Snyder Lecture Series
In 1991, David G. Cogan inaugurated the Snyder Lecture to honor Charles J. Snyder, who for many years was the librarian at the Massachusetts Eye and Ear Infirmary. Snyder's interest in ophthalmic history had led to the publication of a series of essays as the "Our Ophthalmic Heritage" section of the Archives of Ophthalmology while Cogan was its editor. Many of Snyder's essays were collected in book form in 1967 (Snyder C.J. Our Ophthalmic Heritage. Boston, Mass: Little Brown & Co.)
The 2019 Snyder Lecturer:
David G. Harper, M.D.
A native of Ashland, Wisconsin, David received his Bachelor of Science, Master of Science (Anatomy) and Doctor of Medicine degrees from the University of Wisconsin where he also completed a residency in ophthalmology. He then completed a neuro-ophthalmology fellowship under the guidance of Myles M. Behrens, MD at Columbia Presbyterian Hospital and three months of sabbatical time with William F. Hoyt, MD at UCSF.
Enrolling in graduate school during his sophomore year in medical school, David taught gross anatomy to freshman medical students for two years. He also studied with Barry J. Anson, PhD from Northwestern University. Using the large human temporal bone collection at the University of Wisconsin they delineated the embryologic and vascular anatomy of the middle and inner ear and the surgical anatomy of the facial nerve and canal.
David’s clinical career included teaching appointments in the Departments of Ophthalmology at the Bethesda Naval Hospital, the University of California Irvine School of Medicine (where he twice received their “Outstanding Teacher Award”) and at the Salem Veterans Hospital in Salem, VA where he served as Chief of the Ophthalmology Division. A parallel career in the pharmaceutical industry included 5 years as the ophthalmic reviewer at the FDA. His reviews resulted in the marketing of two ophthalmic medications that are still in current use. He has published 23 scientific papers and delivered 43 presentations at various scientific symposia including three in the French language before the French Ophthalmology Society.
David, now retired from clinical practice, collaborates on writing projects with his son, Russell, a professional editor working with the University of Chicago Press.
The Sociology of Refractive Errors: The Good, The Bad, The Mysterious
This paper discusses the evolution of attitudes surrounding refractive error science during more than 20 centuries. From the time of Pliny the Elder in the 1st century AD to the evolution of 21st century refractive surgical techniques, erroneous concepts have often strongly influenced clinical practice. Myopia and presbyopia were the earliest recognized refractive errors because of the associated diminished visual acuity that was obvious to everybody. However, myopic individuals encountered negative attitudes that limited full societal participation.
Presbyopia was not controversial as it happened to virtually every aging person. However, eye practitioners did not understand that apparent presbyopia occurring in younger people was secondary to a significant underlying hypermetropia. The resulting blurred vision and headaches after prolonged close work defined asthenopia in this population group into the 20th century. For unknown reasons, fear of causing irreversible amblyopia in individuals using convex lenses for close work became commonplace. The use of convex lenses was denied to many, while some even encountered recommendations to emigrate to Australia where ranching activities didn’t require prolonged reading. Donders, in his 1864 text book, strongly refuted this erroneous concept, stating that he had never seen amblyopia develop secondary to the use of convex lenses for close work. However, generally poor communications in the latter 19th century assured their slow adoption.
Practitioners noted that myopia, apparently associated with school work, was increasing in frequency in the 19th century. Bizarre ideas about the causes were common, but everybody agreed with the need for a prevention or cure. However, serious attempts at myopia prevention would await the 20th and 21st centuries, and currently the evaluation of topical drug therapies, convex lenses, bifocals and various highly specialized contact lenses all remain under intense study. Meanwhile, corneal surgical techniques for refractive error correction, especially in young people, have become commonplace. However, recent attempts using corneal surgery to provide superior vision for athletes, in the belief that this will enable them to excel at various sports, are probably doomed to failure.
2018 Snyder Lecturer: Robert M. Feibel, M.D.
A native of Cincinnati, Ohio, Bob received his Bachelor of Arts degree from The Johns Hopkins University and Doctor of Medicine degree from Harvard Medical School in 1969. After his internship at the Beth Israel Hospital in Boston, Massachusetts, he and his wife moved to St. Louis, Missouri in 1970 where they have lived since.
Bob completed his residency in ophthalmology at Barnes Hospital and Washington University and has been affiliated with that program since. He is Professor of Clinical Ophthalmology and Visual Sciences and has been an active teacher in the department. He has three times been the recipient of the Ophthalmology Teacher of the Year-Clinical Faculty Award. He has published more than 55 articles and book chapters in the peer review literature, and has served as a peer reviewer for many ophthalmologic journals.
Since retiring from the practice and teaching of ophthalmology, Bob now serves as Director of the Center for History Of Medicine at Washington University School of Medicine, located in the Becker Medical Library. He teaches electives on the history of medicine to first and fourth year medical students, arranges a series of lectures on the history of medicine for both medical and lay audiences, organizes a reading group for physicians and nurses, and arranges special programs in the medical humanities in association with the faculty of the School of Arts and Sciences.
He was recently chosen to be the 2018 Distinguished Alumnus Award Recipient of the Department of Ophthalmology and Visual Sciences; this award will be presented at the annual Spring Update Meeting in April of 2018.
His community and philanthropic activities include an active volunteer association with Opera Theatre of St. Louis, where he has served on the Board of Directors for 37 years and was President of the Opera Guild. He served as a teacher, trustee, officer and president of Temple Emanuel, a reform Jewish congregation. He is a board member of The St. Louis Society for the Blind and Visually Impaired and regularly volunteers at a food pantry.
Bob has been fortunate to have been married to Jane for over 50 years and has had the pleasure of seeing his two daughters and three grandchildren grow up.
Cuban Epidemic Optic Neuropathy (1991-1993) and José Saramago’s novel Blindness (1995)
José Saramago’s novel Blindness describes a city in which all residents but one suddenly become blind. In this contagious epidemic, all victims complain that their vision is milky-white, not black, as blindness is typically portrayed. The overwhelmed authoritarian government quarantines the blind in an abandoned mental hospital, where the total breakdown in society among the inmates contributes to the novel’s allegorical discussion of how human beings conduct themselves individually and how they organize themselves politically in this dystopian and violent community. The only sighted character is the ophthalmologist’s wife, who becomes the moral center and heroine of the story. She states one of the themes of the novel: “By organizing itself, to organize oneself is, in a way, to begin to have eyes.”
While the novel’s allegory employs ideas of eyes, vision, seeing, blindness, and ophthalmology, I call attention to an actual epidemic of blindness in Cuba in 1991-93, the same years that Saramago was presumably composing his novel. Cuban Epidemic Optic Neuropathy caused significant visual loss, peripheral neuropathy, and other neurological symptoms in 50,000 persons, an incidence of almost 0.5% of the entire population of almost 11 million. Initially the Cuban government proposed a viral cause, and denied that the actual cause was vitamin deficiency due to famine and malnutrition, exacerbated in many patients by smoking and alcohol consumption. Eventually, the Cuban government reacted in a humane and effective manner with widespread distribution of multivitamins to both affected patients and then the entire population, which quickly ended the epidemic.
Saramago was a life-long member of the Communist party, and a friend and admirer of Fidel Castro and his government. Although I have no proof that Saramago was influenced by the actual Cuban epidemic, I think it plausible. This presentation describes the history of the actual epidemic, and relates it to some of the medical and literary questions raised by the fictional epidemic.
Published as: Feibel RM, Arch J. Cuban epidemic optic neuropathy (1991-1993) and José Saramago's novel Blindness (1995). American Journal of Ophthalmology 2018; doi: 10.1016/j.ajo.2018.06.006 PMID 29906432
The 2017 Snyder Lecturer: Ivan Schwab, M.D., F.A.C.S
Ivan R. Schwab, M.D. F.A.C.S. is a Professor of Ophthalmology and director of the corneal service at the University of California, Davis.
He graduated summa cum laude from West Virginia University (WVU) in 1969 with a bachelor's degree from the Eberly College of Arts and Sciences and received a medical degree from WVU in 1973. Completing his residency at Pacific Medical Center in San Francisco and following three fellowships including a two year stint at the Francis I. Proctor Foundation, Dr. Schwab returned to WVU as a faculty member in the School of Medicine for seven years beginning in 1982. During his tenure there, he served as Chief of Staff for the WVU Medical Center Hospital. In 1989, he moved to the University of California, Davis, and has been on its faculty since then. He has been active with the American Academy of Ophthalmology and received the Lifetime Achievement Award in 2012 among other awards. He is active in several professional societies having served in leadership positions in the Ocular Microbiology and Immunology Group, and the Cornea Society He is an emeritus Board Director on the American Board of Ophthalmology.
He has won the IgNobel in 2006 for Ornithology, numerous teaching awards within his department as well as being cited as a Distinguished Alumnus of West Virginia University. Dr. Schwab has more than 240 articles in peer reviewed journals as well as numerous chapters and four books including his most recent book, Evolution’s Witness: How Eyes Evolved on the evolution of the eye. He has been on the editorial board of EyeNet, the British Journal of Ophthalmology and is currently on the editorial board of the journal CORNEA, the journal Ophthalmology as well as the PanAmerican journal. He has an active practice, and is engaged in research on ocular surface disease, and in comparative optics and physiology.
Does My Dog See in Color? The Evolution of Color Vision
The millions of hues in our visual world bring us great joy and subtle detail, but it hasn’t always been this way. What brings us to this riot of color? Why do we have color vision at all?
More than three billion years ago, prokaryotes added rhodopsin as a proton pump to be used as an energy source. Eventually, both prokaryotes and eukaryotes would add a rhodopsin to emphasize certain wavelengths in the electromagnetic spectrum. Color vision would have to wait, though, as it would require at least two different rhodosins for the perception of color.
Color vision would not appear until approximately one billion years ago in the early Metazoa, and then, likely only to manage the bright glare, reflections and shimmerings of the early, shallow, aquatic environment that would have been minimally protected by a thin atmosphere or robust aquatic vegetation. The opsins that react to shorter wavelengths of the visible spectrum would be dazzled by the glare and the longer wavelengths would be selected to deal with the luminance and perhaps brightness. Once different opsins proved an advantage in contrast and discrimination for the early Metazoa, the race for color vision would be on, though not all lineages would find advantage in participation.
Arthropods and vertebrates, as the two principal phyla with confirmed color vision, would find advantages in color vision, and this would likely contribute to their phylogenetic success. And, yet, there may be a few outliers among the mollusks, and perhaps the annelids suggesting that some lineages are still toying with the leap to color vision.
Arthropods and vertebrates would use duplication and spontaneous mutation to discover the range of color vision in what is now called the visible electromagnetic spectrum. The choices of these opsins were, in some ways, random but limited and formed by environment and especially physics.
The twists and turns of the evolution of these nuggets of genetic choices is a long and winding story replete with losses and gains, near extinction with resuscitation, and some wondrous examples of the random cleverness of evolution over unfathomable lengths of time. As ophthalmologists, we think in terms of primate color vision which, while interesting in and of itself, is only a small and rather pedestrian side story to the overall course of color vision. The rest of the story is steeped in color vision co-option, neurological channels, multiples of visual pigments, perfection on the wing, and evolutionary oddities that do not seem to fit anywhere but that specific creature.
Color vision depends on different visual pigments, and there is likely an optimal number since each different neurologic input requires a separate channel for interpretation and integration. More than four opsins likely are not helpful, and the neurology and embryology to maintain them are expensive. Although more opsins may provide other information or may be summed, the rare species that have more than four opsins may be using them for other tasks or somehow separating the input much like our own eye uses melanopsin and cryptochromes for circadian rhythm.
The story of the evolution of color vision is so complicated, intertwined, and convoluted that it seems to parallel metazoan evolution itself—and perhaps it is a proxy for the understanding of the machinations of evolution.
Mark J. Mannis, M.D.
Mark J. Manis, M.D., is Professor and Chair of the Department of Ophthalmology & Vision Science, UC Davis Eye Center at the University of California, Davis. He completed his ophthalmology residency training at Washington University in St. Louis and a fellowship in cornea and external disease at the University of Iowa. His primary research includes studies in the development of novel protein-based anti-infective agents, corneal transplantation, visual rehabilitation of patients with corneal disease, management of diseases of the ocular surface, and oculodermal disease. Clinically, he specializes in corneal surgery and diseases of the external eye. Dr. Mannis is editor/author of six recent books on the cornea and ocular surface diseases; he has more than 150 published papers, and was the founding editor of ision Pan-America: the Pan-American Journal of Ophthalmology. Dr. Mannis is a recipient of the R. Townley Paton Award from the Eye Bank Association of America; the Lew Wasserman Award in research from Research to Prevent Blindness, Inc.; the Moacyr Alvaro Gold Medal from the Federal University of Sao Paulo in Brazil; and an honorary doctoral degree from the National University of San Marcos in Peru. He was named the 2014 Castroviejo Medalist by the Cornea Society. Dr. Mannis has spent the last several years in efforts to contribute to vision care in Latin America, for which he was the recent recipient of the Distinguished Scholarly Public Service Award by the Academic Senate of the University of California, Davis.
He has trained fellows since 1990 with over 25 U.S. fellows in cornea and external disease as well as 15 international fellows and almost 100 residents. He conducts a busy referral practice in diseases of the cornea and external eye based at the University of California, Davis.
Jay M. Galst, M.D.
Focusing on the Details: Ophthalmologists and Numismatists
(Some of Us Who Are or Were Both)
Jay M. Galst, M.D. delivered the 25th Charles A. Snyder lecture to the Cogan Ophthalmic History Society at its meeting in New York City on March 28, 2015. Cogan Society member Jay Galst is Clinical Professor of Ophthalmology at the Mount Sinai Icahn School of Medicine, Senior Attending Surgeon at the New York Eye and Ear Infirmary, a past President and Member of the Ocular Heritage Society. He has served as President of the New York Numismatic Club and in 2014 was named a Numismatic Ambassador at the annual ANA convention.
George M. Bohigian, M.D.
Our Ophthalmic Heritage: Superstitions, Symbols and Magic
George M. Bohemian, M.D. delivered the 24th. Charles A. Snyder Lecture to the Cogan Ophthalmic History Society at its meeting in Monterey, California on March 29, 2013.
Danny Hirsch-Kaufmann Jokl, M.D.
Endre A. Balazs, M.D. and David Miller, M.D. and the Serendipitous Origin of Viscosurgery
Danny Jokl, M.D. presented the 23rd Charles A. Snyder Lecture at the 26th meeting of the Cogan Ophthalmic History Society, April 13, 2013, in Kansas City, Missouri..
Gerald Allen Fishman, M.D.
An Historical Perspective for the Early Treatment of Night Blindness and the Use of Dubious and Unproven Treatment Strategies for Patients with Retinitis Pigmentosa
Norman B. Medow, M.D.
Physicians – Poisons – Pupils and a Bella Donna. The Evolution of Forensics
Ira Eliasoph, M.D.
Ophthalmology and Observation: A Life "Apologia pro Vita Ophthalmologica"
William Tasman, M.D. (deceased)
Instrument Ancestry: Genesis of the Ophthalmic Examination
Donald Blanchard, M.D.
Ophthalmology of Hieronymus Brunschwig
Gordon K. Klintworth, M. D. (deceased)
Historical Aspects of Yellow the Color Associated with Cowardice
Arthur M. Silverstein, Ph.D.
When the Cure is Worse than the Disease: A Brief History of Ocular Immunopathology
Michael F. Marmor, M. D.
Monet through his Own Eyes
William Spencer, M. D. (deceased)
The Origin and Development of San Francisco Academic Ophthalmology
J. William Rosenthal, M. D.
Early American Spectacle Makers
Sean Murphy, M. D.
A Passion for Books: William Osler, Casey Wood and McGill University
Steven A. Newman, M. D.
Quantitation in Ophthalmology: A Science in Evolution
John Gittinger, M. D.
Radiation and Cataracts: Cause or Cure
Melvin Alper, M. D. (deceased)
Three Pioneers in the Early History of Neuro-Radiology
James Ravin, M. D.
Albert Einstein and his Mentor, Max Talmey
Ronald Fishman, M. D.
Gordon Holmes, the Cortical Retina and the Wounds of War
H. Stanley Thompson, M. D.
The Growth of American Neuro-Ophthalmology
Frank Newell, M. D. (deceased)
Origins of the National Eye Institute
Andrew Ferry, M. D. (deceased)
Dr. Isaac Thompson and His Celebrated Eye Water
Daniel Albert, M. D.
The Discovery of the Ophthalmoscope
Frederick Blodi, M. D. (deceased)
Some Famous Persons with Visual Problems
Page last updated February 11, 2019