History of ophthalmology: a distinguished or extinguished field of scholarly activity?

Abstract

‘If I have seen further [than certain other men], it is by standing upon the shoulders of giants.’ (Isaac Newton, letter to Robert Hook, February 5th, 1675) Acta Ophthalmologica Scandinavica is one of the few international, peer-reviewed ophthalmology journals to publish papers dealing with the history of ophthalmology. In an analysis of papers on the history of ophthalmology published in Acta in the years 1998–2006, six articles were found, representing less than one per year. These were: (1) ‘Danish Ophthalmology from 1950 to 1975’ (Ehlers 2002); (2) ‘Gustav Østerberg in the footsteps of Hans Christian Andersen’ (Mellemgaard 2002); (3) ‘The history of the Ophthalmological Society of Copenhagen’ (Andersen 2002); (4) ‘The Society’s archives' (Norn 2002); (5) ‘Marius Tscherning (1854−1939):his life and work in optical physiology’ (Norn & Jensen 2004), and (6) ‘Jesus and the eye: New Testament miracles of vision’ (Mansour et al. 2005). An analysis of presentations at the two major European conferences gave similar results. The Nordic Congress of Ophthalmology (NOK) 2006 included a session on the history of ophthalmology, at which six papers were presented: (1) ‘Horner’s syndrome – eponymic confusion and conflict of contriver' (Havelius 2006); (2) ‘The great confusion and the Karolinska Institute in Stockholm 1888–1892’ (Tengroth 2006); (3) ‘A Swedish rural hospital 1886–1903’ (Ehinger 2006); (4) ‘Evil eyes’ (Mellemgaard 2006); (5) ‘Bjerrum’s glaucoma theory in 1889' (Norn 2006), and (6) ‘Tobacco amblyopia – historical overview of 200 years of the subject’ (Grzybowski 2006). Meanwhile, at the 2006 Meeting of the European Association of Vision and Eye Research (EVER), only one paper was presented at the free papers session: ‘Edmonde Mariotte (1620–1684), pioneer of neurophysiology and neuro-ophthalmology’ (Grzybowski & Aydin 2006). However, the General Assembly of EVER, following my formal proposal, has decided to open a subsection for the history of ophthalmology in the hope that more papers will be submitted and a full section might be established in the future. The reason for such scant interest in the history of ophthalmology might be related to the fact that it is perceived as a field of science in which there is almost no possibility of further development and in which nothing of interest can any longer be discovered. Some even claim that everything in the history of ophthalmology has already been described. As an illustration of how present knowledge has its origins in the past and of how many erroneous opinions should be reconsidered, let us examine the case of Wilbrand's knee. As is well known, Wilbrand's knee is part of the optic nerve. It appears in the majority of contemporary textbooks of ophthalmology and neuro-ophthalmology, and damage to it was previously assumed to be responsible for junctional scotoma. However, 10 years ago, Horton demonstrated that Wilbrand's knee is an artefact of monocular enucleation and proposed that anterior chiasmal syndrome has a limited localizing value (Horton 1997). Why the history of ophthalmology should undergo continual re-examination is further illustrated by the fact that many papers on ophthalmology are published in the native language of their authors and are neither translated into other languages nor presented internationally. At NOK 2006 this problem was nicely exemplified by Mogens Norn, in his work on Bjerrum's glaucoma theory. There are at least two other reasons why we should study the history of ophthalmology, apart from mere scholarly interests. Firstly, it demonstrates respect for our predecessors, tutors and masters of ophthalmology, whose lives and work deserve to be described and remembered. Secondly − and this is probably more important for general ophthalmology journals such as Acta, and conferences such as those held by NOK and EVER − the history of our discipline from ancient times to the present day imbues us with the conviction that, to paraphrase Harry Moss Traquair's statement that ‘perimetry is done by perimetrist not, perimeter’, ‘ophthalmology is performed by the ophthalmologist, not by the ophthalmic equipment’. In conclusion, I believe there is ample room for research in the history of ophthalmology, both at the national and international level. Much of this could be presented at EVER 2007 (the deadline for submissions to its newly established subsection is June 1st, 2007) or at NOK 2008 (which already has a history of ophthalmology section!).