence the war. If enucleation in the setting of unilateral ocular trauma had been routinely performed to prevent sympathetic ophthalmia, we might have seen hundreds of enucleations among the 825 Union soldiers. However, we are informed of just two additional enucleations, which are not clearly specified as relating to sympathetic ophthalmia.
Conclusion: Enucleation of the traumatized eye for the treatment of sympathetic ophthalmia was performed occasionally in the United States during the Civil War, including in one soldier, but was not a standard procedure during the War. Enucleation of the traumatized eye for prevention of sympathetic ophthalmia has not been clearly documented among soldiers during the War, and was also unlikely to have been a standard procedure.

Mariela M. Rosas González, Christopher T. Leffler, Victor M. Villegas, Stephen G. Schwartz, and Eduardo C. Alfonso

Forging Ophthalmology in Puerto Rico: Dr. Ramón Emeterio Betances (1827–1898)

Ramón Emeterio Betances (1827–1898) was a pivotal figure in the development of Ophthalmology and public health in nineteenth-century Puerto Rico. Trained in Paris, he returned to Mayagüez, Puerto Rico, in 1856 as the island’s first native-born ophthalmologist. There, he treated cholera patients, implemented preventive measures such as handwashing and boiling water and milk, and earned the reputation of “The Physician of the Poor” for his dedication to enslaved and impoverished communities. His abolitionist and pro-independence activities, including founding a Secret Abolitionist Society to purchase the freedom of enslaved children, led to repeated exiles in France and the Dominican Republic; yet he continued to practice medicine, conduct research, and engage in political organizing.
This presentation examines Betances’s early education and surgical training in France, as well as his leadership during the cholera epidemic in Puerto Rico and his role in introducing chloroform anaesthesia to the island. It also explores his later ophthalmic work in Paris and the Dominican Republic, where he became known as “El Santo Médico” for offering complex cataract and eye surgeries free of charge. It also explores his reports on contemporary European ophthalmic practice, including eyelid surgery and his advocacy for relatively conservative iridotomy over broad iridectomy. By placing Betances alongside earlier Caribbean oculists and contemporaneous Latin American surgeons, this analysis traces how European ophthalmic techniques and public health ideas were adapted to colonial Puerto Rico and its diaspora, forging a local ophthalmic tradition that intertwined clinical innovation, infectious disease control, and social justice.

Ata Salabati and Christopher Leffler

Zarrin-Dast and the Three Methods of Cataract Surgery

Abū Rūḥ Muḥammad ibn Manṣūr, known as Zarrin-Dast (“the Golden Hand”), was an eleventh-century Persian ophthalmologist who wrote Nūr al-ʿUyūn (The Light of the Eyes). The book deals with eye diseases and their treatment and includes a detailed discussion of surgical technique. What makes his work stand out is that he describes instruments and operative steps in a concrete way, which allows us to better understand how cataract surgery was actually being performed in his era.

In The Light of the Eyes, Zarrin-Dast describes three methods of cataract surgery. In all three, the procedure begins with a Nishtar, or lancet, used to enter the eye. He attributes the first method to Iraqi surgeons and describes it as being carried out with the lancet itself. The second method, which he associates with the Hindus, involves incision with the Nishtar followed by use of a solid Mahaṭ needle to depress the cataract. The third method, attributed to the Greeks and Romans, also begins with a lancet incision but then employs a hollow needle (Mahat Majuf) through which lens material is aspirated.

The interpretation of these passages has not been entirely consistent. In his early twentieth-century history, Julius Hirschberg rendered the Iraqi method as being performed with “a small knife (and the cataract needle).” That parenthetical phrase has often been repeated and suggests that a needle was involved in the Iraqi technique as well. A closer reading of the Persian text does not clearly include such a reference in the first method. As discussed in A New History of Cataract Surgery, this distinction affects how the three approaches are understood: namely, a lancet-based technique attributed to Iraqi surgeons, a lancet-plus-solid-needle method associated with Indian practice, and a lancet-plus-hollow-needle approach linked to Greek and Roman surgeons.

Mariam Samuel and Mohammad Javed Ali

Five Genius, Arrogant, and Pompous Lacrimal Surgeons

Purpose: This presentation will briefly describe the arrogant and pompous behaviours of five genius lacrimal surgeons. The five surgeons include Francesco Signorotti (1714), Joseph Barth (1743-1818), Sir William Blizard (1743-1835), Antonio Scarpa (1771-1820), and Baron Guillaume Dupuytren (1777-1835). 
Francesco Signorotti was an 18th century Italian surgeon most notable for his critique of Dominique Anel’s characterization of lacrimal fistulae and probing technique. Though his work lay the anatomical groundwork for approaching lacrimal disease, his approach involved aggressively distributing his detestation and posting his treatise in public places. He was critiqued for his poor professional conduct, which likely discredited his work. 
Joseph Barth was an Austrian anatomist and ophthalmologist whose dissections laid the groundwork for Lacrimal surgery concepts. Despite his ophthalmologic genius, his treatment of his mentee Georg Joseph Beer would be later described as 7 “years of torture.” He exploited Beer for anatomic illustrations for publication in his anatomy books while denying Beer the ophthalmology instruction he sought. 
Sir William Blizard was a British surgeon and anatomist notable for practicing lacrimal irrigation with quicksilver (mercury), an early approach to lacrimal obstruction before modern dacryocystorhinostomy techniques. Despite academic success, his public persona and high status resulted in a commanding, often imposing, lecturing style. 
Antonio Scarpa was an Italian anatomist and surgeon often referred to as the ‘Magister eloquentia maxima’ (Master of the highest oratory art) for his lectures as the Chair of Anatomy at the University of Pavia. His contributions to lacrimal concepts, including his efforts to bypass obstructed nasolacrimal duct with the use of a lead nail, and his theory of eyelid disorders aided in the evolution of lacrimal sciences. His talent for anatomy did not extend to his mannerisms, as he was known to have a vile temper, in one case, slamming the door and shouting when bid to await the Emperor Napoleon. 
Baron Guillaume Dupuytren, a French anatomist and surgeon with several disorders carrying his eponymous, was known in ophthalmology for his work on cataracts and management of lacrimal fistulas with the surgical insertion of metal indwelling cannulas. Academically famous for his surgical work, his authoritarian personality, described as the Brigand of Hôtel-Dieu” led to conflicts with his peers. 
Conclusion: These five individuals furnish fascinating stories about how human ego and greed can not only affect a person at an individual level but also mitigates their vast potential to contribute professionally in a more meaningful manner.

George Sanborn

St. John Ophthalmic Hospital

The Venerable Order of St John opened its first eye hospital just south of the Old City of Jerusalem in 1882 under a royal charter from Queen Victoria. The Order of St John of Jerusalem Eye Hospital Group is a charitable foundation which currently operates six eye hospitals with satellite and mobile eye clinics in the West Bank and Gaza Strip. It is the main provider of eye care in the Palestinian territories.
The main hospital is at its third location in East Jerusalem and is accredited by the Joint Commission International. It has 49 inpatient beds and is staffed by both foreign and local specialists. The hospital has a large outpatient department and specialty retina, cornea, and pediatric services as well as a research unit. The hospital has been able to attract a significant number of volunteer doctors from around the world; these doctors provide both inpatient and outpatient services as well as teaching and training for local providers.
Additional hospitals providing both outpatient and inpatient surgery were established in 1992 in Gaza City and Hebron in 2005. The author was an ophthalmologist at the main East Jerusalem hospital in the 1980s.

Stephen Schwartz, Christopher Leffler, Peter Allen, and Andrzej Grzybowski

Fanny Kaplan and the Attempted Assassination of Vladimir Lenin

Purpose: Fania (Fanny) Kaplan (1890-1918), who was reportedly visually impaired, confessed to the attempted assassination of Soviet leader Vladimir Lenin (1870-1924) in 1918 by shooting him with a pistol from about 10 feet. The precise nature of her visual loss is unknown and raises doubts about whether she had sufficient visual function to perform the act.
Methods: Historical documents were reviewed.
Results: The cause of Kaplan’s visual loss is uncertain but occurred following a bomb blast in 1906. If the explosion was the cause, then she most likely had bilateral closed-globe, blast-related injuries, perhaps with additional functional visual loss. She reportedly received treatment at a medical center in Kharkov (now Kharkiv), then led by the prominent ophthalmologist Leonard Girshman (1839-1921). An informal estimate of the minimum visual acuity required to shoot an adult at 10 feet (3 meters) with a pistol is approximately 1.2 logMAR (Snellen equivalent 20/320 or 6/96).
Conclusions: Based on available historical documents, Kaplan’s visual function was most likely sufficient to carry out the assassination attempt, although her visual impairment may have contributed to the attempt being unsuccessful.

Shalini Shah, Giselle Ricur, Ricardo D. Wainsztein, Christopher T. Leffler, and Stephen G. Schwartz

Tele-ophthalmology: Past, Present and Future

Introduction:  Tele-ophthalmology refers to the use of technology to deliver eye care remotely, thereby expanding access to ophthalmic services beyond traditional clinical settings. Ophthalmology is well-suited for telemedicine because the field is largely image-based. Tele-ophthalmology started to develop several years ago, but the COVID-19 pandemic was a catalyst for widespread adoption. This review of tele-ophthalmology aims to describe the evolution of tele-ophthalmology from early screening models before COVID-19 to the integrated clinical practices emerging post-COVID. 
Methods:  A synthesis of historical tele-ophthalmology developments was created by reviewing published literature, including the NCBI Bookshelf chapter on telehealth in ophthalmology, peer-reviewed journal articles, and professional editorial perspectives. Developments were categorized into pre-COVID (before 2020) and post-COVID (after 2020) phases. 
Results:  Tele-ophthalmology has roots in the early use of telecommunication and imaging technologies to share retinal images and diagnoses across distances. In the late 20th century, fundus photography and email-based “store-and-forward systems” extended screening services for diabetic retinopathy to underserved areas, particularly in primary care clinics, rural communities, and the Veterans Health Administration. Early telemedicine initiatives demonstrated patient satisfaction and the ability to reach remote populations but were limited by cost and workflow integration. Tele-ophthalmology was mainly used for asynchronous screening and specialist consultation rather than longitudinal disease management.  The onset of COVID-19 led to widespread clinic closures and urgent need for remote triage. Emergency regulatory changes facilitated rapid telehealth expansion and telemedicine became essential.  Following the acute pandemic phase, tele-ophthalmology grew into hybrid care models, including postoperative follow-up, chronic disease monitoring, and integration with electronic health records. Eye screenings have been enhanced by artificial intelligence image analysis. Home monitoring devices and virtual visits supplement medication adherence monitoring and stable disease follow-up, though in-person testing remains essential. 
Conclusions: Tele-ophthalmology has evolved from specialized use of remote imaging into broad clinical integration for eye care delivery. While examination-dependent diagnostics still require in-person visits, tele-ophthalmology has provided multiple benefits in access to care, particularly for disease monitoring and preventive screening. As technology advances further, tele-ophthalmology represents a durable component of modern ophthalmic care. 

Eric Wan, Sophie Gorup, Thomas C. Dunn, and Alice T. Gasch

Chernobyl 1986 to 2026: What Can Ophthalmology Learn from the Biggest Nuclear Disaster?

Introduction:
On April 26, 1986, at 1:23:47 AM, the Chernobyl Nuclear Power Plant suffered devastating explosions and meltdown. It was April 25 5:23:47 AM in Washington, DC. The COHS 2026 meeting coincides with the disaster’s 40th anniversary. Chernobyl would become the worst and most expensive nuclear disaster in history, costing $939 Billion in today’s dollars. Chernobyl is uninhabitable for 20,000 years. What have we learned since then? 
Methods: We consulted primary source materials, including eyewitness accounts and investigative commissions, and peer-reviewed publications. We interviewed physicians and scientists who were directly involved in responding to the Chernobyl disaster and/or studied the impact of the disaster. We compared our findings to those of Dr. Newman in his 2014 COHS presentation and AJO publication “Ophthalmic Injuries at Hiroshima and Nagasaki: David Cogan and the Atomic Bomb Casualty Commission.”
Results: A number of ophthalmic conditions were attributed to radiation exposure from Chernobyl. Just months after the explosion, radiation angiochorioretinopathy (i.e., Chestnut syndrome) was identified in Chernobyl clean-up workers. Later, diffraction grating syndrome was observed in a clean-up worker irradiated with direct line of sight of the exposed radioactive core. Exposure to the radiation in workers at Chernobyl resulted in dose-dependent increases in chorioretinal degeneration and age-related cataracts. Other effects over decades included vitreous destruction, chronic conjunctivitis, neoplasms of the eyelid, and decreased accommodation. 
Dr. David Cogan, while with the Atomic Bomb Casualty Commission, suspected that radiation doses sufficient to produce ocular pathology would be fatal. He likely did not appreciate the potential for delayed development of radiation-associated cataracts. He accurately speculated that detailed quantitative evaluation was necessary to advance the scientific understanding of radiation’s impact on ocular pathology. Chernobyl provided the unfortunate opportunity. While there is still considerable debate on the dose required for cataract formation, research on Chernobyl demonstrated that the dose threshold is likely to be much lower than previously assumed - at least 7 times lower and certainly survivable. Experts we consulted speculated that it may take approximately 10 years to develop cataracts after instantaneous exposure to high dose radiation. 
Conclusions: Gorbachev famously stated that Chernobyl was “perhaps the real cause of the collapse of the Soviet Union.” The disaster also advanced our understanding of nuclear radiation’s impact on ocular health and safety. These lessons echo in our present day, particularly as nuclear medicine experiences rapid growth and nuclear power expands.

Nina Yang and Peter Le

The Evolution of Vitreous Humor: From Spirit to Modern Insights

The vitreous humor is a transparent, viscoelastic hydrogel that occupies the space between the crystalline lens and retina. Vitreous plays a vital role in our body as it maintains ocular structure, provides ocular clarity, and regulates retinal stability. Age-related degeneration and vitreoretinal diseases have been shown to disrupt this specialized matrix, contributing to ophthalmic pathologies including retinal detachment, vitreous hemorrhage, and proliferative retinopathy. Because of this, pars plana vitrectomy has become the foundational pillar of modern vitreoretinal surgery. Unfortunately, native vitreous humor does have minimal regenerative capacity. Therefore, the development of intraocular substitutes such as expansile gases and silicone oils has proven to be suitable substitutes for native vitreous humor, despite their inability to fully replicate native vitreous physiology.

Historically, the conceptual understanding of vitreous has undergone substantial evolution. Early theories attributed it to being “spirit-like”, and anatomical descriptions portrayed it as an inert, amorphous substance. However, with the advancements in microscopy and biochemical analysis, a better understanding of the vitreous complex structure is being revealed. Beginning with the historical work done by Meyer and Palmer in 1934, the isolation of hyaluronic acid established vitreous as an organized extracellular matrix. Discoveries like these have provided the foundation of subsequent efforts in engineering artificial vitreous materials.

Modern research in vitreous has started to shift its focus to biomimetic hydrogel systems that are designed to mimic the native vitreous properties, including high water content, transparency, and viscoelasticity. Natural polymer gels, synthetic hydrogels, and emerging stimuli-responsive materials are starting to demonstrate promising mechanical and biocompatible results in preclinical studies. Smart hydrogels have the capacity to enhance properties, including stronger tamponade, potentially offering advantages beyond that of native vitreous humor. Nevertheless, no replacement is perfect as there are still imperfections in long-term stability, risk of inflammation, or simply incomplete replication of native vitreous function that continue to limit current clinical applications.

This review examines the historical evolution of vitreous characterization and the development of artificial vitreous, explores current vitreous substitute technologies, and highlights promising biomaterial strategies aimed at achieving physiological vitreous replacement or augmenting native vitreous humor function. A comprehensive understanding of this evolution is essential to guide future innovation in vitreous substitution and improve long-term outcomes post-vitreoretinal surgery.

Sarah Yoest, Alan Letson, and Sayoko Moroi

A Brief History of Services for the Blind and Visually Impaired in Central Ohio

Blindness and low vision services in Ohio date back to 1837. The Ohio legislature established the nation’s first public school for blind children in Columbus less than a decade after development of Braille and the first U.S. school for the blind.
Philanthropic donors established Clovernook in Cincinnati in 1903, Cleveland Sight Center in 1906, Cincinnati Association for the Blind in 1911, and Sight Center of Northwest Ohio in Toledo in 1923. These organizations were formed to provide recreation, socialization and employment opportunities for blind and low vision adults. Most jobs were in weaving, broom making and Braille printing. 
The Ohio Commission for the Blind was established in 1908 and supported manufacturing programs and independent living for blind individuals.
Columbus was slower to develop center based opportunities for adults. In 1940, the Monett House was established for blind and partially blind individuals as a place to live, socialize and perform limited work in a workshop. The Vision Center of Central Ohio was established in Columbus in the 1970’s and provided comprehensive services until 2014 when it closed due to funding insufficiency.
Injuries from the World Wars produced a population of formerly sighted people in need of rehabilitation. College curriculums were developed for rehabilitation teachers and orientation and mobility instructors. The veteran’s administration did much of the early rehabilitation research and continues to provide excellent and comprehensive services.
The Institute for Research in Vision, part of Arthur Culler’s vision for The Ohio State University Department of Ophthalmology and Department of Optometry did research in physics and optics of reading in people with low vision in the 1950s and 1960s. In the 1960s clinical low vision services were developed in Cincinnati, Cleveland, Toledo and OSU Optometry.. 
While the history is long, the evolution of services has been limited due to varied funding from government and private sources. In central Ohio the College of Optometry and the Department of Ophthalmology and Visual Sciences (DOVS) at The Ohio State University provide clinical low vision services. Historically, low vision services in Ohio consist of a patchwork of state, local and private entities with variable funding capacities. The limiting factor at all levels appears to be inadequate or unreliable funding. Efforts at OSU DOVS are being made to develop a comprehensive program including clinical services, orientation and mobility, rehab teaching, occupational and physical therapy, social services, AI technologies, and psychosocial programming in a financially sustainable organization.

Page last updated April 12, 2026