The History of Ophthalmology

Blindness being an ancient affliction, ophthalmologists of one type or another have existed at least as far back as the Code of Hammurabi, wherein the punishment for miscarried eye surgery was amputation of the hands of the surgeon. Despite this disincentive, the specialty survived. Its past is interlaced not only with the history of medicine, but also, because of the long effort to understand the nature of light and vision, the history of physics, biology, and even epistemology. It is full of interesting characters, ranging from the great Thomas Young to that great rascal, the charlatan-surgeon John Taylor.

This History of Ophthalmology was commissioned by the American Academy of Ophthalmology to coincide with its centennial in 1996. It has been admirably realized by Daniel Albert, one of the few American ophthalmologists who could have done it, with the help of the historian Diane Edwards. Albert, currently chairman of the Department of Ophthalmology at the University of Wisconsin, has brought his thirty years of historical scholarship to the best recent treatment of the subject, comprehensive enough to be interesting yet compact enough (under four hundred pages) to make it likely to have wide distribution. It relies a good deal on Frederick C. Blodi’s translation of Julius Hirschberg’s century-old History of Ophthalmology (1982–92), which, although it was the definitive text, weighed in at eleven folio-size volumes, making it feasible for institutional libraries but unwieldy and inaccessible to the average reader. What is more, unlike Hirschberg’s organization of the subject by time period and country, Albert has divided the text into subtopics such as anatomy, pathology, microbiology, and surgery, and traced the entire time-line for each, which not only makes the text more readable but demonstrates the specialty’s reliance on developments in medicine generally. There are mini-essays not only on such great ophthalmologists as William Bowman and Ernst Fuchs, but also on Rudolf Virchow and Hermann Boerhaave.

Two unexpected gems are included. The histories of glaucoma by the late Peter Kronfeld and of cataract surgery by the late Frederick Blodi are the best treatments I have read and, as far as I know, have never been previously published. Clinicians often try to plumb the past of specific clinical entities, but rarely is it done as well as this.

The ophthalmoscope is one of those few technological advances that have literally opened up entire new vistas of disease. Its treatment here is the best since C. W. Rucker’s History of the Ophthalmoscope (1971), which, because it was privately published with an unduly pessimistic and diminutive press-run, is largely unavailable. Because ophthalmology encompasses that universal affliction of humanity, errors of refraction, Albert has written chapters on optometry and on spectacles (the most essential prostheses of all), which will bring a new perspective to readers unfamiliar with Edward Rosen’s original “The Invention of Eyeglasses”. ¹ There is even an unusual contribution by historian Robin D. Ross on pioneering women in ophthalmology. (This should blunt any criticism of Albert’s 1993 book of ophthalmic biographies, which he unchivalrously entitled Men of Vision.) Frank Newell contributes a singular account of the origin of the National Eye Institute, and Stanley Truhlsen the story of the American Academy of Ophthalmology, both unavailable elsewhere.

The book is well illustrated, with a bonus series of twelve color plates, beautifully (and no doubt expensively) reproduced from classic ophthalmic texts and reflecting the importance of illustrations to writers on eye disease. The History of Ophthalmology should be read by clinicians-in-training, as well as by others who will be pleasantly surprised by the colorful history of the first of the medical specialties.