one hundred important ophthalmology books of the...

From Thompson & Blanchard , AMA Arch. of Ophth vol. 119 (2):761-763; May 2001, and reproduced here at http://webeye.ophth.uiowa.edu/dept/20thCenturyBooks - with AMA permission

One HundredImportant Ophthalmology Books

of the 20th Centuryby

H. Stanley Thompson M.D. & Donald L. Blanchard M.D.Introduction

We originally set ourselves to this project with theencouragement of Dr Albert, the Editor of the AMAArchives of Ophthalmology, but it kept growinguntil it was much too long to publish in the pagesof the Archives. The alternative was to introducethe idea and the list of 100 books in the Journal witha very clear arrow -http://webeye.ophth.uiowa.edu/dept/20thCenturyBooks- pointing to where the main text could be foundon the internet. The fact that you are now readingthis suggests that you have been able to follow thatarrow. If you have stumbled on this by chance orby word of mouth you should know that thismaterial started out in the Archives ofOphthalmology, and that the “arrow” is on pages761-763, volume 119, issue 5, May 2001.We have found the project to be interesting,enjoyable and intensely instructive, but at the endwe found ourselves making some coin-tossdecisions about rounding the collection out toexactly 100 titles. This made us uncomfortablyaware of the imperfections of our list. We haverecognized from the beginning that the mere act ofpresenting such a list is to ask for dissent anddisparagement. To start with, what does"important" mean? Does it just mean popular? IsDuke-Elder on the list just because a lot of copies ofhis book were sold? It has been our hope to call abook "important" when there seems to be someagreement that the book has made a significantcontribution to ophthalmic knowledge or practice.We concede that it often takes time for the word toget around about the excellence or significance of acertain book. This means that when a consensus hasbeen reached there may well have been quite a fewcopies sold.Some books published in the last decade of the 20th

Century will continue to be useful and popular wellinto the 21st century, but so far, they have only hadtime to put their stamp on the 1990s. For this reasonwe have found it hard to evaluate them as 20th

century monuments. By the year 2020 a generalagreement may have finally been reached about theimportance of these books. If our list is a littleweighted towards the first half of the century, thisdelay may have been a contributing factor. By the

same token, some books first written in the 1890scontinued, through new editions, to have a majorinfluence into the 20th century, and we haveincluded a few of these in our list. The result is thatour definition of the 20th century is a little fuzzy atboth ends.Another problem with our list is that many of themost significant contributions to ophthalmicknowledge were first offered in professionaljournals, and the author never got around towriting a book on the subject. Ours is unabashedlya list of books. An objection might easily be raisedthat books are just one kind of retrievableinformation package, so why not consider all suchpackages in every kind of database? Our firstanswer is that we are fond of books. Books are notonly discrete, compact and accessible, they also canbe attractive because their physical qualities appealto some of our other senses. The palpable heft of thebook, the feel of the binding and the paper, the artand skill of the typography and illustrations are allpart of "reading" a book. A book comes saturatedwith the personality and voice of the author; it isdesigned to be held in its owner's hands and to beread, shelved and re-read as needed. Our secondreason is that we have to draw the line somewhere,and by limiting ourselves to books we have side-stepped the impossible task of writing acomprehensive History of Ideas in 20th CenturyOphthalmology.We have asked many others to give us theirchoices, but in the end this is our personal list, tiltedinevitably by our own personal, Americanexposure to ophthalmic books and by ourinclination towards the English language. Wehave made no attempt to rank all 100 of these booksin order of their importance: we are not thatfoolhardy! We have listed them chronologicallywithin eleven areas of ophthalmology. Our feelingis that there might be a fairly general agreementthat most of these 100 ophthalmic titles deservemention among the most influential of the century.The remainder will be on someone’s list but noton everybody’s.

http://webeye.ophth.uiowa.edu/dept/20thCenturyBooks


From Thompson & Blanchard, AMA Arch. of Ophth vol. 119 (2):761-763; May 2001, and reproduced here at http://webeye.ophth.uiowa.edu/dept/20thCenturyBooks - with AMA permission

2Table of ContentsOne hundred 20th century ophthalmic books arranged chronologically within each subspecialty area. Thesubspecialty areas themselves are arranged roughly in anatomical order from the front of the eye to the backof the eye.

General OphthalmologyNorris and Oliver, System of Diseases of Eye, 1897-1900Wood, Casey, The Amer. Encycloped. of Ophth ., 1913–1921Berens, Conrad, The Eye and its Diseases, 1936-1949Duke-Elder, Sir Stewart, Text.&System Ophth., 1941-‘72Adler, Francis Heed, Physiology of the Eye, 1933-1992May, Charles Henry, Manual of Disease of Eye, 1900-‘73Vaughan & Asbury, Gen’l Ophthalmology, 1958-1999AAO, Basic and Clinical Science Course, 1940-2000Grant, Morton, Toxicology of the Eye, 1962Duane, Clinical Ophthalmology, 1976Fraunfelder & Roy, Current Ocular Therapy, 1980Spalton et al. , Atlas of Ophthalmology, 1984Albert & Jacobiec, Principles & Pract Ophth’y., 1994Cataract SurgerySmith , Henry, The Treatment of Cataract, 1910Arruga, Cirugia ocular, 1946Kirby , Daniel B., Surgery of Cataract, 1950Kelman, Charles, Phacoemulsification etc., 1975Jaffe, Norman, Cataract Surg. & Complic., 1972-97Eisner, Georg, Augenchirurgie, 1973

Cornea & External DiseaseAxenfeld, Theo, The Bacteriology of the Eye, 1908Vogt, Alfred, Atlas of the Slit Lamp, 1921Berliner, M. L., Biomicroscopy of the Eye, 1943-49Castroviejo, Ramon, Keratectomy & Keratoplasty, 1964Donaldson, David, Atlas External Diseases of Eye, 1966Fedukowicz, Helena B., External Infections of Eye, 1963Grayson, Merrill, Diseases of the Cornea, 1979Krachmer, Mannis & Holland, Cornea, 1997GlaucomaElliot, Robert, Treatise on Glaucoma, 1922Uribe-Troncoso, M., A Treatise on Gonioscopy, 1947Sugar, H. Saul, The Glaucomas, 1951Becker & Shaffer, Diag. & Therapy of Glaucomas, 1961Ascher, Karl, The Aqueous Veins, 1961Chandler & Grant, Lectures on Glaucoma, 1965Shields, M. Bruce, Textbook of Glaucoma, 1982Anderson, Douglas, Testing the Field of Vision, 1982Alward, Wallace L., Color Atlas of Gonioscopy, 1994

Neuro- ophthalmologyWilbrand & Saenger, Die Neurologie des Auges., 1900-1922Posey & Spiller, The Eye and Nervous System, 1906Inouye, Tatsuji, Sehstörungen bei Schussverletzungen, 1909Traquair, Harry, An Intro to Clinical Perimetry, 1927Cogan, David G, The Neurology of Ocular Muscles, 1945Walsh, Frank, Clinical Neuro-ophthalmology, 1947Bender, Morris, The Oculomotor System, 1964Hoyt & Beeston, Ocular Fundus in Neurol. Disease, 1966Smith & Glaser, Neuro-ophth. Symp., 1965-1980Leigh & Zee, The Neurology of Eye Movement, 1983Loewenfeld, Irene E., The Pupil, 1993

Optics & RefractionJackson, Edward, Skiascopy and its pract’l applic., 1895Gullstrand, Allvar, Monochromatische Aberrationen, 1900Obrig, Theo, Contact Lenses, 1942Mandell , Robert, Contact Lens Practice, 1965Milder & Rubin, Fine Art Prescribing Glasses, 1979Pediatric OphthalmologyMaddox, Ernest, Tests & Studies of Ocular Muscles, 1898-1935Worth , Claud, Squint, 1903-1936Howe , Lucien, The Muscles of the Eye, 1907-1908Peter, Luther C., The Extra-Ocular Muscles, 1927Bielschowsky , Alfred, Lectures on Motor Anomalies, 1940Scobee, Richard, The Oculoratory Muscles, 1947Burian & von Noorden, Binoc. Vis. & Oc. Motility, 1974Hereditary Ocular DiseaseIshihara, Shinobu, Ishihara Charts for Color Blindness, 1917Waardenburg, PJ, Das menschlichen Auge etc., 1932François, Jules, L’Hérédité en Ophtalmologie, 1958Franceschetti, François & Babel , Hérédo-dég.Ch .-rét., 1963Krill , Alex, Hereditary Retinal and Choroidal Diseases, 1972Retina & VitreousRamon y Cajal, Santiago, Structure of Retina, 1894-1933Woods , Alan C., Endogenous Uveitis, 1956Gonin, Jules, Le Décollement de la Rétine, 1934Meyer-Schwickerath , G., Lichtkoagulation, 1959Schepens , Charles, Retinal Detachment & Allied Dis., 1983Cibis, Paul, Vitreoretinal Path ., Surg.Retinal Detach., 1965Gass , J.D., Stereoscopic Atlas of Macular Disease, 1970Shields, Jerry, Intraocular Tumors, 1983Ryan, Stephen J., Retina, 1989Oculoplastic SurgeryCzermak, Wilhelm, Augenärztlichen Operation, 1907-1908Meller, Josef, Ophthalmic Surgery, 1908Whitnall, S. Ernest, Anatomy of the Human Orbit, 1921Sheehan, J. Eastman, Plastic Surgery of the Orbit, 1927Wheeler, John Martin, The Collected Papers of JMW., 1939Spaeth , Edmund, New Meth of Ophthal Plastic Surg., 1925Hughes, W. L., Reconstructive Surgery of the Eyelids, 1943Stallard, H. B., Eye Surgery, 1946Fox, Sidney A., Ophthalmic Plastic Surgery, 1952Mustardé, J. C., Repair and Reconstr. of Orbital Region , 1966Beard, Crowell, Ptosis, 1969Jones & Wobig, Surgery of Eyelids & Lacrim. Syst., 1976Henderson, John W., Orbital Tumors, 1973Dutton , Jonathan, Atlas Clin. & Surg. Orbit Anat., 1994Ocular Anatomy and PathologyFuchs, Ernst, Lehrbuch der Augenheilkunde, 1889–1945Parsons, J. Herbert, The Pathology of the Eye, 1904-1908Salzmann, Maximilian, Anat. & Histo . des Auges, 1912Fuchs, Adalbert, Atlas of the Histopathology of Eye, 1924Mann, Ida Caroline, Development of the Human Eye, 1928Collins & Mayou, Pathol. & Bacteriology of the Eye, 1918Wessely, Karl, Auge, (Henke–Lubarsch), 1928-1937Wolff, Eugene, The Anatomy of the Eye and Orbit, 1933Reese, Algernon, Tumors of the Eye, 1951Friedenwald, Jonas et al., Ophthalmic Pathology, 1952Hogan and Zimmerman, Pathology of the Eye, 1962Spencer, William, Ophthalmic Pathology, 1985Hogan, Alvarado & Weddell, Histology of the Eye, 1971


From Thompson & Blanchard, AMA Arch. of Ophth vol. 119 (2):761-763; May 2001, and reproduced here at http://webeye.ophth.uiowa.edu/dept/20thCenturyBooks - with AMA permission

3Check ListOne hundred 20th Century ophthalmic books, arranged alphabetically by author.

AAO, Basic and Clinical Science Course, 1940-2000Adler , Francis Heed, Physiology of the Eye, 1933-1992Albert & Jacobiec, Principles & Practice of Ophth., 1994Alward, Wallace L., Color Atlas of Gonioscopy, 1994Anderson, Douglas, Testing the Field of Vision, 1982Arruga , H., Cirugia ocular, 1946Ascher, Karl, The Aqueous Veins, 1961Axenfeld, Theo, The Bacteriology of the Eye, 1908Beard, Crowell, Ptosis, 1969Becker & Shaffer, Diagnosis & Ther. of Glaucomas, 1961Bender, Morris, The Oculomotor System, 1964Berens, Conrad, The Eye and its Diseases, 1936-1949Berliner, M. L., Biomicroscopy of the Eye, 1943-49Bielschowsky, Alfred, Lectures Motor Anomalies, 1940Burian & von Noorden, Binoc. Vis. & Oc. Motil, 1974Castroviejo, Ramon, Keratectomy & Keratoplasty, 1964Chandler & Grant, Lectures on Glaucoma, 1965Cibis, Paul, Vitreoretinal Path., Surg.Retin Detach., 1965Cogan, David G., Neurology of the Ocular Musc., 1945Collins & Mayou, Pathol. and Bacteriol. of the Eye, 1918Czermak, Wilhelm, Augenärztlichen Operat., 1907-1908Donaldson, David, Atlas of Extern. Dis. of the Eye, 1966Duane, Thomas, Clinical Ophthalmology, 1976Duke-Elder , Sir Stewart, Text. & Syst. Ophth, 1941-1972Dutton, Jonathan, Atlas Clin. & Surg. Orbit Anat., 1994Eisner, Georg, Augenchirurgie, 1973Elliot, Robert, Treatise on Glaucoma, 1922Fedukowicz, Helena B., Extern. Infections of Eye, 1963Fox, Sidney A., Ophthalmic Plastic Surgery, 1952Franceschetti, François & Babel, Hérédo-dég.Ch-rét ., 1963François, Jules, L’Hérédité en Ophtalmologie, 1958Fraunfelder & Roy, Current Ocular Therapy, 1980Friedenwald, Jonas et al., Ophthalmic Pathology, 1952Fuchs, Ernst, Lehrbuch der Augenheilkunde, 1889-1945Fuchs, Adalbert, Atlas of Histopath of Eye, 1924Gass, J.D., Stereoscopic Atlas of Macular Disease, 1970Gonin, Jules, Le Décollement de la Rétine, 1934Grant, Morton, Toxicology of the Eye, 1962Grayson, Merrill, Diseases of the Cornea , 1979Gullstrand, Allvar, Monochromatische Aberrationen, 1900Henderson, J.W., Orbital Tumors, 1973Hogan, Alvarado & Weddell, Histology of the Eye, 1971Hogan and Zimmerman, Pathology of the Eye, 1962Howe , Lucien, The Muscles of the Eye, 1907-1908Hoyt & Beeston, Ocular Fundus in Neurol. Disease, 1966Hughes, Wendell L., Reconstructive Surg. of Eyelids, 1943Inouye , Tatsuji, Sehstörungen bei Schussverletzungen, 1909Ishihara, Shinobu, Ishihara Charts for Color Blindness, 1917Jackson, Edw., Skiascopy and its practical application, 1895Jaffe , Norman, Cataract Surgery and its Complic., 1972

Jones and Wobig, Surg. of Eyelids & Lacrim. Syst ., 1976Kelman, Charles, Phacoemulsification etc., 1975Kirby, Daniel B., Surgery of Cataract, 1950Krachmer, J H., Mannis, M., & Holland, E., Cornea, 1997Krill , Alex, Heredit. Retinal & Choroidal Diseases, 1972Leigh & Zee, The Neurology of Eye Movement, 1983Loewenfeld, Irene E., The Pupil, 1993Maddox , Ernest, Tests & Studies of Ocular Musc., 1898Mandell, Robert, Contact Lens Practice, 1965Mann, Ida Caroline, Development of Human Eye, 1928May, Charles Henry, Manual of Diseases of the Eye, 1900-‘73Meller, Josef, Ophthalmic Surgery, 1908Meyer-Schwickerath, G., Lichtkoagulation, 1959Milder & Rubin, Fine Art Prescribing Glasses etc., 1979Mustardé, J. C., Repair and Reconstr. of Orbital Region, 1966Norris and Oliver, System of Diseases of Eye, 1897-1900Obrig, Theo, Contact Lenses, 1942Parsons, J. Herbert, The Pathology of the Eye, 1904Peter , Luther C., The Extra-Ocular Muscles, 1927Posey and Spiller, The Eye and Nervous System, 1906Ramon y Cajal, Santiago, Structure of Retina, 1894-1933Reese, Algernon, Tumors of the Eye, 1951Ryan, Stephen, Retina, 1989Salzmann, Maximilian, Anat.& Histol. des mensch. Au., 1912Schepens, Charles, Retinal Detachment Surgery, 1983Scobee, Richard, The Oculorotory Muscles, 1947Sheehan, J. Eastman, Plastic Surgery of the Orbit, 1927Shields, M. Bruce, Textbook of Glaucoma, 1982Shields, Jerry, Intraocular Tumors, 1983Smith, Henry, The Treatment of Cataract, 1910Smith & Glaser, Neuro-ophth. Symp., 1965-1980Spaeth, Edmund, New. Meth. of Ophthal Plastic Surg., 1925Spalton & Hitchings, Atlas of Ophthalmology, 1984Spencer, William, Ophthalmic Pathology, 1985Stallard, H. B., Eye Surgery, 1946Sugar, H. Saul, The Glaucomas, 1951Traquair, Harry, An Intro. to Clinical Perimetry, 1927Uribe-Troncoso, Manuel, A Treatise on Gonioscopy, 1947Vaughan & Asbury, General Ophthalmology, 1958-1999Vogt, Alfred, Atlas of the Slit Lamp, 1921Waardenburg, PJ, Menschlichen Auge., 1932Walsh, Frank, Clinical Neuro-ophthalmology , 1947Wessely, Karl, Auge, (Henke-Lubarsch), 1928-1937Wheeler , John Martin, The Collected Papers of JMW., 1939Whitnall, S. Ernest, The Anatomy of the Human Orbit, 1921Wilbrand and Saenger, Die Neurologie des Auges., 1900–1922Wolff, Eugene, The Anatomy of the Eye and Orbit, 1933Wood, Casey, The American Encycloped. of Ophth., 1913–1921Woods, Alan C., Endogenous Uveitis, 1956-61Worth, Claud, Squint, 1903-1936


Thompson & Blanchard. One Hundred Important Ophthalmology Books of the 20th Century. May, 2001.http://webeye.ophth.uiowa.edu/dept/20thCenturyBooks.

4

General Texts and Encyclopedias

In the middle of the 19th Century, with the invention if the ophthalmoscope by Helmholtz and the brainsand energy of Albrecht v. Graefe, ophthalmic knowledge seemed to be exploding and ophthalmology soonbecame a recognized specialty of medicine. After a few decades the need was felt to summarize all this newknowledge. In Germany this was done, with astonishing thoroughness, under the editorship of AlfredGraefe and Theodor Saemisch (the Graefe-Saemisch Handbuch der gesamten Augenheilkunde, 1874-1880)and in France by deWecker and Landoldt (Traité Complet d’Ophthalmologie, 4 volumes, 1880-1889) andafter the turn of the century by Lagrange of Bordeaux and Valude of Quinze-Vingts, Paris (Encyclopédiefrançaise d’Ophtalmo-logie, 9 volumes, Octave Doin, Editeur, Paris, 1903-1910.

Norris, Wm. F. & Oliver, Chas. A. A Systemof Diseases of the Eye. Philadelphia, J.P.Lippincott, 1897-‘00.This massive four-volume work was a multi-authored compendium edited by Norris andOliver. There were many illustriouscontributions, including a large chapter byHermann Wilbrand on perimetry,summarizing 19th century advances in theanatomy of the visual pathways and theintracranial lesions that produced visual fielddefects; and a lengthy section on glaucoma byPriestley Smith. This four volume “System”,which was seen as an American version of thefamous French text by deWecker andLandoldt, grew out of the very popular singlevolume “Text-Book of Ophthalmology” by thesame authors (Philadelphia, Lea Brothers,1893). Their decision to switch to a multi-authored, multi-volume version promptlymade their “Textbook” obsolete, even thoughit had already been translated into Chinese.The “System” was never revised. Theiroriginal “Textbook” had appeared in 1893 onthe heels of two remarkable one-volumeophthalmology texts: Duane’s translation ofErnst Fuchs’ Lehrbuch in 1892, and GeorgeDeSchweinitz’s 1892 “Diseases of the Eye”.Both of these texts stuck to the one-volumeformat and persisted through 10 editions inEnglish.

Wood, Casey A. (ed) The AmericanEncyclopedia and Dictionary of Ophthalmology.Chicago, Cleveland Press, 1913-1921 (18 vols).More than 100 ophthalmologists contributedto this work, with Thomas Hall Shastidwriting about 10% of the entire set (including3000 biographical sketches and a 375 pagehistory of ophthalmology). This massive set ofbooks underlined for the public and for themedical profession that ophthalmology, eventhough it dealt with a small organ, had

considerable content that required many yearsof concentrated study and practice to master.At approximately the same time (1916-17), thefirst voluntary medical specialty certifyingboard in America was founded: the AmericanBoard of Ophthalmology.

Berens, Conrad. The Eye and its Diseases, by 82international authorities. Philadelphia, W BSaunders, 1936. This book was exceedinglypopular, and after the war, in 1949, a secondedition was put together, still in one volume,with contributions by even more internationalauthorities. Berens must have been apersuasive man and a skillful editor becausethe book runs smoothly along with succinctsummaries of knowledge by various well-known authors.

Duke-Elder, Sir Stewart. 1. Textbook ofOphthalmology (7 volumes, 1941-1954) 2.System of Ophthalmology, (19 volumes, 1958-1972). UK editions, London, Henry Kimpton;US editions, St Louis, Mosby. The “Textbookof Ophthalmology” began in the late 1930s,and was just getting going when the worldwar started. The second half of the set waswritten after the war. This delay made the firstvolumes seem old, and rather than do themover again, Duke-Elder undertook to edit amuch more comprehensive, multi-authored“System of Ophthalmology”.

Duke-Elder’s “System” was sold allover the world as the ultimate compendium ofophthalmic knowledge, although it wasdeliberately short on surgical procedure.Duke-Elder felt that surgical technique was afleeting skill, a slave to fashion, and a meretechnical servant of the art and science ofophthalmology. This attitude may have servedas a subtle damper on innovation andprogress in ophthalmic surgery . Duke-Elder’sspecial talent was in summarizing a great



5jumble of information into a single smoothlywritten, helpful paragraph; his astonishinglyretentive memory and his encyclopedic outputallowed him to stand like a Colossus astridethe middle 40 years of the ophthalmic century.The System of Ophthalmology was highlyvalued: a young American ophthalmologistwho collected the entire 19 volumes in the1960s may have paid 5% of one year’s incomefor the set. Like most sets of books that takemore than a decade to complete, the Systemwas barely finished before it was seen asgetting a little long in the tooth. None of thegreat surgical advances of the last generationcan be found in this set, but it is still a goldmine of information on the ophthalmic basicsciences and it will always have value becauseof the author’s fascination with the history ofhis specialty.

Adler, Francis Heed Physiology of the Eye.Clinical Application. St Louis, Mosby, 1992.The first edition of this book appeared in 1950;2nd edition, 1953; 3rd edition, 1959; 4 th edition,1965; 5 th edition, a multi-authored volumeedited and in part re-written by Robert Moses,was published in 1970; 6 th edition, Moses,1975; 7 th edition, Moses, 1981; 8 th edition,Moses & W.M. Hart, 1987; 9 th edition, Hart,1992.

This famous text had its start in 1933 witha book by Adler called Clinical Physiology of theEye, New York, The Macmillan Company,1933. The book was appreciated and admiredand it filled a void, but physiology is a movingtarget, and Adler admitted that he had limitedhimself to those aspects of ocular physiologythat sparked his interest. Almost twenty yearswent by before Adler attempted an update,and this time the book had a new publisher.As the new title suggests, he still wanted todiscuss ocular physiology in the context of arelated clinical problem. “Adler’s Physiologyof the Eye” has become a highly respectedtextbook of almost 900 pages, used throughoutthe world in the training of ophthalmologists;it is the envy of other medical specialties.

May, Charles Henry. Manual of Diseases of theEye. New York, William Wood, 1900. Dr. Maygraduated near the top of his Columbiamedical school class at age 22 and after 2 yearsas a junior assistant at Mt Sinai Hospital begana medical practice. He was influenced by

Cornelius Agnew, his professor ofophthalmology at Columbia, to take up thestudy of the eye, and undertook to spend 14months in Europe. Upon returning to NewYork he received appointments at manyhospitals and eventually directed theophthalmology service at Bellevue. At age 39he not only introduced a new double discophthalm-oscope, but also published this littlebook addressed to medical students andgeneral practitioners. Both were very popular.The book contained 22 colored plates, most ofthem fundus drawings, all of them done byDr. May. He worked hard at keeping the bookup to date. By 1917 there had already been 18printings of the first 8 U.S. editions and theninth edition had arrived. The book had beentranslated into seven different languages anda British edition had been supervised by Mr.Claud Worth. When Dr. May died in 1943 thebook had gone through 18 U.S. editions andhad been translated into 10 languages. Formany years almost every medical studentbought a copy. The book continued as “May'sManual” for another 30 years under theeditorship first of Dr. Charles Perera, and thenDr. James H. Allen. All told, there were about80 editions of this book published in variouslanguages over the years, and many of themwere reprinted more than once.

Vaughan, Daniel & Asbury, Taylor. GeneralOphthalmology. Los Altos, CA. Lange MedicalPublications, 1958. This is another book aboutophthalmology that is not intended forophthalmologists. It has always been in amodest, yellow, soft cover. In the 1960s itchallenged Charles May's Manual of Diseasesof the Eye and soon took over as the mostpopular summary of ophthalmology formedical students and general practitioners. Itwas translated into several languages and hasserved many doctors as an introduction tomodern ophthalmology. It offers just what thegeneral medical practitioner needs to knowabout ophthalmology: a basic understandingof the problem and a sense of when to referthe patient to a specialist. (15th edition 1999,with Riordan-Eva, P. Appleton, Lange).

American Academy of Ophthalmology. Basicand Clinical Science Course. San Francisco, CAA.A.O. 1940-2000. In 1938, Dr Harry Gradle ofChicago proposed that the American



6Academy of Ophthalmology start a HomeStudy Course for ophthalmologists in training.When it got rolling in 1940 - again because ofDr. Gradle's energetic support - far morepractitioners than residents signed up, butafter the war the residents began signing up indroves. Booklets that surveyed a subspecialtyarea were written by well-knownophthalmologists (for example, Saul Sugar,Wilbur Rucker, Bruce Fralick), and a "faculty"of volunteer Academy members compiledreading lists, prepared questions andindividually graded the written examinations.

In 1970 the course was restructured andits name was changed to the Basic and ClinicalScience Course, or "BCSC" for short. By 1975 itwas clearly aimed at both ophthalmologists intraining and at ophthalmologists in practice.Every year a set of about 10 volumes waspublished, each volume devoted to aparticular "section" of ophthalmic knowledge.

The set has now grown to 12 substantialbooks with readable text (rather than bareoutlines) and with color photos throughout,plus an index volume; and plans are beingmade for a 13th volume. Each year three ofthese books are rewritten from the ground upby a fresh subcommittee, while the rest areedited lightly every year by the same teamthat put them together. Thus the entire set isrewritten about every four years.

The American Academy ofOphthalmology, through the "BCSC", has beendistributing fresh ophthalmic knowledgethroughout the world for the last 60 years. Thecomplete set now runs to 4200 printed pages,and about 1350 of these sets are sold everyyear (25% of them overseas). The total pressrun is in the neighborhood of 26,000 volumeseach year - and every year any left over booksare sent free to needy ophthalmology traininginstitutions around the world. This massiveproject has been of incalculable benefit to thequality of ophthalmic care in this century.

Grant, Morton , (1915-). Toxicology of the Eye.Charles C. Thomas, Springfield, IL, 1962 2nded. 1974; 3rd ed.1986; 4th ed. with JoelSchuman, 1993). This office reference work hasbeen nurtured along through several editionsby Dr. Grant, the pioneering Bostonglaucomatologist. The book is a fat, butreadily accessible, clinical work with cleardescriptions and good documentation. It is the

book to turn to when considering the oculartoxic side effects of various drugs andpreparations. The listing of both generic andtrade names of medicines makes thisespecially helpful in practice. Lately the texthas benefited greatly from Dr. F. Fraunfelder'sNational Drug Registry to keep up-to-date onnew areas of toxicity as they emerge aspatterns.

Duane, Thomas. Clinical Ophthalmology. NewYork, Harper and Row, 1976. This innovativetext was designed to be always up-to-date. Itwas bound in a set of six sturdy 3 ring bindersand it was hoped that every owner wouldbecome a subscriber. Revised chapters weresent by mail to replace the old chapters (a planreminiscent of the Academy ofOphthalmology’s Basic and Clinical SciencesCourse). Every year a few chapters wereredone, so that in 4 or 5 years the whole set ofvolumes would be revised. The set is nowcalled "Duane's Clinical Ophthalmology". Formore than 20 years it has been a veryinfluential textbook.

Dr. Duane was Professor ofOphthalmology at Jefferson Medical Collegeand Ophthalmologist-in-Chief at Wills EyeHospital in Philadelphia. He was a lifetimeteacher and he was interested in helping thepracticing ophthalmologist to make informedjudgments about a patient’s diseases andtreatments in the midst of a busy schedule. Hewas also addressing doctors who were in theprocess of Board Certification and licensing.Duane recruited the first group of sectioneditors and many contributors then helped toprepare concise chapters. Dr. Duane died in1993 and his associate editors Edward Jaegerand William Tasman have kept the projectgoing. In 1982 a parallel set of loose leaf bookswas started emphasizing the basic sciences ofOphthalmology; it was called "Duane'sFoundations of Clinical Ophthalmology". The updates for both sets, under the sameeditorship, are now supplied by Lippincott-Williams and Wilkins.

Fraunfelder, F. & Roy, F. H. Current OcularTherapy. Philadelphia, Saunders 1980 (5thedition 2000). The entries in this book are byvarious authors and they cover almost everydisease a practicing ophthalmologist mightencounter. Each entry offers a brief



7description of how the diagnosis is confirmedand then summarizes current treatment. Someophthalmologists see this book as merely acondensed version of material that can befound in instructive detail elsewhere,however a great many ophthalmologists havefound this book very useful and comforting;they have a copy to help them through a busyday at the office and an extra copy at home.

Spalton, David J., Hitchings, Roger A.,Hunter, Paul A. Atlas of ClinicalOphthalmology. London, Gower MedicalPublishing, 1984, and in US Philadelphia,Lippincott, 1984. (2nd ed., Wolfe/Mosby/Yearbook, 1994). This is a masterpiece ofmedical book design: it is a large book (adouble page spread is 12" by 20") with twocolumns per page. The photos throughout areclean, and uncluttered by arrows and letters.Each has a matching, adjacent, computer-generated diagram with arrows identifyingthe important parts. All the graphs and chartshave been re-drawn with the same pastelpalette of pale green, blue or yellow so that

they don't jar the page. Any ophthalmologistriffling through the enlarged 2nd edition isdazzled by 537 pages of irresistible visualdelights. It is not surprising that this book hasbeen such a popular and effective teachingtool.

Albert, Daniel M & Jacobiec, Frederick A.Principles and Practice of Ophthalmology.Philadelphia, W.B. Saunders, 1994 (2ndedition 2000). This work was started whileboth the authors were at the MassachusettsEye and Ear Infirmary. Both are ophthalmicpathologists. Jacobiec is chair at MEEI andAlbert is now chair at the University ofWisconsin. This book was begun as a Harvardproject, but quickly outgrew this focus as theyrecruited experts across the country ascontributors. This set of 6 books is one of thebest single summaries of ophthalmicknowledge since Duke-Elder, and might wellbe a modern clinical ophthalmologist's "desertisland" choice.

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Cataract Surgery

At the beginning of the century Hermann Knapp of New York was strongly recommending taking theentire cataractous lens out of the eye with its capsule intact. He liked to tumble the lens on its way out. In1917 Ignacio Barraquer of Barcelona invented a little suction cup that he called an erysophake. With thissuction he could grip the lens firmly and remove it without tearingthe capsule. In 1949 Harold Ridley of London boldly tried to replace the cataractous crystalline lens withan intraocular acrylic lens. He had trouble securing the lens in the posterior chamber so he tried fixatingthe lenses in the anterior chamber angle. Most patients ended up with a cloudy cornea and glaucoma andhad to have the plastic lenses removed. Joaquin Barraquer tried Ridley’s lenses with similar bad results andended up in 1958 offering a way of dissolving the supporting zonules with an enzyme (“alpha-chymotrypsin zonulolysis”) thus contributing to the continuing popularity of intracapsular surgery.Binkhorst, despite Ridley’s failure, had the courage in 1958 to try a 4-loop iris-clip plastic intraocular lens,and then offered a 2-loop iridocapsular lens in 1965. Krasner suggested sponging up the anterior vitreous.Cryoextraction of the lens was introduced by Krawicz in 1961 . Kelman introduced phacoemulsification in1967, and gradually the advantages of the small incisions, extracapsular extraction and the new posteriorchamber lenses won over the profession.

Smith, Henry. The Treatment of Cataract.Calcutta, Thacker, Spink & Co, 1910. Lt.-Colonel Smith of the Indian Medical Service,who was famous for his ever-present cigar,had done over 24,000 cataract extractions innorthern India when he wrote this book. Heliked to slip the entire lens out of the eyethrough a Graefe knife incision, with a curvedspatula under the lens and a bulbous-tipped

lens hook pressing the cornea against thelower half of the lens. The on-the-spot pen andink sketches of every step by Derrick T. Vailand the huge experience of Colonel Smithserved to popularize intracapsular cataractextraction by the “Smith-Indian” technique.



8Arruga, Hermengildo (1886-1972 ). Cirugiaocular. Barcelona, Salvat Editores, 1946 (The3rd edition was translated into English asOcular Surgery by Hogan & Chapparo, NY,McGraw-Hill, 1952; There were 5 Spanisheditions and translations into 3 languages).Arruga was the brilliant son of a Barcelonaophthalmologist who began his medicalstudies at age 16. At 21 he was studyingophthalmology in France and Germany withLandolt, de Lapersonne and Hirschberg. Helater embraced Gonin’s new treatment forretinal detachment. He lived a long andadmirably full life. This well-made andhandsomely illustrated volume was animportant source of instruction for 20 years.

Kirby, Daniel B. (1891-1953) Surgery ofCataract. Philadelphia, J.B. Lippincott, 1950.This book, assembled with great care,appeared at the peak of the popularity ofintracapsular cataract extraction. It is printedon high quality paper and has 339 in-textfigures and 21 color plates, each with 2 or 3paintings by Gus Bethke. At everyopportunity Kirby emphasizes the history ofcataract surgery, often illustrating his pointwith a vignette or comment from the oldliterature. Every student of modern cataractsurgery ought to read this book. The technicalaspects may already be 50 years behind thetimes but the patients and their cataracts arethe same, and Kirby’s knowledge, experienceand humanity come through. Kirby’s follow-up book (Advanced Surgery of Cataract, 1955)lays out his own preferred techniques andaddresses the management of complications.It is clearly just an appendix to his 1950 book .

Kelman, Charles (1930-). Phacoemulsificationand Aspiration: the Kelman Technique of CataractRemoval. Birmingham, Ala., Aesculapius Pub.Co., 1975. Kelman was as innovative tocataract surgery in the 20th century as Davielwas in the 18th. In 1967 he introducedphacoemulsification. He entered the eyethrough a small incision, removed the anteriorcapsule of the lens, and then using anultrasound probe he fragmented the cloudedlens and removed every scrap of it by suction,leaving the posterior capsule suspended bythe intact zonules as a hammock for the plasticreplacement lens. The response was promptand mostly negative as outlined in his auto-

biography, (Through My Eyes: The Story of aSurgeon Who Dared to Take on the Medical World, New York, Crown,1985). The procedure hasof course been modified a great deal in the lastgeneration, but Kelman’s phaco-emulsificationhas become the standard cataract procedurethroughout the world, and today we expectcataract surgery to have a minimalrecuperation time, and each year we expectever more flexible and forgiving posteriorchamber lenses. (See also: The History ofModern Cataract Surgery by Charles Kelmanand Marvin Kwitko, Kugler Publications,1998)

Jaffe, Norman S. Cataract Surgery and itsComplications. St Louis, C V Mosby, 1972.When this book first appeared it came acrossas a lone, thoughtful voice in an exciting newfield. It is now in its 6 th edition (1997) withyounger Jaffes as co-authors. This series haskept up with cataract surgery during theperiod of greatest innovation and change sinceDaviel by serving up to a generation ofsurgeons a dependable and nourishing diet ofinstruction on new tricks and techniques,garnished with cautionary notes andsupported by the steadying voice ofexperience.

Eisner, Georg. Augenchirurgie : Einführung indie operative Technik. Berlin, Springer Verlag,1973 (1st US edition 1980, 189pp; 2nd USedition 1990, 318pp. Translated into Englishby T.C. Telger as Eye Surgery: an Introduction toOperative Technique). Eisner teachesophthalmology at Goldmann’s department atthe University of Bern.A book like this is just what every teacher ofophthalmic surgery needs to help answerquestions, and what every would-be eyesurgeon needs to own and study. Instead ofmerely mimicking his master, the student canfind in this book a lucid explanation of whythe knife should be held just so, and the knottied left over right, etc. It has many helpful,easy-to-understand, two-color diagrams byPeter Schneider, diagrams that no doubthelped the 1973 edition to be named as one ofthe “Fifty Most Beautiful German Books of theYear” by the Book Art Foundation of theAssociation of the German Book Trade.


Ophthalmology

9


Cornea and External disease

Axenfeld, K. Theodor P. P. (1867-1930) TheBacteriology of the Eye (Translated from theGerman by Angus McNab). London, Ballière,Tyndall & Cox, 1908, and New York, WilliamWood & Co, 1908. Victor Morax (1866-1935) ofParis wrote a chapter in the Encyclopédiefrançaise d’Ophtalmologie, (Paris, OctaveDoin, 1903-1910) on the bacteriology ofconjunctival disease. Axenfeld who becameprofessor at Freiburg, expanded on his friendand colleague’s chapter and brought togetherother material to produce a textbook in 1908that became very influential. Axenfeld’s bookpopularized the clinical use of the Gram stain.

Vogt, Alfred (1879-1943). Lehrbuch und Atlasder Spaltlampen-mikroskopie des lebenden Auges,2nd edition. Berlin, Springer, 1930-31,Stuttgart, Ferdinand Enke, 1942. The firstversion of this amazing three-volume atlasappeared in 1921 as a single slim volumededicated to Allvar Gullstrand, the inventor ofthe slit lamp (Atlas der Spaltlampen-mikroskopie des lebenden Auges, BerlinSpringer, 1921). An English version of 153pages also appeared at the same time,translated by Robert von der Heydt ofChicago, and also printed by Brockhaus inLeipzig (Atlas of the Slit Lamp-Microscopy ofthe Living Eye Berlin, Julius Springer, 1921).Vogt was Professor and head of theophthalmology department at Zürichfrom 1923-1943. He worked with diathermy inthe treatment of glaucoma and retinaldetachment, but his major contribution was inthe clinical use of the slit lamp. In 1920Gullstrand’s new instrument was stilluncommon, but Vogt, then director of theUniversity Ophthalmic Hospital in Basel,turned it into an indispensable part of themodern eye examination. He contrived tonarrow the light beam, brighten and simplifythe light source, and focus the light on the slit.The resultant even, narrow beam requiredsome dark adaptation in the observer, butdetail was seen as never before. Then he usedhis modified slit lamp to perform techniquesof focal illumination, transillumination,specular examination and indirect lateral

examination. These are all well described inhis text, but it is the illustrations by Jakob Iselithat leap off the page and still bring gasps ofadmiration from modern ophthalmologistsbecause of the exquisite attention that waspaid to the minutest details. It is obvious fromthe drawings that Iseli was facile with theinstrument and understood what he wasseeing: his paintings are often composites ofwhat could be seen at different planes offocus, and in those first slit lamps the center ofrotation of the lamp and the microscope werenot co-axial. And imagine the work of keepinga hot, smoking, sparking and sighing arc lampconstantly tuned up while he was drawing.

In 1925 Vogt hired Bregenzer as an artistand taught him to paint what he saw in the slitlamp with the same kind of breath-takingdetail. A much enlarged three-volume editionthen came out between 1930 and 1942, (Vol I,Berlin, Springer, 1930; Vol II, Berlin, Springer,1931; Vol III, F. Enke, Stuttgart, 1942. At aboutthe same time Volume 3 also appeared locallyin Zurich, in an English translation). Many ofIseli’s paintings were incorporated into thisnew edition, but all the new ones were byBregenzer. It was the magnitude of this workand the excellence of the paintings thatbrought fame to Vogt, and the book is onceagain in print. In 1977 a luxury edition wasbrought out in German by WayenborghPublishing and the same company thenpublished an English translation by Blodi (VolI,1978; Vol 2, 1979) and in 1981 a reprint of theZürich English version of the 3rd volume.

Berliner, M. L. Biomicroscopy of the Eye. NewYork, Paul B. Hoeber, 1943-1949. Vol 1appeared in 1943 and was reprinted in 1949when the second volume came out. Berlinertaught slit lamp biomicroscopy at variousNew York hospitals, and these volumes are aspare-no-expense effort to put these clevertechniques and beautiful images between thecovers of a book. Zeiss slit lamps were usedand it seems that the electric bulbs suffusedthese images with a warmth that was notpresent in Iseli’s arc-lamp drawings. Thepaintings by J. McGuiness Myers in Berliner’s



10book also have a style that differs from thosein Vogt’s atlas. Iseli’s paintings suggest thenotes of a meticulous explorer, scrupulouslyaccurate, recording every detail no matterhow trivial; but there is a teacher looking overMcGuiness Myers’ shoulder, asking foremphasis where it is clinically important. Thisgives the Berliner/Myers pictures a confidentair of certainty that makes them betterteaching instruments.

Castroviejo, Ramon (1904-1987). Atlas dequeratectomías y querato-plastias. Barcelona,Salvat Editores, 1964; English edition, Atlas ofKeratectomy and Keratoplasty, Phila,Saunders, 1966; German edition Keratektomieund Keratoplastik (translated and edited by F.Hollwich) Stuttgart, G. Thieme Verlag, 1968.Castroviejo was born in northern Spain, theson of an ophthalmologist. At age 24, havingcompleted medical school and ophthalmictraining, he accepted a position as an assistantat the Chicago Eye & Ear Hospital. The nextyear he was working at experimental cornealtransplantation under Dr Benedict at the MayoClinic, and the following year (1931) he wasinvited by Dr Maynard Wheeler to NewYork’s Columbia Presbyterian. Within a fewyears Castroviejo was making successfulsquare corneal grafts in humans. The squaregraft remained his signature procedure untilthe early 1950s. He opened his own eyehospital in New York in the 1940s, andpatients were sent to him from all over theworld. Castroviejo was a pioneer of cornealtransplantation and he trained many cornealsurgeons. It was his drive and energy thatproduced the techniques and the instrumentsthat made corneal grafting a successfuloperation. His book summarized his work andthe latest technology of the day.

Donaldson, David D. Atlas of External Diseasesof the Eye. Vol 1 Congenital anomalies andsystemic diseases. St Louis, C V Mosby, 1966.(Vol 2, Orbit, lacrimal apparatus, eyelids andconjunctiva, 1968. Vol 3, Cornea and Sclera, 1971.Vol 4, Anterior Chamber Iris, and Ciliary Body,1973. Vol 5, The Crystalline Lens, 1976) Thestereophotographs in these books, taken withthe “Donaldson camera”, brought externaldisease to life.

Fedukowicz, Helena B. External Infections ofthe Eye : bacterial, viral and mycotic. NY,Appleton Century Crofts 1963. HelenaBiantovskava Fedukowicz (1900-1998) wasborn in the Ukraine and educated in the SovietUnion, where she eventually became aprofessor of Ophthalmology at Vinniza withan interest in infectious disease. She arrived inthe US in 1949. After some English lessons, shegot a job, through the efforts of Dr GeorgeWise, running an ophthalmic bacteriologylaboratory at New York University supportedby the NYU chairman, Dr. Alson E. Braley.Her book, on the clinical bacteriology of theeye was the first written in English and thefirst since Axenfeld’s book. Beatrice Gloverhad drawn an excellent series of color plates,but the publisher refused to use them sayingthat color would be too expensive.Fedukowicz insisted that color was essential.This impasse was broken when an anonymousdonor paid the cost of the plates. The bookbecame very popular and was used widely inteaching institutions; subsequent co-authorededitions appeared in 1978 and 1985, with aSpanish edition in 1987. Fedukowicz waselected an Honorary Fellow of the AmericanAcademy of Ophthalmology in 1982. Later itcame out that the anonymous donor was Dr.George Wise.(see: Baum, Jules. Helena B.Fedukowicz, Documenta Ophthalmologica99:215-218, 1999

Grayson, Merrill. Diseases of the Cornea. StLouis, C.V.Mosby, 1979. (2nd ed. 1983; 3rded. by R. Arffa, 1991; 4th ed. by R. Arffa,1997). This one volume introduced theophthalmologist in training to corneal disease.It was thorough, well-organized and richlyillustrated with color photographs thatseemed unusually clear and expressive. Itproved to be very popular.



11Krachmer, J. H., Mannis , Mark & Holland,Edward. Cornea. St Louis, C.V.Mosby, 1997.The medical illustrator involved with thisproject was Martin Finch. It started with aspectacular atlas (Krachmer, Jay H. and Palay,David, Color Atlas, Mosby, 1995) and went on

to a three volume text (Vol 1: Fundamentals;Vol 2: Diagnosis and Management; Vol 3:Surgery). With 250 contributors it must havebeen a staggering editorial job, but there is nodoubt that it is now the most completecompendium available on the subject.

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Glaucoma

In 1857 von Graefe found that taking out a large piece of the iris seemed to help many patients withglaucoma (Graefe’s Archiv 3:456, 1857, and then 4:127, 1858; 8:242, 1862; and 15:108, 1859). Graefe’searly work on this subject was translated into English and published by the New Sydenham Society in1859). Eserine eye drops, made from the Calabar bean, were used before iridectomy to produce a miosis sothat the iridectomy could be made peripherally in the iris. It was soon noticed that occasionally theglaucoma seemed better after the eserine so that the surgery was no longer needed. Graefe also suggestedthat a visual field examination could, and should be done in the office (Graefe’s Archiv 2:258, 1856).Towards the end of the 19th century glaucoma was considered to be identical to elevated intraocularpressure (and vice versa). “Low-tension glaucoma” by definition, did not exist. The English languageglaucoma expert was Priestley Smith.

Elliot, Robert Henry (1864-1936). Treatise onGlaucoma. 1922, Henry Frowde and Hodder &Stoughton, London, (Paul B. Hoeber in NewYork). Major Elliot, working at theGovernment Ophthalmic Hospital in Madras,India, began in 1909 to use a trephine to makea very anterior sclerectomy under aconjunctival flap, coupled with a peripheraliridectomy, in the hope of improving on theoperation of Félix Lagrange (Bordeaux), andwhen he reported 50 cases in 1909 he didn’tknow that Freeland Fergus (Glasgow) andSøren Holth (Christiania) had just reportedsomething similar. His book on “Sclero-corneal Trephining” appeared in 1913 after900 cases and the procedure receivedworldwide publicity. Elliot took part in aglaucoma discussion with Priestley Smith andLagrange at the International Congress ofMedicine in London. He then made a trip toAmerica visiting many ophthalmic centersand doing his operation 135 more times.Elliot’s trephining procedure was a lot moreeffective in treating chronic glaucoma than aniridectomy, so, with such a vigorous send offit is not surprising that his trephiningprocedure took it’s place beside Holth’siridencleisis as one of the most popularglaucoma operations for the next 40 years.Elliot’s first book was Sclero-cornealTrephining in the Operative Treatment ofGlaucoma, 1913, George Pulman & Sons,

London. (Second edition, 1914, Geo Pulman,London and Paul B. Hoeber, New York). Thisbook made him famous and he followed upwith annual summaries on progress inglaucoma in the Ophthalmic Yearbooks of1913 to 1916, a short book called “Glaucoma, aHandbook for the General Practitioner” 1917,H.K. Lewis, London; and in 1918, “Glaucoma;A Textbook for the Student ofOphthalmology”, H.K. Lewis, London, (Paul.B. Hoeber in New York). It was the enlargedsecond edition of this book, (published in 1922and called Treatise on Glaucoma, HenryFrowde and Hodder & Stoughton, London,and Paul B. Hoeber in New York) that did amajor service to ophthalmology by improvingthe quality of teaching about glaucoma, andby posing some questions about themechanisms of the disease process.

Iridencleisis was dropped for fear ofsympathetic ophthalmia, and the post-operative complications of cyclodialysis madeit fall from favor. Variations of Elliot’strephination are still in use: Scheie’s thermalsclerectomy was popular for a while, andCairns’ 1968 trabeculectomy turned out to beanother external filtering operation thatworked quite well.



12Uribe-Troncoso, Manuel (1869-1959). ATreatise on Gonioscopy. Philadelphia,F.A.Davis, 1947. Gonioscopy had a longhistory before 1947, but this book brought thetest into the ophthalmologist’s office. For areview of the history of gonioscopy (Trantas,Salzmann, Koeppe, Barkan) see Dellaporta,Survey Ophthalmology 20: 137-149, 1975.Uribe-Troncoso’s 1947 book was the firstcomprehensive book on gonioscopy. Trantas’word ‘gonioscopy’ was in the title and wasused throughout the book. Color paintings byGus Bethke were the best then available. Theanatomic landmarks of the chamber angle asseen with the gonioscope were named andclarified in this book. Examination of thechamber angle now had a familiar name,familiar landmarks and there were clinicalindications for its use in the ophthalm-ologist’s office, but it was still an awkwardprocedure: the patient was lying down, and alarge, bulbus, limbus to limbus Koeppe lenswas used to view the angle directly. Theinternal curvature of the lens vaulted over thecornea and this space had to be filled withwater. The lens was then pressed to thepatient’s eye while the patient was turned onhis back so that a suspended microscope andilluminator could be brought up for viewing.The water would often leak out, allowing airto bubble up and spoil the view. NeverthelessTroncoso’s book marked the elevation ofgonioscopy to an important clinical test, inpart because Sugar, Gradle and Kronfeld wereverifying the value of Barkan’s classification ofthe glaucomas by the appearance of thechamber angle.

Goldmann’s major contribution togonioscopy was the Haag-Streit 900 slit lamp.This was an instrument in which themicroscope and the light beam and theattached camera were always in focus togetherno matter what angle separated them, becausethey all moved together when the joy stickwas moved. The joy-stick could be operatedwith one hand, leaving the other free to holdGoldmann’s mirrored lens against the eye.

Sugar, H. Saul (1912-1993). The Glaucomas.New York, Hoeber-Harper, 1951 (2nd edition1957). Dr. Sugar was a thoughtfulophthalmologist who made manycontributions to the literature, including someof the early work on pigmentary glaucoma.

He was in private practice in Detroit and, inaddition to being the Head of the Departmentof Ophthalmology at Detroit’s Sinai Hospital,he was a professor at Wayne State UniversityMedical School, and head of the glaucomaservice there. His 1951 book was the firstAmerican textbook on Glaucoma and it wasbased largely on his own considerableexperience and knowledge. He was interestedin gonioscopy (see Sugar’s chapter in vol. 2 ofBerliner’s 1949 Biomicroscopy text).Gonioscopy was used by Barkan not only forsurgical goniotomy but also to differentiateone kind of glaucoma from another (noteSugar’s use of the plural in his title). This textencouraged many others to tackle some of theunsolved problems in the glaucomas.

Becker, Bernard & Shaffer, Robert N.Diagnosis and Therapy of the Glaucomas. StLouis, C.V. Mosby, Through seven there havebeen many co-authors and editors includingKolker, A.; Hetherington, J. Jr.; Hoskins, H.D.; Stamper, R.; Lieberman, M.; Drake, M andKass, M). Dr. Becker was Chairman of theDepartment of Ophthalmology at WashingtonUniversity in St. Louis for 35 years (1953-88),he established a glaucoma research center, andwas the founding editor of "InvestigativeOphthalmology". His brilliance and eruditionare legendary. He was an enthusiasticcollector of old ophthalmic books andeventually gave his entire collection to theMedical Library at Washington University.His energetic fund raising for that libraryresulted in it being named “The BernardBecker Medical Library”.

Dr Shaffer was active in California formost of his clinical years. He produced astereo atlas of gonioscopy and was a leadingexpert in gonioscopic surgery in infants. Healso did work on malignant glaucoma and thevitreous diversion syndrome, and served formany years as the Executive Director of theAmerican Board of Ophthalmology.

This text, designed for students ofophthalmology, was very clear and definiteabout the mechanisms at work in glaucomaand what should be done about it. It began in1961 with the goal of making available thecurrent thinking about pathogenesis,diagnosis, and management of the glaucomasin a single volume, and it did it remarkablywell. If it can be said that "Lectures on



13Glaucoma" by Chandler and Grant was thedefinitive glaucoma textbook on the EastCoast, especially in New England, then Beckerand Shaffer's book was certainly theglaucoma bible of the West Coast. Differenttreatments were recommended, and they evenused opposite numbering systems foropenness of the angle. These differences havesoftened as the new editors have worked onthe text and brought diverse backgrounds tothe work. The importance of pressureelevation with steroid administration wasstressed, and impressive efforts have beenmade in later editions to keep the therapy upto date.

Ascher, Karl W. The Aqueous Veins.Springfield, Charles C. Thomas, 1961. Dr.Ascher was originally from Prague where hehad a special interest in keratoplasty. Becauseof the war he came to the US in 1939 andworked at the University of Cincinnati Collegeof Medicine with Derrick Vail. Having studiedwith Alfred Vogt, Ascher was an expert withthe slit lamp and detected and recognized theimportance of aqueous veins. These aretransparent vessels which transport aqueousfrom Schlemm's canal into the conjunctival orepiscleral veins. This discovery settled threedebates that were active at the time. Firstwhether the aqueous fluid was a stagnantsystem, second whether primary open angleglaucoma was a problem of retention or ofover-production of fluid, and third whetherSchlemm's canal was normally a non-functioning space, which was only active inglaucomatous conditions with raisedintraocular pressure. The working out of thesequestions also helped lead to the popularity oftonography in the middle part of the century.

Chandler, Paul A. & Grant, W. Morton.Lectures on Glaucoma. Philadelphia, Lea &Febiger, 1965 (2nd edition, 1968; 3 rd edition1986. A fourth edition 1996 was madeavailable as "Chandler and Grant'sGlaucoma" edited by David Epstein, RandAllingham, and Joel Schuman.)Chandler and Grant worked at theMassachusetts Eye and Ear Infirmary andgave a series of clinical lectures on glaucomathere. These lectures were primarily to"provide a practical guide for recognition andmodern treatment of the various forms of

glaucoma and for the solution of problemsencountered clinically." They brought theselectures together for publication, deliberatelyavoiding the research aspects of glaucoma andthe details of surgical techniques. For yearsthis book was carefully studied and minedsentence by sentence for its nuggets of clinicalwisdom. It has grown and broadened in thelast generation, surgical teaching has beenincluded and many new ideas have beenintroduced. It is still a clinician’s guide but ithas become far more than a set of Bostonlectures.

Shields, M. Bruce,(1941-). Textbook ofGlaucoma . Baltimore, Williams and Wilkins,1982.. This much admired text grew along awell-trodden path: first the author puttogether A Study Guide for Glaucoma(Baltimore, Williams & Wilkins 1982) for hisstudents. This was very popular so heexpanded it in 1987 into a Textbook ofGlaucoma, which was even more popular.This was followed by 3rd (1992) and 4th (1998)editions, with contributions by other authors.Great care was taken to keep the book up todate: for example, sections on. nerve thicknessand the modulation of wound healing wereexpanded. Dr. Shields was professor ofophthalmology and director of the glaucomaservice at Duke University when this workwas done.

Anderson, Douglas R., (1938-). Testing theField of Vision. St Louis, C.V. Mosby, 1982.This was the first of an important series ofbooks about visual field testing. The secondbook (1987) was called "Perimetry with andwithout Automation". This grew into a 3rdbook (1992) called. "Automated StaticPerimetry". The 4th edition was co-authoredwith Patella, V. in 1999. Dr.Anderson is aprofessor of ophthalmology at the BascomPalmer Eye Institute in Miami. He directs theglaucoma service, so it is natural that hisbooks emphasize glaucomatous field lossrather than defects of neurologic origin. Thegeneral shift from kinetic perimetry toautomated static perimetry can be seen in thisseries of books. This in turn is a reflection ofthe success of the Humphrey Visual FieldAnalyser with its various new models,strategies and programs for getting the mostaccurate representation of the visual field.



14These new programs require a text such asAnderson and Patella’s to explain how best todo and interpret the fields. It was at firsthoped that automated visual field testingwould provide a purely objective result. But itsoon became obvious that without supervisionand encouragement by an experiencedperimetrist the test could turn out entirelyuntrustworthy results. The book faces up tothis problem and offers an excellent guide forthe perimetrist on how to oversee the testingmoment by moment, how to change thestrategy as needed and how to explain to thepatient the purpose and technique of thetesting to get the best results.

Alward, Wallace L. Color Atlas of Gonioscopy.Wolfe Publishing, Mosby-Yearbook, 1994.This book, illustrated by Lee Allen, is not aglaucoma text, it is a slim guide to gonioscopyfor the fledgling ophthalmologist. In the early

1940s Lee Allen, in Iowa City, made a directgoniolens so light in weight that it could beheld on the cornea by the eyelids and capillaryattraction alone. An improved version wasequipped with an internally reflecting surfacebuilt into the plastic; this gonioprism was heldagainst the cornea and manipulated with athumb guide. The patient could then be seatedand examined at a slit lamp. The Allen-Thorpeversion was provided with 4 mirrors so itdidn’t have to be rotated all the way around.However after only a decade or so of use thishandy gonioprism was replaced byGoldmann’s lens. Lee Allen’s drawings of thechamber angle using his gonioprism, made inthe late 1940s and early 1950s are outstanding,and remain unsurpassed in clarity. Theirpublication here in Alward’s instructionalbook is a winning combination that is muchprized as a teaching tool.

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Neuro-ophthalmology

Wilbrand, Hermann and Saenger, Alfred. DieNeurologie des Auges: ein Handbuch für Nerven-und Augen-ärtze. Wiesbaden, J.F. Bergmann,1900-1922. Having done chapters for othertexts, in 1899 Wilbrand started on his ownwork, in collaboration with Alfred Saenger. Itwas called “The Neurology of the Eye: ahandbook for neurologists and ophth-almologists”. There were to be nine volumesin the set, and they were published over aconsiderable period of time and were notcompleted until 1922. These volumes offered adetailed summary of the contributions toGerman neuro-ophthalmology over the lasthalf of the 19th century. This exhaustive set,together with the endless Graefe-Saemisch(neither of them ever translated into English)were the origin of the statement that “The‘Laurels of Originality’ often celebrate nothingmore than an ignorance of the old Germanliterature.”

Posey, William Campbell and Spiller,William G. The Eye and Nervous System, theirdiagnostic relations by various authors.Philadelphia, J.P. Lippincott, 1906 WhenWilliam Thomson retired from his clinic at theWills Eye Hospital in January 1902, he wassucceeded in June by William Campbell

Posey, a man who had an even strongerinterest in the neurological problems of vision.Posey collaborated with William GibsonSpiller, the neurologist at the PennsylvaniaHospital, who had spent four years in Europetraining with Oppenheim, Obersteiner,Edinger, Déjerine and Gowers. In 1906 theyproduced a fat, multi-authored textbook called“The Eye and Nervous System”. There were100 pages on eye movements by AlexanderDuane, 40 pages on the 5th, 7th andsympathetic nerves by Edward Jackson, and80 pages on neuroses and psychoses byDeSchweinitz. This single volume wasPhiladelphia’s answer to what Wilbrand andSaenger were doing. ‘Posey and Spiller’ wasAmerica’s first text devoted exclusively to thesubject matter now called Neuro-ophthalmology. For a generation this bookwas the best one volume text on the neurologyof vision.

Inouye, Tatsuji (1880-1976). Die Sehstörungenbei Schussverletzungen der kortikalen Sehsphäre,nach Beobachtungen an Verwundeten der letztenjapanischen Kriege. Leipzig, W. Engelmann,1909 (An English translation of this work isavailable through the journal Brain)



15The anatomists of the late 19th century hadidentified the visual pathways in the brain allthe way to the occipital cortex, (see Polyak’smasterful review: especially Chaps. 4 & 12 ofThe Vertebrate Visual System, Univ ChicagoPress, 1957) and Wilbrand and then Henschenhad laid out the expected visual field lossassociated with various cerebral lesions. A fewfocal injuries to the brain were needed toconfirm the facts in humans. During and afterJapan’s war with Russia (1904-1905 ), Inouyewas able to test the visual fields in woundedsoldiers for insurance purposes and realizedthe importance of his observations. A fewyears later, during World War I the Londonneurologist Gordon Holmes, examiningsoldiers with shrapnel injuries to the brain,began to sort out the exact representation ofthe retina in the visual pathways and cortex(Brain,1916, 39:34; BJO,1918, 2:353). On theGerman side Wilhelm Uhthoff was makingsimilar observations; he may have had feweroccipital injuries to work with because of theshape of the German helmet. For 75 yearsHolmes’ map was the best available. In 1991Horton and Hoyt (Arch Ophth. 109: 816-824)were able to make a small improvement onHolmes’ map of the representation of thevisual field in the human occipital cortex.

Traquair, Harry Moss (1876-1954). AnIntroduction to Clinical Perimetry. London,Henry Kimpton 1927.(St Louis, C V Mosby,)(6th ed. 1949).In the first quarter of the century, the tangentscreen, as recommended by Bjerrum andRönne in Copenhagen, and picked up byA.H.H.Sinclair of Edinburgh (TOSUK, 1905)was being popularized in America byAlexander Duane, Harry Friedenwald andLuther C. Peter, and it was beginning toreplace the arc perimeter. Traquair ofEdinburgh, Scotland took a special interest intangent screen campimetry, and in 1927produced a book called “An Introduction toClinical Perimetry” that he personally carriedthrough six editions. The 7th was done in 1957by Traquair’s student G.I. Scott. Traquair’sbook, in which he introduced the concept of“the Island of Vision”, was the standardperimetry text throughout the world untiledged out by David O. Harrington’s text book“Visual Fields” in the late 1950s.

Cogan, David G. The Neurology of the OcularMuscles. Springfield, Charles C. Thomas,1945 (published simultaneously in UK byBlackwell, Oxford, and in Canada by theRyerson Press, Toronto). Cogan’s small butfully referenced book was written in a veryeconomical style so that one could pick upseveral important points in a singleparagraph. Many of the brainstem syndromesthat disturbed eye movements mentioned byBielschowsky were brought into sharper focus. No better description of the cranial nervesserving the eye muscles could be found.

Walsh, Frank Burton (1895-1978) ClinicalNeuro-ophthalmology Baltimore, Williams &Wilkins, 1947.Walsh was a Canadian from Saskatchewanwho had served in World War I. He receivedhis medical degree from the University ofManitoba in 1921, interned in Winnipeg, andbegan to practice general medicine. Afterseven years he decided he wanted tospecialize and began a residency at JohnsHopkins in 1930 with Dr Wilmer as his chief.Walsh was particularly influenced by FrankFord, the pediatric neurologist, who wasworking on a book called “Diseases of theNervous System in Infancy, Childhood andAdolescence” (Springfield, Charles C. Thomas1937). Walsh’s 1947 book, “Clinical Neuro-ophthalmology”, was so impressive and sopopular that he soon started working on thesecond edition and this came out in 1957; ithad three columns instead of two and wasaltogether a very impressive compendium ofneuro-ophthalmic knowledge. The thirdedition was the product of a collaborationbetween Dr Walsh and his 1958 fellowWilliam F. Hoyt of San Francisco. It appearedin 1969. The fourth edition of “Walsh andHoyt” came out in the 80’s revised and greatlyenlarged by Neil Miller, Walsh’s successor atthe Wilmer Institute. For the fifth edition of“Walsh & Hoyt”, Miller and his co-editorNancy Newman solicited chapters from manyneuro-ophthalmologists. The dramaticincrease in the size of this book through itsfive editions is an indicator of the geometricexpansion of neuro-ophthalmic knowledge inthe 2nd half of the 20th century.



16Bender, Morris B. The Oculomotor System. NY,Hoeber, 1964. In 1961 Dr. Bender put togethera symposium on eye movement control at theMt Sinai Hospital Department of Neurology inNew York, and this book was the result. Thesymposium attracted investigators from allover the world, and since that time, theseworkers and their successors have metrepeatedly to compare notes, (see the work ofDaroff, Dell’Osso, Robinson, Leigh, Zee,Baloh, Sharpe, Halmagyi, Paige and others).This has led to significant new understandingof eye movement control.

Hoyt, William Fletcher & Beeston, Diane. TheOcular Fundus in Neurologic Disease: a diagnosticmanual and stereo atlas. St Louis, CV Mosby,1966. In the 1870s and 1880s many voices hadstrongly urged that the ophthalmoscope byused by all physicians to examine the retinaand the optic nerve head (see especiallyEduard Jaeger, Hughlings Jackson, CliffordAllbutt, and William Gowers). This book, by aneuro-ophthalmologist (Hoyt) and aphotographer (Beeston), follows in the sametradition. There are 14 viewmaster reels and afold-up viewer at the back. The book sold outalmost immediately and was never reprinted.A generation of neuro-ophthalmologists usedthis book, if they could find a copy, to teach ageneration of ophthalmologists about thedifferential diagnosis of the elevated opticnerve head.

Smith, J. Lawton & Glaser, Joel S. Neuro-ophthalmology – University of Miami Symposia,Vol 1. Springfield, Charles Thomas, 1964.Vols 2-4, 6-10. St Louis, C.V Mosby,1965-1980.Vol 5. Hallandale FL, Huffman, 1971. Thesewere the years of spectacular growth of thesubspecialty of neuro-ophthalmology, andLawton Smith was a major player: he wasguru, enthusiast, teacher, catalyst andsalesman. In the mid 1960s his “MiamiSymposium” was the only annual meeting forneuro-ophthalm-ologists. In this series of tenbooks Smith and Glaser manage to convey the

bubbling and uneven quality of the newsubspecialty, and the excitement of learningsomething new every day. It was this sense ofimmediacy that Smith later transferred to hisrole as founding editor of the Journal ofClinical Neuro-ophthalmology.

Leigh, John & Zee, David S. The Neurology ofEye Movement. Philadelphia, F.A. Davis Co,1983, 281 pp. (2nd edition, 561 pp, 1991; 3rdedition, 646 pp. 1999). These two clinicianswrote their book for ophthalmologists,neurologists and neurosurgeons who in turncontinue to find it of value in recognizing andunderstanding clinical problems. The peg-board upon which various eye movementabnormalities have been hung up and sortedout is that of control systems analysis andmodeling as recommended by theneurophysiologist David A. Robinson. Thistechnique has helped to answer many difficultquestions about the pathophysiology ofhuman eye movements.

Loewenfeld, Irene E. The Pupil: Anatomy,Physiology and Clinical Applications. Ames,Iowa State University Press, 1993, 2223 pages,(2nd printing Butterworth & Heinemann,1999). Otto Löwenstein (1890 -1965) wasprofessor of Neuropsychiatry at University ofBonn from 1933-38. He was interested inpupillary movements and eventually settledin New York where he practiced medicine andcontinued his efforts to record and understandpupillary movements. In 1940 IreneLoewenfeld began to work in Löwenstein’s labat NYU (and later at Columbia) first as atechnician, then as a graduate student, andeventually as a collaborator in pupillaryresearch. Together they made many importantcontributions to pupillary physiology over thenext decades. In 1993, Loewenfeld completedthis thorough and important book on theworkings of the pupil of the eye starting withand building upon Löwenstein’scontributions.(See review in Amer. J. Ophthal.116:117-119,1993)


Ophthalmology

17


Optics and Refraction

Although spectacles had been invented in the 13th Century, and were common as reading aids ever since theeye had been recognized in the early 17th century to be an optical device, a real understanding of how tomeasure a patient’s eye for glasses only came in the 19th century. The standardized vision chart with 20/20notation was proposed by Snellen in 1862; Donders clarified the scientific basis of refraction in 1864, andin 1876 Nagel suggested the “diopter” as a standard unit of lens power. In the first years of the 20th

century some ophthalmologists were doing very careful refractions, trying to incorporate cylindrical powerinto spectacles after estimating corneal astigmatism with Javal’s keratometer, and refining the refractionwith and without atropinic eye drops. This was in contrast to the rough estimates that went into thedispensing of most glasses.

Jackson, Edward. Skiascopy and its practicalapplication. Philadelphia, The Edwards &Docker Co. 1895. This book was a deliberate(and successful) effort to popularize the testthat had been called “the shadow test”(Cuignet, 1875) and is now called“retinoscopy”(Thorington, 1897). The bookwas frequently reprinted in the first decadesof the century. This technique used thedoctor’s observations rather than the patient’sresponses and it became an almost universalfirst step in estimating refractive error. Jacksonencouraged full correction of ametropia. In1887 Jackson had recommended a crosscylinder for estimating cylinder strength andonly later did he realize how quickly andeffectively the cross cylinder could be used todetermine cylinder axis. In 1907 at theColorado Ophthalmological Society, Jacksonbegan to give instruction on the use of thecross cylinder, a handy test that made itpossible, in the course of a simpleexamination, to measure the power and theaxis of the total astigmatism both corneal andlenticular. In some clinics automatedrefractometers are beginning to replaceretinoscopy as a way to find a starting placefor a refraction.

Gullstrand, Allvar, (1862-1930). AllgemeineTheorie der monochromatischen Aberrationen undihre nächsten Ergebnisse für die Ophthalmologie.Upsala, Berling, 1900. (General theory ofmono-chromatic aberrations and its directresults for ophthalmology). This bookintroduced Gullstrand’s work in optics toophthalmology and helped establish him asthe 20th century's worthy successor toHelmholtz. Gullstrand was Professor ofOphthalmology at the University of Upsala

from 1894 until 1914. During this time he wasan active surgical ophthalmologist andteacher. In 1914 a special post of Professor ofOptics was created for him there, so that hecould pursue his primary interest in physio-logical optics. He is known for his work on thethird edition of Helmholtz's "Treatise onPhysiological Optics" published 1909-1911 andtranslated into English in 1924. In this workGullstrand edited and annotated the work ofHelmholtz with a pious respect for theoriginal text. He then added a series of lengthyappendices of his own work, which broughtthe area of optics up to date especially inregard to the field of ophthalmology. Heconfirmed Helmholtz’s ideas about themechanism of accommodation by describingthe intracapsular lens changes, and he showedhow the shape of the cornea could be mappedwith reflections. At the turn of thecentury unwanted reflections weretroublesome in the examination of the fundus.Gullstrand worked first on the theoreticaspects of the problem, and then produced aworking, stand- mounted reflex-freeophthalmoscope.

Gullstrand introduced aspheric lenses toophthalmology. Even more importantly hedeveloped a slit beam for lateral illumination,leading the way to the Zeiss slit lamp. Hiscontributions in the area of dioptrics led to aNobel Prize in 1911. Gullstrand’s originalwork is still under-appreciated by mostEnglish speaking ophthalmologists, perhapsbecause of the complex geometric formulasused in his German texts. His influence on 20th

century ophthalmology was immense, and itcan be seen today in the optics of the slitlamps that are now casually used in every eyeexamination.



18Obrig, Theo. E., A.B . Contact Lenses.Philadelphia, Chilton, 1942. This bookrecords the history of a hundred years ofattempts to fit a lens in direct contact with theeye. Obrig did pioneering work with plastic“scleral contact lenses”. He made a cast of thefront of the globe, as others had done, andthen molded a plastic shell to conform to theshape of cornea and sclera. Refraction wasrepeated over the shell, and zones of poorscleral fit were marked on the shell. The lenswas then sent away to have the opticsinstalled and the shell modified for a uniformtight fit. The technique was tricky and the lensuncomfortable, but it actually worked andwas used for special circumstances.

Mandell, Robert. Contact Lens Practice.Springfield, Charles C. Thomas 1965. (Fourthedition 1988). Dr. Mandell was active as aprofessor at the University of California,College of Optometry, Berkeley while thesebooks were coming out. Dr. Mandell was veryinfluential in establishing fitting patterns forhard corneal contact lenses that were easy onthe cornea. The trend at first was to fit the lensto the flattest axis of the cornea , and this ledto chronic epithelial stippling and a tendencyfor the lens to flip out with a firm blink. Thisaccounted for the peculiar head back posture

of early contact lens wearers. In his bookMandell emphasized the need for a vaultedlens and proper centering, always withconsideration for the oxygen needs and healthof the corneal epithelium. As the wide varietyof soft contacts and then rigid gas permeablelens became available, Mandell kept pace andprovided fitting guides with illustrations inthe later editions.Bifocal contact lenses were tried, and somepatient’s were happy to have one eyecorrected for distance vision leaving the othereye focused for reading. This was referred toas “monovision”.

Milder, Benjamin & Rubin, Melvin L. TheFine Art of Prescribing Glasses Without Making aSpectacle of Yourself. Gainesville, TriadScientific Publications, 1979. Refraction is alltoo often taught to residents by bored juniorinstructors who only manage to convey theirunhappiness with the job. Milder and Rubinaccepted the serious challenge of teaching animportant subject to reluctant would-beophthalmologists, and they have succeededbrilliantly, and produced this smoothlywritten and light-hearted book. An enlargedsecond edition appeared in 1991, and it is stillheavily used by ophthalmology residents.

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Pediatric Ophthalmology

Maddox, Ernest Edmund (1863-1933). Testsand Studies of the Ocular Muscles. Bristol, JohnWright, 1898. This book reviewed the detailsand summarized the examination of thealignment of the eyes. It started with a littlebook called The Clinical Use of Prisms and theDecentering of Lenses, 1889, which was revisedand enlarged in a second edition in 1893 whenMaddox was 30 years old. In the first quarterof the 20th century ophthalmologistseverywhere had learned to use his tools anddevices to estimate and measure oculardeviations: the Maddox Rod, the MaddoxWing, the Maddox Double Prism.

Worth, Claud Alley (1869-1936). Squint, itsCauses, Pathology and Treatment. London, JohnBale and Danielsson, 1903 (and in U S.,Philadelphia, P. Blakiston's Son & Co, 1903).

During the next 25 years Worth supervised sixeditions of his summary of his experience withcomitant strabismus. (3 rd edition, Bale Sons andDanielsson, 1906; 5 th edition, London, Ballière,Tindall & Cox. 1921) After Worth's death in1936, a "7th edition" was produced in 1939,called Worth's Squint; or, The binocular reflexes andthe treatment of strabismus . This was a new book,written entirely by Francis Bernard Chavasse.(Those who have referred to this book as"Worthless" have sacrificed the truth for a pun).Chavasse died in 1941, and an "8th edition"(London, Baillière, Tindall & Cox) appeared in1950 called Worth & Chavasse's Squint : thebinocular reflexes and the treatment of strabismus .This was a complete re-doing by Keith Lyle ofChavasse's "Worth's Squint" (Lyle was born inthe year of Worth's first edition). A 9th ed. by T.



19Keith Lyle and G.J.O. Bridgeman appeared in1959.

What was it about Claud Worth that madethe publishers cling to his name 33 years afterhis death ? Worth was born into a well-to-doEnglish farming family, and quite against hisfather's wishes, developed a passion forsailing that stuck with him all his life. He isnow perhaps better known to sailingenthusiasts than to ophthalmologists("Worth's chain pawl"; "Yacht Cruising", 1910;“Yacht Navigation" , 1927).

After training in ophthalmology he wasable to concentrate on one area - strabismus -and he developed an unusual expertise. Hestarted the first Orthoptic Clinic at Moorfieldsand set about systematically examiningchildren with comitant squint and recordingevery detail. He invented the amblyopscopeand began trying to train the fusion sense inchildren. His book was based on 2337 suchcases seen between 1893 and 1903. This kindof monograph may not seem unusual today,but at the turn of the century it wassensational, " . a beautiful demonstration ofthe value of that somewhat rare gift - thecapacity for undertaking, with sustainedinterest, laborious and honest observation inthe elucidation of clinical problems." (Duke-Elder)

Howe, Lucien (1848-1928). The Muscles of theEye. New York, G.P.Putnam’s Sons, 2volumes, 1907-1908 .Dr Howe was a prominent Americanophthalmologist who attended manyEuropean meetings. In 1884, at age 36 hewrote to the American Journal ofOphthalmology from Heidelberg about thedemonstration he had just witnessed of theuse of a cocaine solution as a local anesthetic.At 40 he agitated for control of ophthalmianeonatorum by placing prophylactic drops inthe eyes of every newborn, and wasinstrumental in getting “The Howe Bill”through the New York legislature in 1890. At60 he published his magnum opus -aninfluential 2 volume text on ocular motilitythat was 900 pages long, with 2000 referencesand 356 in-text figures and various appendicesand indices. It was clearly the most thoroughbook on the subject in English, and it wasmuch admired and was dubbed “a classic”even before the second volume was available.

He lived another 20 years and did someimportant philanthropy.

Peter, Luther C., (1869-1942). The Extra-ocularMuscles; a clinical study of normal and abnormalocular motility. Philadelphia : Lea & Febiger,1927, 294 pages. (2nd edition, 1936, 351 pages.3rd edition 1941, 368 pages). Luther Peter, at theUniversity of Pennsylvania, who had written avery successful book on perimetry in 4 editions(1916-1938), put out this book on eye movementproblems, using the same publisher, and itserved a generation of American students ofophthalmology. Taken together the threeeditions provide a fascinating review of "pre-Scobee orthoptics", and of the parade ofingenious instruments and devices offered forthe diagnosis and treatment of eye movementproblems.

Bielschowsky, Alfred (1871-1940). Lectures onMotor Anomalies. Hanover, Dartmouth CollegePublications, 1940. softcover, 128pp.Bielschowsky was a well established Germanprofessor of Ophthalmology, who in 1935accepted an invitation from Adelbert Ames tojoin the Dartmouth Eye Institute. He practicedthere for five years and lectured widely on eyemovements. These lectures were given at theResearch Study Club of Los Angeles in 1938,and were then published in the AmericanJournal of Ophthalmology (1938-39). They wereto be part of a major textbook in English on thissubject, but he died suddenly on Jan 5 th 1940 ona trip to Manhattan and was buried in Hanover,NH.

Scobee, Richard G. (1914-1952). The OculorotaryMuscles. St Louis, C. V. Mosby, 1947. Scobeewas an energetic and cheerful young man atWashington University in St Louis with apassionate interest in straightening children’seyes. (“Strabismus is not only my work, it is myhobby” he said). In a decade he wrote 70 paperson the topic. He summarized what he waslearning in this book and it had an energizingeffect on the new subspecialty of pediatricophthalmology and on orthoptic training. Histragic death at age 38 was from coronary arterydisease. All who knew him seem to rememberhim with warmth and admiration.



20Burian, Hermann (1906-1974) and vonNoorden, Gunther K. (1928-). Binocular Visionand Ocular Motility . St Louis, C.V. Mosby,1974, (fifth edition 1996). Dr. Burian worked inGoldmann’s lab in Berne and with Tschermakin Prague before joining Bielschowsky at theDartmouth Eye Institute in 1935. At the closeof the Institute in 1945, Burian practiced inBoston and then went to Iowa City in 1951,where he was active in ocular motilityresearch and practice and inelectrophysiology. He died in 1974 just beforethe book came out. Dr. von Noorden did his medical training inGermany and his ophthalmology training inIowa while Burian was there, and he remained

on the Iowa faculty for a year before moving tothe Wilmer Institute. He has been active atBaylor in Houston, emphasizing strabismus andamblyopia.

Burian wrote the chapters in the book onphysiology, perception, examination, andneuromuscular control, while von Noordenemphasized the clinical aspects of eye deviationand therapy. The revising and updating forsubsequent editions, have been done by vonNoorden alone. This book encourages the readerto want to understand the mechanisms at workin ocular motility. The authors set out to explainthese things thoughtfully, with the practicingophthalmologist in mind, and with languagethat is crisp and clear.

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Hereditary Ocular Diseases

Ishihara, Shinobu (1879-1963). Test for Colour-Blindness. Tokyo, Handaya Company, 1917.Ishihara attended medical school at TokyoUniversity with a military scholarship and anobligation to serve in the Army upongraduation in 1905. He then studiedOphthalmology at Tokyo University underProf. J. Komoto. He went to Germany in 1912and learned more ophthalmology with Prof.W. Stock in Jena. When the war began in 1914he returned home to Tokyo and worked as aninstructor in the Military Medical School.During this time he was asked to devise a testto screen recruits for abnormalities of colorvision. His adjutant (also a physician) wascolor blind and helped by testing the testplates. At first the charts were not for sale andwere used exclusively by the Army. Some ofthese first plates used the cursive Japanesephonetic script (‘hiragana’) and some askedthe subject to trace a tortuous line across theplate.

In May 1916, Ishihara received his Doctorof Medical Sciences from Tokyo University(Thesis: “The Cause of Idiopathic Night-Blindness and Conjunctivitis Sicca”). Laterthat same year he made a set of plates usingthe ‘kanji’-based Japanese phonetic script(‘katakana’). He personally painted all thedots for his charts with watercolors. Hiscontribution was in designing new plates thatused several different stratagems to bring outanomalies in color vision. The original hand-

painted charts are still at the University ofTokyo.

Ishihara was not the first to use pseudo-isochromatic plates; Jakob Stilling hadpublished a set of 8 such plates in 1877 and1883. Oguchi and then Fuminori Ita hadproduced some color charts in Japan in 1913.Ishihara’s plates were evidently superior: theyseemed to give better results and were easierto interpret. In 1917 he first considered thatthe plates might be valuable elsewhere in theworld and made a set of charts using Arabicnumerals, which he called the “InternationalEdition”, but he could find no one to publishthe plates. Finally, in late 1917, he had 600copies printed by the Handaya Company athis own expense with instructions in English.The title was “Test for Colour-Blindness”, and very few copies were sold.

In 1921 Ishihara sent 90 copies off toUniversities and ophthalmologists around theworld. In 1923 Meisling evaluated the platesand gave them his enthusiastic support and,as a result, the International Edition wasaccepted as the preferred color vision test forseamen and railroad employees inScandinavia. This created a new demand forthe booklet and, in 1925, the Kanehara Co.took up the job of marketing and distributingthe International Edition (IshiharaPseudoisochromatic Charts for Color Blindness,Tokyo, Kanehara & Co, 1925). This wasreferred to as the 5 th edition; the previous 4



21having come from Handaya Co. Bothcompanies still exist and have kept to theiragreement for 75 years: Handaya handles theJapanese versions and Kanehara the overseasversions.

At the 13th International Congress ofOphthalmology at Amsterdam/The Hague in1929 the plates were recomm-ended for testingnaval personnel and air force pilots. Ishihara’scharts were then used throughout the worldfor many decades and they are still consideredthe best screening test for congenital colorblindness.

In 1922 Ishihara succeeded ProfessorKomoto as Chair of Ophthalmology. In 1937he served as Dean of the Faculty of Medicine.In 1940 he retired and became professoremeritus. In 1925 Prof. Ishihara wrote atextbook called "Concise Ophthalmology"which was exceedingly popular in Japan andwent through 22 editions He donated theroyalties from his color vision test to establisha foundation that still provides research grantsfor color vision studies. In 1963 the JapaneseGovernment named him as a NationalTreasure.

Waardenburg, P.J., (1886-1979). Dasmenschlichen Auge und seine Erbanlangen.'s-Gravenhage, Martinus Nijhoff, 1932. Thistext (The Human Eye and its GeneticDisorders) stirred up a European interest inthe subject, so that in the 1930s Waardenburgin Leyden, François in Ghent, andFrancheschetti in Geneva were independentlycollecting information about familial eyedisease, but this work was all delayed by thewar. After the war, Waardenburg collaboratedwith Franceschetti and Klein to produce“Genetics in Ophthalmology” (Royal VanGorcum, The Netherlands, 1961)

François, Jules ( 1907-1984). L’Hérédité enOphtalmologie. Société Françaised’Ophtalmologie, 1958, Masson & Cie. Paris .(An English translation supervised by MrFrank W, Law, appeared in 1961, C.V. Mosby,St Louis). In 1959 François followed up withanother French Ophthalmology Societyvolume called Les Cataractes Congénitales .

These books led to further importantcollaborations.

Franceschetti, Adolphe,(1896-1968). François,J. and Babel, J. Les Hérédo-dégéneresencesChorio-rétiniennes. Société Françaised’Ophtalmologie, 1963, Masson, Paris . AnEnglish translation, ChorioretinalHeredodegenerations, was published by CharlesC. Thomas, Springfield, Illinois in 1974. Thesethree postwar publications in Belgium, TheNetherlands and Switzerland were full ofcase histories and family trees and they addedgreatly to the understanding of the heredity ofeye diseases, at a time when Watson andCrick had just cracked open the door thatwould eventually lead to molecular biology ingenetics. No doubt, when the human genomeis fully mapped there will be extensive re-classifying of many of these conditions.

Krill, Alex E. (1928-1972). Hereditary Retinaland Choroidal Diseases Vol 1. Evaluation, Vol 2,(Krill & Archer) Clinical Characteristics. NewYork, Harper & Row, 1972. Krill was aprofessor of ophthalmology at the Universityof Chicago, Pritzker School of Medicine andeditor of "Ophthalmology Digest". His mainresearch interest was in the influence of theretinal pigment epithelium in chorio-retinaldisease. He studied this through genetics,fluorescein angiography, andelectrophysiology. This knowledge helpedhim with the taxonomy of retinal diseases; hewas able to step past the renaming of diseasesbased on reports of certain familialoccurrences, and try to categorize them byfluorescein appearance and by function. Thefirst volume summarizes the tests thenavailable to help sort out different chorio-retinal diseases. Volume two was incompleteat the time of his death in an airplane crash.Drs. Archer, Deutman, and Newell and manyother contributors worked together tocomplete Krill’s book – a book that seemed tobring some functional order to a group ofuncommon and hard to grasp diseases.August F.Deutman’s “The hereditary dys-trophies of the posterior pole of the eye”(Assen, Van Gorcum, 1971) provided abrilliant follow up to Krill’s work .

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22

Retina and Vitreous

Ramon y Cajal, Santiago (1852-1934). DieRetina der Wirbelthiere. Wiesbaden, J.F.Bergmann, 1894. This work on the structure ofthe vertebrate retina was done in 1892-93, andtranslated into French, it first appeared in theBelgian review La Cellule. With Cajal'sassistance, Richard Greeff then translated itinto German and it was published, along withsome other papers by Cajal, in 1894. This waspart of the work for which Cajal earned theNobel Prize in 1906. Then in 1933 just beforehis death, Cajal produced an expanded andrevised edition in French. This appeared inTravaux du Laboratoire des RécherchesBiologiques de l'Univérsité de Madrid, 1933.These three editions were brought togetherand translated into English by S. Thorpe andM. Glickstein and published by Charles C.Thomas in 1972 as The Structure of theVertebrate Retina. The beautifully precisedrawings of silver-stained retinal neuronswere in stark black and white. Nothing likethem had been seen before; the cellular natureof retina and brain tissue was demonstrated,and the concept soon followed thatinformation always entered the neuron by thedendrites and emerged via the axon. Thesedramatic observations led to a much betterunderstanding of retinal elements and theirinterconnections.

Woods, Alan C. Endogenous Inflammations ofthe Uveal Tract. Baltimore, Williams &Wilkins, 1956-1961 . This book was the last of aseries of works by Dr. Woods during hislifelong effort to understand ocular inflam-mations. During the war years of 1916-1918 hewrote a series of 5 articles about OcularAnaphylaxis. His 1933 book “Allergy andImmunology in Ophthalmology”summarized knowledge of ocular tuberculosisand the concept of ocular inflammationsinduced by focal infections elsewhere in thebody. In 1934 when Wilmer retired, Woodsbecame professor and Director of the WilmerInstitute. In 1956 he wrote a book called“Endogenous Uveitis” with some excellentillustrations by Annette Burgess. Then in 1960he became persuaded that previous exposureto histoplasmosis was a contributing factor incertain macular lesions (AJO 49:205). Evidence

supporting this idea was summarized in 1961,in the second edition of “Endogenous Uveitis”(called “Endogenous Inflammations of theUveal Tract”). Books by Ted Schlaegel ofIndianapolis and Ronald Smith & RobertNozik of California built on Dr Woods’ workand addressed the subject of uveitis for thenext generation of ophthalmologists.

Gonin, Jules (1870 -1935). Le Décollement de laRétine. Lausanne, Librairie Payot, 1934. Goninspent the entire second half of his lifewrestling with the problems of retinaldetachment. By 1918 he had becomeconvinced that Theodor Leber was right whenhe suggested in 1882 that tiny adhesionsbetween the vitreous gel and the adjacentretina – for the most part ophthalmoscopicallyinvisible – could contract and tear a hole in theretina; and that the retina then becamedetached when fluid from the vitreous gotthrough the hole and worked its way betweenthe retina and the choroid. Gonin thenemphasized the importance of sealing thehole. Gradually a technique was worked outthat involved draining the fluid and usingdiathermy through the sclera to stir up a localinflammatory response in the choroid to plugthe hole. This book summarizes his pioneeringwork on understanding and treatingdetachments of the retina.

Meyer-Schwickerath, G. Lichtkoagulation.Stuttgart, Ferdinand Enke, 1959, Suppl. 33,Klin. Mbl. Augenheilk. This monographreviews the history of the author’s pioneeringwork with photocoagulation of the retina,from using the sun as a source of light, then acarbon arc lamp, and finally the xenon arclamp. It appeared in English, translated byStephen Drance, as Light Coagulation St Louis,C.V. Mosby,1960.

Schepens, Charles L. Retinal Detachment andAllied Diseases (2 vols). Philadelphia,Saunders, 1983. (2nd edition with Mary E.Hartnett and Tatuo Hirose. Boston,Butterworth Heinemann, 2000). Schepensmounted the indirect ophthalmoscope on thedoctor’s head and this made it possible toindent the sclera to see the peripheral retina,



23and this helped to localize the retinal hole thatwas causing the detachment. The draining ofthe fluid could then be done in the rightlocation and the encircling band and bucklecould be made to apply pressure in the rightplace. Schepens and his group had a majorinfluence on retinal detachment surgerythrough the entire last half of the century.

Cibis, Paul (1911-1965) Vitreoretinal Pathologyand Surgery in Retinal Detachment CV Mosby,St Louis, 1965. Old retinal detachments have away of scarring and stretching the retina andthey have always been difficult to treat. In thisbook Dr. Cibis summarizes his work onsurgically releasing pre-retinal membranesand using silicone as an artificial vitreous. Dr.Cibis died soon after the completion of thistext leaving a strong family ofophthalmologists including his wife, son anddaughter. His work has continued in St. Louisand for a time vitreous surgery was the mostactive area of advancement in clinicalophthalmology. This was largely due toCibis’s early work on "hopeless" cases ofretinal detachment.

Gass, J. Donald M. Stereoscopic Atlas ofMacular Disease . St Louis, CV Mosby, 1970.(2nd edition, 1977, in one volume with 951 intext illustrations and 133 stereoviews on 19ViewMaster reels; 3 rd edition 1987; 4thedition in 2 volumes, 1997) Dr. Gass spent hisentire academic career as an expert on maculardisease, and his name will probably still comeup when macular problems are discussed atthe turn of the next century. This bookremains the definitive work on the subject andthe color photos are of the finest quality. Eachnew edition has kept up with recently

recognized clinical entities and sorts outvarious conditions that had previously beenwrongly lumped together.

Shields, Jerry. Diagnosis and Management ofOrbital Tumors. Philadelphia, Saunders, 1983.2nd edition, 1989; 3 rd edition IntraocularTumors rewritten and revised by Shields, J.and Shields, C. 1992; 4 th edition, Lippincott-Williams and Wilkins, 1999 Dr. Jerry Shieldshas been the Director of the Ocular OncologyUnit at Wills Eye Hospital for some years andhas enormous clinical experience, especiallyin uveal melanomas.The latest edition of this text was done incollaboration with his wife, Dr. Carol Shields -also at Wills Eye Hospital - and theirOncology fellows. It is rare for onedepartment, in one hospital to have such anactive subspecialty practice, and perhaps rarerfor one such unit to be able to produce a worldclass text for 2 decades without recruitingexpertise from all over the country. Uvealmelanomas and retinoblastomas get mostattention, followed by phakomatoses,epithelial tumors, and lymphoid and leukemicprocesses in the eye. It is a worthy successor toReese’s book of the previous generation.

Ryan, Stephen J . Retina. St Louis, Mosby,1989. With associate editors: T. Ogden, A.Schachat, R. Murphy, B. Glaser, and their 164contributors. The 2725 illustrations weresupervised by Timothy Hengst. A secondedition appeared in 1994 (188 contributors,3573 illustrations), and a third edition in 2000.This 3 volume, multi-authored work, underthe general editorship of Dr Ryan wasimmediately recognized as an authoritativestandard text for vitreo-retinal specialists.

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Oculoplastic Surgery

Three generations before World War I stimulated a general interest in facial and ophthalmic plastic surgeryJohann Friederich Dieffenbach (1792-1847) was working in Berlin and Friedrich August von Ammon(1799-1861) in Dresden, laying the foundations of modern plastic surgery.

Czermak, Wilhelm. AugenärztlichenOperationen. 2nd edition, Berlin & Wien,Urban & Schwarzenberg, Vol 1: 1907, Vol 2:1908. Czermak, professor at Prague from 1895,was only 50 when he died in 1906, and his

successor Anton Elschnig undertook to bringout a second enlarged edition of thisimportant text. Volume 1 of which is devotedalmost entirely to the eyelids. Czermakenlarged Krönlein’s approach to the orbit.



24Meller, Josef. Ophthalmic Surgery.Philadelphia, Blakiston’s Son & Co, 1908,(translation reviewed by Walter L. Pyle).Meller was then Privatdocent at the 2nd EyeClinic in Vienna. So many Americans hadgone to this Clinic in Vienna to hear Fuchs’lectures that there was a demand for a smallsurgical text designed for the ophthalmologistin training. Meller’s book is well laid out andthe rules are made clear (“Never draw theGraefe knife backwards, don’t even bring it toa standstill”) and the illustrations are ofexemplary clarity. A second US edition,(edited by William M. Sweet.) Philadelphia,Blakiston’s Son & Co, appeared in 1913, and a3rd US edition in 1923. Meller was now at theFirst Eye Clinic in Vienna as ClinicalProfessor. (a sixth edition, revised by Böck,who was Meller’s successor as Professor atthe 1st Eye Clinic, appeared in 1953)

Whitnall, Samuel Ernest. The Anatomy of theHuman Orbit and Accessory Organs of Vision.London, Henry Froude & Hodder andStoughton, 1921. Whitnall was an Englishman(Oxford and St Thomas’) who emigrated toCanada in 1919 to become professor ofAnatomy at McGill University. Whitnallcarefully dissected the human orbit anddescribed the distribution of the levatoraponeurosis, the superior transverse ligament(“Whitnall’s ligament”) and the insertion ofthe lateral canthal tendon, all of which was agreat help to ophthalmic plastic surgeons.

Sheehan, J. Eastman. Plastic Surgery of theOrbit. NY, Macmillan, 1927. Dr Sheehan wasa New York facial plastic surgeon with manyinterests, who wrote a book about plasticsurgery of the nose in 1925. This book on theorbit is handsomely put together, with manywell-made drawings and photographs and isdedicated to Harold Delf Gillies the Englishplastic surgeon. It is “the first book devotedsolely to orbital plastic surgery” (Mustardé)

Wheeler, John Martin .(1879-1938). TheCollected Papers of John Martin Wheeler, M.D. onOphthalmic Subjects. Institute ofOphthalmology, Columbia-PresbyterianMedical Center, 1939. Dr Wheeler trained inNew York and served at Fort McHenry,Maryland in World War I and developed agreat interest in ophthalmic plastic surgery.

He took over the directorship of the Bellevueophthalmology service from C.H. May in1925, and in 1928 he resigned to become thefirst director of the new Institute ofOphthalmology at the Presbyterian Hospital.His papers were usually on surgical subjectsand they were admirably short and clearlystated. This book contains 30 papers onoculoplastic and orbital problems, many ofthem influential. They reveal that he was amodest man and a caring physician. Hisstudent Wendell Hughes stayed at Bellevue tofound an oculoplastics service and went on toteach other well-known ophthalmic plasticsurgeons, among them Alston Callahan andByron C. Smith.

Spaeth, Edmund Benjamin. (1890-1976)Newer Methods of Ophthalmic Plastic Surgery .Philadelphia, P. Blakiston's Sons, 1925. Thiswas the first book in English devoted tooculoplastic surgery. In 1939 Dr. Spaethincorporated much of this book into a newtext called Principles and Practice of OphthalmicSurgery (Philadelphia, Lea & Febiger). Thispopular book quickly went through severaleditions: 2nd,1941; 3rd 1944; 4th ,1948. EdmundSpaeth’s interest in ophthalmic plastic surgerybegan in World War I. His large privatepractice in Philadelphia reflected his expertisein these problems, and for many years theresidents at Wills Eye Hospital learned fromhim the basics and the fine points of the thennew field of ocular plastic and reconstructivesurgery.

Hughes, Wendell L. Reconstructive Surgery ofthe Eyelids. St Louis, C V Mosby, 1943. Thedetailed reviewof the history of eyelid surgeryin the first chapters of this book was originallyprepared as a thesis for Hughes’s 1941application for membership in the AmericanOphthalmological Society, but because of itslength (94 figures and 331 references) it wasnot printed in the Transactions of the AOS.The American Ophthalmic Plastic andReconstructive Surgery Society was foundedchiefly by former Hughes fellows, and thismay account for that Society’s unusual interestin the history of their subspecialty.

Stallard, H. B. Eye Surgery . Baltimore,Williams and Wilkins, 1946. (2nd edition 1950;3rd edition, Bristol, John Wright & Sons,1958,



25and Baltimore, Williams & Wilkins, 1958; 4 th

edition, 1965; 5th edition 1973; 6th edition 1978and 7th edition 1988 by Roper-Hall.) Stallardgave a prominent place to oculoplastic surgery(35%, 34% and 27% of the pages in each of thefirst 3 editions respectively). His book was aworldwide standard text in ophthalmicsurgery for 30 years.

Fox, Sidney. Ophthalmic Plastic Surgery. NewYork, Grune and Stratton, 1952.( 2nd edition1958, 3rd edition 1963, fourth edition 1970,fifth edition 1976).Dr. Fox had a large clinical practice in NewYork, and was on the staff of many hospitalsincluding New York University. His populartext was concerned with the surgical problemsof the lids and conjunctiva. He believed thatthere were too many procedures, and thatmost general ophthalmologists never got achance to sort them out and master a few ofthem. He set out to correct this situation witha straightforward, declarative style and simpleclear illustrations – the same confident stylethat he had used in 1944 in a small book called“Your Eyes’’ addressed to the general reader.In Ophthalmic Plastic Surgery he was openlyopinionated and didn’t hesitate to throw someprocedures on the trash heap that were quitepopular at the time. His later book "Surgery ofPtosis" appeared in 1968, before Beard's work,and was the first major textbook concernedonly with the surgery of eyelid ptosis. Onceagain, he was impressed with how many waysthere were to fix these things, and with thedifficulty that most general ophthalmologistshad in mastering the surgical principlesinvolved. There were, naturally quite a fewobjections, to which he responded insubsequent editions by reorganizing andclarifying. His books are a rich source of oldertechniques because he was interested in thehistory of the way things had been done. Hereadily admitted that in surgical techniques,as in life, "we live and learn -and change”.

Mustardé, John Clark. Repair andReconstruction in the Orbital Region. Edinburgh,E & S Livingstone, Ltd. 1966. 382 pages. USedition, Baltimore, Williams & Wilkins, 1966(2nd edition, Edinburgh, ChurchillLivingstone 1980, 400 pages; 3 rd ed. 1991, 575pages) Mustarde was a plastic surgeon with

a special interest in the face and orbit. In theearly 1940s he worked with Stallard in a Cairomilitary hospital, then spent two years as aprisoner of war. After the war he worked withSir Harold Gillies before returning to Scotlandto practice. His 1966 book was immediatelyrecognized as a helpful guide by anexperienced surgeon.

Beard, Crowell. Ptosis. St Louis, Mosby, 1969.Illustrated by Joan Esperson. As soon as thisbook appeared Dr Beard became the world’sexpert on the repair of ptosis of the eyelids;the book seemed to offer clinical insights andclear step by step instruction unavailableelsewhere. Beard was very explicit about theanatomical rationale for his procedure,depending on the type of ptosis. In itssubsequent editions this book remained thestandard work on ptosis. Dr Beard spent mostof his academic career at the University ofCalifornia San Francisco. There he was agreatly sought after consultant and teacher.Doctors crowded into his operating room towatch his surgery. A video of Dr Beard’ssurgery was offered by the AmericanAcademy of Ophthalm-ology in 1976. A textby Beard and Quickert, M., Anatomy of theOrbit is a good supplement to this study. Afourth edition, called Beard's Ptosis was co-authored by M. Callahan (Birmingham,Aesculapius, 1990) in which the text wasexpanded and revised but Beard’s basics wereleft untouched.

Jones, Lester T. and Wobig, J.L. Surgery of theEyelids and Lacrimal System. Birmingham, AL,Aesculapius, 1976. Dr. Jones trained as anEye, Ear, Nose, and Throat surgeon. To furtherhis knowledge of anatomy he did minutedissections of the human orbit under water.This allowed visualization of tiny strandsfrom major muscles and tendons that madeinterlacing attachments throughout the orbit.With this special expertise he helped write aseries of booklets for the American Academyof Ophthalmology on anatomy. He appliedthis understanding of the orbit to devisingsurgical techniques with a rational anatomicalbasis. This resulted in some dramaticimprovements in lacrimal and eyelid surgery.



26Henderson, John W. with George M. Farrowand others Orbital Tumors. Philadelphia,Saunders, 1973. (2nd edition with Dr. GeorgeFarrow, New York, Brian C. Decker, 1980. 3 rd

edition with Jean Campbell, George Farrowand James Garrity, New York, Raven Press,1993) In this book an ophthalmologist orbitalsurgeon gives practical, articulate advice andthereby contributes to the transfer of the careand management of orbital tumors from theneurosurgeon to the ophthalmologist. WalterE. Dandy’s book , “Orbital Tumors”, (NY,Oskar Piest, 1941) summarized the 1 st half ofthe century on this subject at a time when itwas clear that taking out an orbital tumor wasoften a neurosurgeon’s job.

Dutton, Jonathan J. Atlas of Clinical andSurgical Orbital Anatomy. Philadelphia,Saunders, 1994. This atlas is a virtuoso displayof orbital and periorbital anatomy.Histologic sections of the orbit that have beenturned into layers of crisp instructionalpaintings by the medical illustrator Thomas G.Waldrop.

There are also sections on the eyelids andthe lacrimal system. Somewhere, at this verymoment, these images are probably beingscanned into Powerpoint slides for teachingpurposes.

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Ocular Anatomy and Pathology

Twentieth century ophthalmic pathology grew from the anatomical knowledge of the previous century andthe idea that diseases could be classified anatomically (ie, diseases of the cornea, diseases of the retina, etc).Important contributions were made by Antonio Scarpa (1752-1832), James Wardrop (1782-1869), JohnDalrymple (1803-1852), William Bowman (1816-1892), Hans Virchow (1821-1902), Theodor Leber (1840-1917) and others. Although microscopes were in use throughout the 19th century, the histology of diseaseonly blossomed after the introduction of tissue fixation techniques (J.E. Purkinje, 1787-1869), oilimmersion lenses and substage condensers (G.B. Amici, 1786-1863; E. Abbé, 1840-1905) and the process ofembedding the globe in paraffin and celloidin (P. Hänsell, 1840-1912)

Fuchs, Ernst (1851-1930). Lehrbuch derAugenheilkunde. Leipzig und Wien, F.Deuticke, 1889. Ernst Fuchs, who had trainedin Vienna under Arlt and was Professor ofOphthalmology in Liege from 1881-1885,wrote a prize winning essay in 1884 on thecauses and prevention of blindness andbecame the Professor at the second Eye Clinicin Vienna in 1885. There he undertook to writethis book, a textbook of only one volume thatsummarized the material covered in hislectures. The book was quickly translated byAlexander Duane of New York and publishedin 1892 by the D. Appleton Company as“Textbook of Ophthalmology”. It was anexceedingly popular text during the first halfof the 20th Century: there were 18 editions inGerman, and most of the 10 editions inEnglish (1892-1933) were closely monitored byDr. Duane, and it became increasingly difficultto stick to the one volume format.

In the first edition there are only 17 figuresshowing what might be called microscopicanatomy, but Fuchs clearly believed thatunderstanding the microscopic details of eye

diseases would lead to effective treatment. Anentire generation of ophthalmologists in thefirst quarter of the 20th Century came toVienna to hear him lecture, and they tookhome this book and the message that themicroscope was the key to new knowledge.

Parsons, J. Herbert. (1868-1957) The Pathologyof the Eye, 4 vols, London, Hodder &Stoughton, 1904-1908 (1st US ed - New York,G P Putnam’s Sons, 1904-1908). Parsonsacknowledged the previous work of Greef(1902-06) and Ginsberg (1903) of Berlin andthen produced this classic set of volumes. Thisbook helped to make ophthalmic pathologyinto a recognized field of specialization, andfor decades remained the standard Englishreference work on this subject.

Salzmann, Maximillian. Anatomie undHistologie des menschlichen Augapfels imNormalzustande, seine Entwicklung und seinAltern. Leipzig und Wien, F. Deuticke, 1912.The book also appeared simultaneously fromthe University of Chicago Press as The



27Anatomy and Histology of the Human Eyeball inthe Normal State; its Development and Senescence,translated by E.V.L. Brown. This book wasgreatly admired and often brought home fromAustria by ophthalmologists attending Fuchs’lectures. It was reprinted in 1931. There arenine very fine black and white collotype platesat the back of the book made by Max Jaffé inVienna.

Fuchs, Adalbert . Atlas of the Histopathology ofthe Eye. Leipzig & Vienna, Franz Deuticke,1924. Available in German and in English.Adalbert Fuchs was the son of Ernst Fuchsand an excellent ophthalmic pathologist. Thisatlas, the first ever with color plates (44 ofthem), was produced in response to a demandfrom Ernst Fuchs’ students. Its purpose was tohelp the ophthalmologist to “attain a betteranatomical foundation for his clinicalknowledge”.

Mann, Ida Caroline (1893-1983). Developmentof the Human Eye. Cambridge, The UniversityPress. 1928. (2nd edition, London,1949, NewYork, Grune and Stratton, 1950; 3 rd updatededition 1964). Ida Mann was the first womanophthalmic surgeon at Moorfields EyeHospital. She had access to a large humanembryology specimen collection at theInstitute of Pathology, St Mary’s Hospital,London and undertook a comprehensivestudy of the embryology of the eye. Buildingon the work of Bach and Seefelder (Atlas zurEntwicklungsgeschichte des menschlichen Auges,Leipzig, 1911-14), she made many majorcontributions to the subject and using her ownillustrations, put them together in this book,the first comprehensive monograph devotedto the subject. The companion volume"Developmental Abnormalities of the Eye"came out in 1937 and was reprinted in 1957.

Collins, E. Treacher & Mayou, M. Stephen.Pathology and Bacteriology of the Eye.Philadelphia, Blakiston, 1918. This secondedition was the first as a free standing text. Itcovers aberrations in development,neoplasms, injuries, infections, parasiticdiseases and inflammation. The first edition(1911) was one of the volumes of a “System ofOphthalmic Practice” edited by theindustrious Walter L. Pyle.

Wessely, Karl. Auge. Volume 11, in three partsof 1024, 534 and 641 pages, respectively,Berlin, Julius Springer, 1928-1937. This is theophthalmic section of “Henke-Lubarsch” - amassive reference work, packed withinformation fundamental to Pathology, calledthe “Handbuch der Speziellen PathologischenAnatomie und Histologie” edited by FriedrichHenke (1868-1943) and Otto Lubarsch (1860-1929). Henke-Lubarsch was produced over a40 year span, starting in 1924. After the war itwas continued under the editorship of RobertRössle. These 2200 pages on Ocular Patholgy(Vol 11) were edited by Karl Wessely ofMunich and contain extensive contributionsby Von Hippel, Greef, Ginsberg, Elschnig, vonSzily, Löhlein and others.

Wolff, Eugene (1896-1954). The Anatomy of theEye and Orbit. Philadelphia, Blakiston,1933.(4th ed. 1954; 5 th ed. Phila, Saunders,1961,edited by Raymond Jack Last; 6 th ed. 1968, R.J.Last; 7 th ed. London, H.K. Lewis, 1976, editedby Roger Warwick; 8 th ed. London, ChapmanHall, 1997 edited by Anthony Bron, RameshC.Tripathi and Brenda J.Tripathi.) Wolff, anEnglish ophthalmologist, produced a bookwhich became the standard anatomy text forophthalmologists in training for the entire lasttwo thirds of the century. He also wrote APathology of the Eye (Blakiston, 1935-1951)based on a series of lectures anddemonstrations given at the RoyalWestminster Ophthalmic Hospital.

Reese, Algernon B . Tumors of the Eye. NewYork, Paul B. Hoeber, Inc., 1951. ( 2nd edition1963; 3rd edition 1976.) Dr. Reese worked atthe Institute of Ophthalmology of thePresbyterian Hospital, and the MemorialCenter for Cancer and Allied Diseases in NewYork. Working at these active institutions hecollected a large series of patients with tumorsof the eye and orbit.. Although this is chieflyan oncology book, it had a profound influenceon ophthalmic pathologists because there hadnot been a comparable book since FelixLagrange in 1901. The book is organized withgreat clarity by tumor type and is wellillustrated with Bethke and Quinlan drawings.



28Friedenwald, Jonas S and Helenor CampbellWilder, Edward Maumenee, Ted Sanders,John Keyes, Michael Hogan and W.C. & EllaOwens. Ophthalmic Pathology: an Atlas andTextbook. Philadelphia, Saunders, 1952. Thismulti-authored book was characteristic of thecollaborative tone of American ophthalmicpathology throughout the rest of the century.The book was a joint project of the AmericanAcademy of Ophthalmology andOtolaryngology, and the Armed ForcesInstitute of Pathology and its starting pointwas to combine Friedenwald’s text(Friedenwald, Jonas S. (1897-1955) Pathology ofthe Eye, NY, Macmillan, 1929) and GeneralDeCoursey’s Atlas (DeCoursey, Elbert and Ash,J.E., Atlas of Ophthalmic Pathology, 1938;prepared at the Army Medical Museum, Office ofthe Surgeon General, U. S. Army, from material inthe Registry of Ophthalmic Pathology, later tobecome the Armed Forces Institute of Pathology,and published by the AAO; 2nd ed. 1939; 3 rd ed.1942). This turned out to be the first edition ofwhat was to become the definitive text ofophthalmic pathology.

Hogan, Michael J., and Zimmerman, Lorenz(eds). Pathology of the Eye. Philadelphia,Saunders, 1962. This, the second editionbecame justly famous around the world andwas perhaps the most influential ophthalmicpathology book of the century.

Spencer, William. Ophthalmic Pathology.Philadelphia, Saunders, 1985. The third andfourth editions of this massive book wereedited by Wm. Spencer, again under thesponsorship of the American Academy ofOphthalmology and the Armed ForcesInstitute of Pathology. (3rd edition 1985, threevolumes; 4th edition 1996, four volumes,Saunders.) The illustrations in the 1985 3 rd

edition place this three volume book wellabove its predecessors.As new techniques and new understandingbecame available the book continued to grow,so that the 1996 4 th edition, in four volumes,became a truly comprehensive andauthoritative text. Pathologists working withother organs wish that they had a referencework of this quality in their area.

Hogan, Michael J., and Alvarado, Jorge A.,Weddell, Joan E. Histology of the Human Eye.Philadelphia, Saunders, 1971. For 150 yearsthe light microscope had been the histologist’schief instrument, and many histologists madefamous use of it (Mueller, Schwann, Purkinje,von Kölliker, Bowman, E. Fuchs, Parsons,Salzmann, A. Fuchs, Duke-Elder/Wybar).Hogan and Alvarado took a major stepforward with this text by including electronmicroscopy in the histologist’s tool kit. Thesuccess of this book was due in part to thespectacular three-dimensional representationsof ocular ultrastructure by Joan EspersonWeddell. Before this book, ophthalmologistsknew next to nothing about electronmicroscopy of the eye, but when this bookbecame part of their training,ophthalmologists learned to read in theophthalmic literature about “endoplasmicreticulum” and “microtubules” withoutfeeling the urge to turn the page immediatelyto the next article.


one hundred important ophthalmology books of the...

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