The Eye in History Frank Joseph Goes
INDEX
×
Chapter Notes

Save Clear


1Descriptive
  1. Famous Ophthalmologists
  2. Anatomy of the Human Eye
  3. Accommodation
  4. Daltonism Color Blindness
  5. How We See?
  6. Animal Eyes: The Evolution of the Eye
2

Famous Ophthalmologistschapter 1

Frank Joseph Goes
Chapter Outline
  • ☞ Famous Ophthalmologists
  • ☞ The Hall of Fame
 
INTRODUCTION
Ophthalmology is the branch of medicine which deals with the anatomy, functions, pathology and treatment of the eye, and areas surrounding the eye such as, the eyelids and the lacrimal system.
The term “Ophthalmologist or Eye, MD” as they are called in the USA, Augenarzt in Germany–Ophtalmologue in France, Oogarts in Dutch, implies a medically trained surgical specialist (Fig. 1.1). The word ophthalmology comes from the Greek roots “ophthalmos meaning eye and logos meaning word thought or discourse”. So, ophthalmology literally means “The science of eyes”.
As a discipline it applies to animal eyes also, since the differences from human practice are surprisingly minor and are related mainly to differences in anatomy or prevalence, not to differences in disease processes. However, veterinary medicine is regulated separately in many countries and states resulting in few ophthalmologists treating both humans and animals.
The eye, including its structure and mechanism, has fascinated scientists and the public in general since ancient times: 2/3 of all input to the brain comes from vision. Many of the expressions in the English language that mean to understand are equivalent vision terms. When one says “I see”, he means “I understand”.
Given the importance of vision for the quality of life, many ophthalmologists consider their job to be rewarding, as they are often able to restore or improve a patient's sight. Advances in diagnosis and treatment of disease, and improved surgical techniques have extended their abilities to restore vision like never before.
In most countries, an ophthalmology residency after medical–university–school is undertaken.
The residency lasts for 4 to 6 years after the Medical Doctor degree, although subspecialty training is undertaken later on by about 30 percent of the Eye MD's.
Some countries distinguish between ophthalmologists who perform surgery and the ones who do not.
After becoming an ophthalmologist, the specialist can further train in subspecialties such as: Neuro-ophthalmology, Strabology, Refractive surgery, Pediatrics, Anterior segment surgery, Vitreoretinal surgery and so on.
Overlap areas exist between Ophthalmology and Optometry.
Both professions perform testing for common ocular problems affecting children (i.e. Amblyopia and strabismus) and the adult population (cataract, glaucoma, and diabetic retinopathy) (Figs 1.2 and 1.3). Optometrists usually refer to ophthalmologists for surgical assessment and treatment of ocular diseases if required.
Ophthalmologists may refer patients with poor vision to optometrists specializing in low vision for optical aids or low vision rehabilitation. Both ophthalmologists and optometrists are trained in refraction for glasses and contact lenses.4
zoom view
Fig. 1.1: eye, md clinical examination eye, md surgery
zoom view
Fig. 1.2: Divergent strabismus (squint) of the right eye
zoom view
Fig. 1.3: External eye examination with flashlight
Regulations differ from country to country. Some countries have no optometrists at all, in some states in the USA optometrist can even perform laser treatments and in some countries optometrists are absolutely not allowed to perform medical acts.
Dispensing optician or opticians are technically trained professionals who sell glasses, low vision devices, spectacles and contact lenses. They mount glasses in spectacle frames and they adapt them according to the need and the physionomy of the client. Here also important differences and different regulations exist according to the country where they practice or have their shops.
An Orthoptist is a paramedic specialist who practices Orthoptics and works in the ophthalmic sector. He or she works in a field pertaining to the evaluation and treatment of patients with disorders of the visual system such as—amblyopia or lazy eye, double vision, strabismus or crossed eyes, reading problems with an emphasis on binocular vision and eye movements Orthoptists are uniquely skilled in diagnostic techniques. They treat defects of binocular vision (such as strabismus and amblyopia) by nonsurgical measures, especially by exercises to strengthen the eye muscles.
Orthoptists commonly work in pediatric ophthalmology settings. Orthoptists serve patients of all ages, but because of the nature of many binocular disorders, the majority of patients are children.
 
FAMOUS OPHTHALMOLOGISTS
This is an incomplete list, which may never be able to satisfy certain standards for completeness. For technical reasons it was not possible to insert a photo for each of them.
In the chapter 8: Anatomy and Function of the Eye, the early discoveries are discussed.
 
Pre-18th century
Marie Colinet, wife of Wilhelm Fabry, employs a magnet for removing a foreign body from the eye, 1627.
 
18th-19th Century
 
Jacques Daviel (France:1696–1762)
He is the ‘father’ of modern cataract surgery. He performed extracapsular extraction instead of needling the cataract or pushing it back into the vitreous.5
zoom view
Fig. 1.4: Frans Cornelis Donders
It is said that he carried out the technique on 206 patients, out of which 182 were reported to be successful. These figures are not very credible, given the total lack of both anesthesia and aseptic technique at that time.
 
Frans Cornelis Donders (Netherlands:1818–1889)
He published pioneering analyses of ocular biomechanics, intraocular pressure, glaucoma, and physiological optics (Fig. 1.4). He made possible the prescribing of combinations of spherical and cylindrical lenses to treat astigmatism. He was the most eminent ophthalmologist of 19th century Dutch physicians, whose investigations of the physiology and pathology of the eye made possible a scientific approach to the correction of refractive disabilities such as nearsightedness, farsightedness, and astigmatism. Donders’ interest in ophthalmology began in 1847 with a study of muscae volitantes, the problem of specks seen floating before the eye.
 
Allvar Gullstrand (Sweden:1862–1930)
Nobel Prize winner in 1911 for his research on the eye as a light-refracting apparatus (Fig. 1.5). He described the schematic eye, a mathematical model of the human eye based on his measurements known as the optical constants of the eye. As the holder of the Research Professorship in Physical and Physiological Optics, Gullstrand devoted himself mainly to calculations and methods for achieving a more suitable form of refracting surfaces in optical instruments, and to the investigation of optical system laws of higher order. His measurements are still used today.
 
Jan Evangelista Purkyne
(Purkyne) (Czechia 1787–1869) was a versatile scholar with wide-ranging interests and an exceptional capacity for innovative thinking. Purkyne was a friend of the famous German poet Johann Wolfgang von Goethe. When he was a medical student, Purkyne used to investigate the physiology of sight by experimenting on himself with a variety of drugs, including Belladonna. His interest in the physiology of light led him to make animated cartoons, and thus he became one of the earliest motion picture pioneers.
zoom view
Fig. 1.5: Allvar Gullstrand
He is best known for his discovery of Purkyne cells, large nerve cells with many branching extensions found in the cortex of the cerebral cortex. He is also known for his discovery of Purkyne fibers, the fibrous tissue that conducts the pacemaker stimulus along the inside walls of the ventricles to all parts of the heart. An early user of the improved compound microscope, he discovered the sweat glands of the skin, germinal vesicles. He recognized fingerprints as a means of identification and noted the protein-digesting power of pancreatic extracts.
 
Hermann Snellen (Netherlands: 1834–1908)
He introduced the Snellen chart to study acuity. He did research on astigmatism, glaucoma and other eye diseases, as well as research on the correction of visual acuity using eyeglasses and ophthalmological surgery.
While other versions had been developed before him by Eduard Jäger von Jaxtthal and others, Snellen developed his eponymous eye chart in 1862 to measure visual acuity, which rapidly become a global standard. The most significant innovation was his use of what he called optotypes, specially designed characters generated on a 5×5 grid, rather than using standard fonts. They provide a physical standard measure that could be used when printing the chart. Standard vision was measured as the ability to correctly read a line of optotype characters when they subtended 5 minutes of arc and were separated by 1 minute of arc. Since its inception, more copies of the Snellen chart have been sold in the United States than any other poster (Fig. 1.6).6
zoom view
Fig. 1.6: Snellen chart
It has remained a ubiquitous standard in medical offices into the 21st century.
 
Carl Ferdinand von Arlt (Austria:1812–1887)
He proved that myopia is largely due to an excessive axial length, published influential textbooks on eye disease, and ran annual eye clinics in needy areas long before the concept of volunteer eye camps became popular. His name is still attached to some disease signs, e.g. “von Arlt's line” in trachoma.
 
Albrecht von Graefe (Germany:1828–1870)
Along with von Helmholtz and Donders, he was one of the “founding fathers” of ophthalmology as a specialty and certainly the most important ophthalmologist of the nineteenth century (Fig. 1.7).
Von Graefe was a brilliant clinician and charismatic teacher who had an international influence on the devel­opment of ophthalmology. Next to pioneering the mapping of visual field defects and improving the diagnosis and treatment of glaucoma, he also introduced a cataract extraction technique that remained the standard for over 100 years, and many other important surgical techniques such as iridectomy. He rationalized the use of many important eye drugs, including mydriatics and miotics. He was the founder of the one of the earliest ophthalmic societies “Deutsche ophthalmologische Gesellschaft” and one of the earliest ophthalmic journals “Albrecht von Graefe's Archiv für Ophthalmologie”.
zoom view
Fig. 1.7: Albrecht von Graefe
 
Hermann von Helmholtz (Germany: 1821–1894)
He invented the ophthalmoscope (1851) and published important work on physiological optics, including color vision (Fig. 1.8). He was a German physician and physicist who made significant contributions to several widely varied areas of modern science. In physiology and psychology, he is known for his mathematics of the eye, theories of vision, ideas on the visual perception of space, color vision research, and on the sensation of tone, perception of sound, and empiricism. In physics, he is known for his theories on the conservation of energy, work in electrodynamics, chemical thermodynamics, and on a mechanical founda­tion of thermodynamics. As a philosopher, he is known for his ideas on the relation between the laws of perception and the laws of nature, the science of esthetics, and ideas on the civilizing power of science. The largest German association of research institutions, the Helmholtz Association with 33,000 employees in 17 research centers and an annual budget of approximately 33 billion Euros, is named after him.
zoom view
Fig. 1.8: Hermann von Helmholtz
7
 
20th–21st Century
 
William Horatio Bates (USA: 1860–1931)
Creator of the unorthodox Bates Method is credited for being the founder of the Natural Vision Improvement movement.
 
Bashar al-Assad (Syria: 1965)
He is the Syrian President. He did his ophthalmology residency in a London hospital.
 
Ignacio Barraquer (Spain: 1884–1965)
He invented in 1917 the first motorized vacuum instrument (erisophake) for intracapsular cataract extraction (Fig. 1.9). He is the founder of the Barraquer Clinic (1941) and the Barraquer Institute (1947) in Barcelona, Spain.
 
José Barraquer (Spain: 1916–1998)
He is “father of modern refractive surgery”, developed in the 1960s, lamellar techniques including keratomileusis and keratophakia, as well as the first microkeratome and corneal microlathe.
 
Vladimir Petrovich Filatov (Ukraine: 1875–1956)
His contributions to the medical world include the tube flap grafting method, corneal transplantation and preservation of grafts from cadaver eyes and tissue therapy. He founded “The Filatov Institute of Eye Diseases and Tissue Therapy, Odessa”, one of the leading eye care institutes in the world.
 
Svyatoslav Nikolayevich Fyodorov (Russia: 1927–2000)
He popularized radial keratotomy. Russian ophthal­mologist, eye microsurgeon, creator of radial keratotomy, professor, full member of the Russian Academy of Sciences and Russian Academy of Medical Sciences and politician. Fyodorov performed in 1960 the first intraocular lens replacement operation in the Soviet Union. In 1980, he became a head of Moscow Research Institute of Eye Microsurgery. Fyodorov was a member of the Congress of People's Deputies in 1989–1991. He was elected to the lower house of the Russian parliament, the State Duma, in 1993 and he ran for president in 1996. Returning from an academic conference in 2000, Fyodorov died in the crash of his clinic's four-seater helicopter on the outskirts of Moscow (see Chapter 44: Refractive Surgery–The History of Radial Keratotomy: A Tribute to Svyatoslav).
zoom view
Fig. 1.9: ignacio Barraquer
 
Charles Kelman (United States: 1930–2004)
He developed the ultrasound and mechanized irrigation/aspiration system for phacoemulsification, for the first time allowing cataract extraction through a small incision (see Chapter 42: Cataract—Charles Kelman: Inventor of Phacoemulsification).
 
Tadeusz Krwawicz (Poland: 1910–1988)
He developed in 1961, the first cryoprobe for intracapsular cataract extraction.
 
Ioannis Pallikaris (Greece: 1947)
He performed the first laser assisted intrastromal keratomileusis or LASIK surgery (see Chapter 44: Refractive Surgery—Birth of lasik).
 
Marshall M Parks (USA: 1918–2005)
He is the “father of pediatric ophthalmology”.
 
Sir Harold Ridley (UK: 1906–2001)
He was the first to successfully implant an artificial intraocular lens in 1949, after observing that plastic fragments in the eyes of wartime pilots were well tolerated. He fought for decades against strong reactionary opinions to have the concept accepted as feasible and useful (see Chapter 42: Cataract—Sir Nicholas Harold Lloyd Ridley: The First Intraocular Lens).
 
Tsutomu Sato (Japan)
He is pioneer in incisional refractive surgery, included techniques for astigmatism and the invention of radial keratotomy treatment for myopia in 1930.
8
 
Charles Schepens (Belgium:1912–2006)
He is “father of modern retinal surgery”, developer of the Schepens indirect binocular ophthalmoscope whilst at Moorfields Eye Hospital and founder of the Schepens Eye Research Institute, Boston, USA. This premier research institute is associated with Harvard Medical School and Massachusetts Eye & Ear Infirmary.
 
THE HALL OF FAME
Below is the list of the honorees (until 2010) who were chosen to represent Ophthalmology in the Hall of Fame by the ASCRS (Fig. 1.10). The American Society of Cataract and Refractive Surgery. The Ophthalmology Hall of Fame was created by ASCRS in 1999 to honor pioneers in an ongoing celebration of their distinguished careers and contributions. These pioneers laid the foundation for the use of lasers and intraocular lenses, developed and advanced the knowledge and treatment of glaucoma, trained thousands of ophthalmologists who practice throughout the world, and developed institutions that will continue ophthalmic research for years to come. The physicians selected for this honor are chosen by their peers—more than 30,000 ophthalmologists in the US and abroad. Each year newly chosen honorees are added.
2010
  • Judah Folkman, MD (deceased)
  • Alan C Bird, MD
2009
  • Endre A Balazs, MD
  • Jacques Daviel (deceased)
zoom view
Fig. 1.10: Logo of ASCRS Hall of Fame
2008
  • Allvar Gullstrand (deceased)
  • Stephen Trokel, MD
2007
  • Dame Ida C Mann, DBE, MB, DSc (Lond), MA (deceased)
  • David J Apple, MD
2006
  • Algernon B Reese, MD (deceased)
2005
  • Gholam A Peyman, MD
  • Jules Francois MD (deceased)
  • Robert M Sinskey, MD
2004
  • Claes H Dohlman, MD
  • Govindappa Venkataswamy, MD (deceased)
  • Jonas S Friedenwald, MD (deceased)
2003
  • Danièle S Aron-Rosa, MD
  • Paul A Chandler, MD (deceased)
  • Joaquin Barraquer, MD
  • William F Hoyt, MD
  • Norman S Jaffe, MD
  • Jules Stein, MD (deceased)
2002
  • Arnall Patz, MD (deceased)
  • Edward WD Norton, MD (deceased)
  • Bernard Becker, MD
  • Jules Gonin, MD (deceased)
2001
  • Cornelius D Binkhorst, MD (deceased)
  • David G Cogan, MD (deceased)
  • Svyatoslav N Fyodorov, MD (deceased)
  • Hermann von Helmholtz, MD (deceased)
  • Gerd Meyer-Schwickerath, MD (deceased)
2000
  • Ernst Fuchs, MD (deceased)
  • Hans Goldmann, MD (deceased)
  • Albrecht von Graefe, MD (deceased)
  • Robert Machemer, MD
  • Frank B Walsh, MD (deceased)
9
1999
  • José I Barraquer, MD (deceased)
  • Ramon Castroviejo, MD (deceased)
  • Stewart Duke-Elder, FRS (deceased)
  • J Donald M Gass, MD
  • Charles D Kelman, MD (deceased)
  • A Edward Maumenee, v (deceased)
  • Marshall M Parks, MD (deceased)
  • Harold Ridley, FRS (deceased)
  • Charles L Schepens, MD (deceased)
  • Lorenz E Zimmerman, MD
Some of the most famous and also internationally best known are mentioned below with a short CV as described in the Hall of Fame.
 
David J Apple †
Dr Apple is professor of ophthalmology and pathology and director of the Laboratories for Ophthalmic Devices Research at the John A Moran Eye Center, University of Utah, Salt Lake City (Fig. 1.11). A native of Illinois, Dr Apple graduated in 1966. He served his internship and residency in pathology at Louisiana State University and Charity Hospital in New Orleans. Dr Apple used his training and skills as both an ophthalmologist and pathologist to investigate the impact of intraocular lens implantation on the eye. His work profoundly influenced the design, manufacturing, and surgical implantation of this innovative device. His work also led to new understanding of surgical techniques in areas such as capsulorhexis, hydrodissection, cortical cleanup, and dealing with the posterior capsule. He trained a generation of ophthalmologists (known as the Apple Corps) who have continued the tradition of bringing scientific discipline to understanding cataract and refractive surgery. Dr Apple has published extensively, including peer-reviewed journal articles, chapters, and texts, as well as more than 600 publications that document and disseminate his findings. He has delivered more that 1,300 lectures throughout the world to improve the understanding of other ophthalmologists about the impact of their surgical techniques on the eye. Most recently, he wrote a book that succeeds in capturing the personality and contributions of Sir Harold Ridley, the first surgeon to implant an intraocular lens. Among his many honors are the Binkhorst Medal (1988) and the Charles D Kelman Innovator's Award (2005). He is the only American to have been selected to give the European Guest lecture at the highly respected Oxford Ophthalmological Congress, Oxford (1998).
zoom view
Fig. 1.11: David J Apple †
 
Aron-Rosa (France)
The brilliant career of Dr Aron-Rosa has brought the ophthalmic world the picosecond pulsed Nd:YAG laser for the treatment of posterior capsule opacification. Aron-Rosa performed the first Nd:YAG posterior capsulotomy in January 1979.
Born in France in 1934, Danièle Aron-Rosa studied physics before turning to medicine. She received her medical degree in 1962 at the University of Paris, residency at the Hopitaux de Paris Assistée Publique, and a fellowship at the AP HP University of Paris. Her interest in physics led to subsequent interest in ophthalmology during her residency rotation in that specialty (Fig. 1.12).
Inventing the technology to deliver a non-invasive laser incision required Dr Aron-Rosa to determine a laser beam wavelength that would not disrupt the temperature or the integrity of surrounding tissue within 100 µm of the target. By multiplying the Nd:YAG frequency, Dr Aron-Rosa was able to use the laser in various wavelengths.
zoom view
Fig. 1.12: Aron-Rosa
10Although she anticipated the transition from posterior capsulotomy and replacement of posterior capsule laser openings with photodynamic therapy to be difficult, she did not expect Nd:YAG laser capsulotomies to exist 25 years after her 1978 patent.
Dr Aron-Rosa has been the recipient of several prestigious awards including the Chevalier de la Legion d'Honneur in 1983 by President Mitterand. Dr Aron-Rosa has served as Professor and Chair of Ophthalmology, at Paris University and Chair of Ophthalmology at Hospital Robert Debrè and Foundation Rothschild, Paris. Dr Aron-Rosa has produced hundreds of articles, papers, scientific books as well as several teaching films on picoseconds YAG Laser surgery.
 
Endre A Balazs
Endre A Balazs, has distinguished himself through pioneering research on the structure and biological activity of hyaluronan, a viscoelastic polysaccharide present in all tissues of the human body but in large amounts in the vitreous of the eye and the soft tissues of joints and skin.
As the world's leading expert on this important macromolecule for over 50 years, Dr Balazs’ work has encompassed numerous pioneering discoveries. These contributions include extracting and purifying the molecule itself, a medical product that has made intraocular surgeries almost routine and benefited countless eye surgery patients, and a crosslinking technique that ties together hyaluronan strands.
Dr Balazs began his research career in the university's Department of Histology and Embryology. He moved in 1947 his research to the Department of Experimental Histology of the Karolinska Institute in Stockholm. In 1951, at the invitation of Harvard Medical School, Dr Balazs moved to Boston to set up the research laboratories and organize the Retina Foundation, of which he later became president. He co-founded the Boston Biomedical Research Institute. He is currently the Malcolm P Aldrich Research Professor Emeritus. In 1962, on Dr Balazs’ initiative, (Experimental Eye Research), the first international eye research journal, was started.
 
Cornelius D Binkhorst (Netherlands:1912–1995)
The Dutch ophthalmologist Cornelius Binkhorst made fundamental contributions to the development of intraocular lenses (Fig. 1.13). He was one of the first surgeons to implant Ridley lenses, but soon began making improvements. In 1958, he introduced the first iris-clip lens, followed by several modifications, all designed to provide better stability and centration in the eye. During a period of great trial and error for implant surgeons, Binkhorst's intellectual honesty and willingness to share both his successes and failures inspired confidence in the many ophthalmologists who came from around the world to train with him. He was also influential in leading his colleagues away from intracapsular cataract extraction towards extracapsular extractions, something many now believe was his most important achievement. Binkhorst was an excellent surgeon and an enthusiastic teacher whose deep commitment to improving IOL implantation was recognized by all who knew him.
zoom view
Fig. 1.13: Cornelius D Binkhorst
 
Alan C Bird
Alan C Bird is best known for his work on retinitis pigmentosa and research into inherited retinal degeneration (Fig. 1.14). This research focused on the clinical and genetic documentation of families who exhibited retinal dystrophies and identification of the genes responsible for the retinal disorders.
Dr Bird was born in London. He studied neurology and neurosurgery and earned his medical degree from University of London at Guys Hospital. Later, he turned to ophthalmology and completed a residency at Moorfields Eye Hospital and a fellowship in neuro-ophthalmology at Bascom Palmer Eye Institute in Miami, Florida.
zoom view
Fig. 1.14: Alan C Bird
11In 1969, he returned to London and took a staff appointment at the Institute of Ophthalmology at Moorfields, where he remained until the end of his career.
In the 1970s, Dr Bird's interest in the retina emerged and he concentrated on degenerative and inherited diseases. While at the Institute of Ophthalmology, he worked with numerous fellows in a variety of multidisciplinary activities involving electrophysiology, specialized imaging, psychophysics, immunology, and pathology. This multi­disciplinary and collaborative research has resulted in the development of new technologies to define the clinical characteristics of retinal disease. His studies have also correlated abnormal gene expression with metabolic dysfunction at the cellular level. This work has led to a clearer understanding of retinal degenerative diseases, with significant implications for clinical management relative to better genetic counselling for patients and the examination of new approaches for treatment, including gene therapy.
Dr Bird has written more than 370 papers published in refereed journals as well as 70 book chapters. In recognition of his work, he has received The Duke Elder, Doyne and Bowman medals in Great Britain, and the Prix Chauvin in France. In 2004, he received the Helen Keller Prize for Vision Research.
 
Stewart Duke-Elder (UK: 1899–1978)
Sir Stewart Duke-Elder, a Scot, was a dominant force in British and international ophthalmology for more than a quarter of a century (Fig. 1.15). He is best remembered as a talented and prolific writer and editor, producing seven volumes of Textbook of Ophthalmology and fifteen volumes of System of Ophthalmology, along with many other textbooks and scientific papers that provided the educational foundation for most of the world's ophthalmologists. This monumental contribution to medical literature earned him the title of Fellow of the Royal Society in England. In addition to his own writings, Duke-Elder served for many years as editor of British Journal of Ophthalmology and Ophthalmic Literature and he was instrumental in the formation and research direction of the Institute of Ophthalmology in London. He was knighted in 1933 and subsequently earned many more honors, serving as the Surgeon-Oculist to King Edward VIII, George V and the present Queen Elizabeth.
zoom view
Fig. 1.15: Stewart Duke-Elder
 
Jules François (Belgium: 1907–1984)
Jules François studied medicine at the University of Louvain, and graduated in 1930 (Fig. 1.16). He began a private ophthalmologic practice in Charleroi, while also conducting scientific work. François also served as director of the ophthalmology clinic of the University of Ghent and emeritus professor of the faculty of medicine.
Among François’ major accomplishments was detailing the anatomy of the central retinal artery of the optic nerve. With Guy Veriest, he designed instruments for tonometry, perimetry, dark adaptation, and electro-oculography. As an outstanding clinician, he described a number of syndromes including vascular pseudopapillitis, corneal dystrophies, facial dysostosis, fundus flavimaculatus, and dystrophic skin-bone cornea.
In the early part of his career, François’ studies centered on general ophthalmology, glaucoma, conjunctivitis, fever therapy, cataract, and biochemistry. Toward the end of his life, he focused on genetic studies and continued his interest in ophthalmic surgery, diabetic retinopathy, and general ophthalmology.
François published more than 1,500 scientific papers and wrote or edited 30 books and numerous book chapters. Several of his books became standard references and include “L’ Hérédité en Ophthalmologie, Les Cataractes Congénitales, and Les Hérédo-degénéréscences Choriorétiniennes (co-authored with Franceschetti and Babel)”.
zoom view
Fig. 1.16: Jules François
12
For his achievements, Japan and many European governments decorated François. He received honorary doctorates from 21 universities, presented numerous named lectures, was the receiver of the Gonin medal (the most prestigious in Ophthalmology) and trained ophthalmologists from 33 different countries. J François was president-secretary or honorary member of more than 120 scientific societies.
 
Ernst Fuchs (1851–1930)
Ernst Fuchs, the son of an ophthalmologist, headed the Second Clinic of Ophthalmology at the University of Vienna from 1885–1915 (Fig. 1.17). During those years, ophthalmologists from around the world traveled to Vienna to learn from the man considered the master of their profession. Fuchs’ extensive clinical studies and histopathologic observations provided the first descriptions and definitions of many conditions and diseases of the eye, including Fuchs dystrophy and more than a dozen others which still bear his name. His Textbook of Ophthalmology, first published in 1889, was regarded as the “bible of ophthalmology” for more than 50 years. Decades after Fuchs’ death, ophthalmologists around the world still relied on this definitive text. Ernst Fuchs was famed for his teaching abilities throughout his career but especially during the last 15 years of his life, which he spent traveling to teach and visit his pupils around the world.
 
Hans Goldmann (Switzerland:1899-1991)
His outstanding intellectual capacity was discovered at an early age and demonstrated throughout his life. He was appointed as teaching assistant of the famous A. Cermak von Seysenegg, Chairman of the Institute of Physiology of the German Charles University in Prague. During his stay at the University of Prague, he was influenced by the famous people of his time, such as Einstein (physicist), Mach (physicist and psychophysicist), Lorenz (behavioral scientist), Popper (philosopher), Schlick (physicist and philosopher), Hering (physiologist), and others. Goldmann absorbed the essence of these disciplines to a very large extent. This, together with his remarkable intellect, enabled him to produce outstanding research work within a large spectrum of sciences more or less directly related to ophthalmology. Goldmann became known in particular for his exceptional and fundamental work on perimetry and glaucoma and he managed to cast his basic insight into practical, easy-to-operate, high-precision diagnostic instruments which, several decades after their invention, are still used by every ophthalmologist. He will enter history as one of the very great pioneers in ophthalmology. He is mostly known for the instruments he developed and refined. He improved the slitlamp-invented the applanation tonometer - standardized perimetry(the instrument carries his name: Goldmann perimeter) and introduced his 3 mirror gonioscopy lens(the Goldmann lens). Besides that, he developed a dark adaptometer (the Goldmann-Weekers adaptometer)and a colorimeter (Fig. 1.18).
zoom view
Fig. 1.17: Ernst Fuchs
zoom view
Fig. 1.18: Hans Goldmann
 
Jules Gonin (1870–1935)
When Swiss-born Jules Gonin took on the task of updating a chapter on diseases of the retina and optic nerve for the French Encyclopedia of Ophthalmology in 1900 he began his life's work and an uphill battle that would eventually earn him the title “father of retinal surgery” (Fig. 1.19). He became interested in retinal detachment, which was thought to be an untreatable cause of blindness. He spent years carefully studying the cause and pathology of this condition and came to believe that spontaneous retinal detachment was always associated with a tear. He developed the method of reattachment by ignipuncture and thermocautery, though for many years his work was heavily criticized.13
zoom view
Fig. 1.19: Jules Gonin
His ideas finally gained widespread acceptance at an international meeting in 1929 when he and other ophthalmologists reported similar successes. From then until he died from a cerebral hemorrhage at age 65, he was very busy performing surgeries. A truly good man, he divided his modest wealth equally among his three children and the blind people he had not been able to cure in Lausanne. To preserve his memory, the University of Lausanne and the Swiss Ophthalmological Society founded the Gonin Medal in 1937, which is awarded every 4 years to a distinguished ophthalmologist.
 
Robert Machemer (B 1933)
Robert Machemer, son of an ophthalmologist, was born in Germany and received his medical degree there (Fig. 1.20). A Nato grant enabled him to go to the Bascom Palmer Eye Institute at the University of Miami, where he conducted research on the vitreous and retina with dramatic consequences for the understanding and treatment of retinal detachment and vitreoretinal diseases such as proliferative vitreoretinopathy. Machemer also created an instrument the vitreous infusion suction cutter (VISC), that made possible endoillumination and the safe removal of vitreous through the pars plana. He performed the first pars plana vitrectomy in 1970, an achievement that earned him the title “father of modern retinal surgery”. In addition to his research and clinical developments, Machemer is renowned for excellence in teaching.
zoom view
Fig. 1.20: Robert Machemer
 
Stephen Trokel (B 1934)
Stephen Trokel is widely regarded for his pioneering work in the development and application of excimer lasers in corneal refractive surgery and as being the first ophthalmologist to recognize the significance of such an application (Fig. 1.21). Dr Trokel's vision and exhaustive research has made laser vision correction a realistic alternative to glasses and contacts for millions worldwide. He remains an innovator working to further develop and implement new technology.
He graduated from Cornell University with a degree in physics and subsequently received his master's degree in radiation biology. After completing his residency at Columbia University's College of Physicians and Surgeons and fellowships at the National Institutes of Health and at Columbia's Edward Harkness Eye Institute, Dr Trokel received a Doctor of Medical Science degree in Ophthalmology-Physiology, also from Columbia.
He has held positions of progressive responsibility at the Columbia University, College of Physicians and Surgeons. Dr Trokel has published numerous book chapters and more than 100 papers in scientific journals. He is also the recipient of numerous awards such as the Senior Honour Award of the American Academy of Ophthalmology, 1989; and the Binkhorst Medal of the American Society of Cataract and Refractive Surgery, in 1991.
zoom view
Fig. 1.21: Stephen Trokel