The cataract surgery of Empress Eugenie of France a century ago by the eminent Spanish ophthalmologist Ignacio Barraquer.

Topic: Empress Eugénie (1826-1920), the widow of Emperor Napoléon III of France, developed mature cataracts late in life. In 1920, at age 94, she underwent surgery to one eye by Ignacio Barraquer (1884-1965), a member of the famous dynasty of ophthalmologists originally from Barcelona, Spain. Clinical relevance: Barraquer used his new instrument which employed a vacuum cup to hold the lens for intracapsular extraction. Methods: Research of historical documents. Results: The surgery was a success; the Empress was pleased that she could read again although she did not have long to live. She was his first famous cataract patient and his fame spread internationally. Barraquer spoke at the International Congress of Ophthalmology held in Washington, DC, in 1922 and demonstrated his technique on patients in Washington, DC, New York, Boston, Philadelphia and Richmond, VA. Conclusion: Barraquer's surgery on Éugenie, who was the most powerful woman in Europe during her husband's reign, influenced the course of development of cataract surgical technique.

Fluorescein angiography: insight and serendipity a half century ago.

It has been 50 years since fluorescein angiography was developed as a clinical procedure by 2 medical students at Indiana University. The story of its discovery and the recognition of its value to ophthalmology involve a combination of insight and serendipity. Fluorescein had been in use clinically for more than half a century, but it took a pulmonary medicine laboratory to provide the stimulus for the development of flash and barrier filters that would make vascular photography practical. The first article was rejected by the ophthalmology literature, but several clinics heard about it and soon documented the enormous diagnostic value of the procedure.

Controversy in ophthalmology at the beginning of the 20th century: opinions voiced in the archives, especially on cataract and glaucoma.

Volumes of the Archives of Ophthalmology from the early years of the 20th century include original articles as well as reports of proceedings of important ophthalmologic conferences held in the United States, Great Britain, and on the European continent. Original articles often provided new information, but speakers at conferences frequently offered lucid opinions on topics relevant to practitioners that were not found elsewhere in journals from that era, and these reports give us a sense of their thinking, particularly about therapeutic practices and knowledge of cataract and glaucoma.

Lucien Howe, hereditary blindness, and the eugenics movement.

Ophthalmologists admire Lucien Howe, MD (1848-1928) (Figure 1), for his leadership and philanthropy. During his presidency of the American Ophthalmological Society (AOS), the organization established an award for contributions to ophthalmology, now known as the Howe Medal (Figure 2), one of the highest honors in the specialty. In addition, there are 2 other Howe Medals and a Howe Award, each of which is given at irregular intervals. The American Medical Association's Lucien Howe Prize Medal in Ophthalmology was first given in 1926. The University of Buffalo (The State University of New York) and the Buffalo Ophthalmological Society have given a Lucien Howe Medal in Ophthalmology since 1928. The Medical Society of the State of New York's Lucien Howe Award was established in 1906.

The multifaceted career of Louis Borsch.

John Louis Borsch Jr, MD (1873-1929), was an ophthalmologist from Philadelphia who spent most of his career in France. During his lifetime he was probably best known as the inventor of the first fused bifocal lens, which was marketed very successfully as the Kryptok lens. He may be better known today for performing cataract surgery on Mary Cassatt (1844-1926), the American Impressionist artist, and on James Joyce (1882-1941), the Irish author. Little known, but remarkable, is his thesis for his second medical degree, Le Traitement Chirurgical de l'Astigmie (The Surgical Treatment of Astigmatism).

The visual difficulties of selected artists and limitations of ophthalmological care during the 19th and early 20th centuries (an AOS thesis).

PURPOSE: To investigate the effects of eye diseases on several important artists who have been given little attention from a medical-historical viewpoint. The examples chosen demonstrate problems artists have had to face from different types of eye disease, including cataract, glaucoma, and retinal diseases. The ophthalmological care provided is described in terms of scientific knowledge at the time. METHODS: Investigation of primary and secondary source material. Discussion with art historians and ophthalmic historians. Examination of work by the artists. RESULTS: Artists can be markedly affected by ocular diseases that change their ability to see the world. The individuals described here worked during the 19th century and first half of the 20th century. Homer Martin suffered from cataracts, and his works reveal changes in details and color as he aged. Henri Harpignies, who had an extremely long career, undoubtedly had cataracts and may also have had macular degeneration. Angle-closure glaucoma blinded Jules Chéret. Auguste Ravier suffered from neovascular glaucoma in one eye and was able to work with his remaining eye, which developed a cataract. Louis Valtat suffered from what was in all likelihood open-angle glaucoma, but specific changes due to this disease are not apparent in his work. Roger Bissière developed glaucoma and did well following filtration surgery. George Du Maurier lost one eye from what was probably a retinal detachment and later suffered from a central retinal problem in the other eye. CONCLUSIONS: Diseases of the eye may profoundly influence artists by altering their perception of the world. The specific effects may vary, depending on the disease, its severity, and the psychology of the artist. Cataracts typically affect an artist's ability to depict color and detail. The effect of glaucoma generally depends on whether central vision is preserved. Disease that affects the center of the retina has a substantial effect on an artist's ability to depict fine details. Ophthalmological care was limited during the lifetimes of the artists under consideration, by comparison to 21st century standards. When medical or surgical therapy was ineffective, the most important thing a physician could offer these artists was consolation against anxiety and depression.