Occlusion therapy for amblyopia, a historical report from 9th century Persian scholar, Ali ibn Sahl ibn Rabban al-Tabari (838-870 CE).

INTRODUCTION: This study reevaluates the historical origins of occlusion therapy for amblyopia, focusing on the contributions of the 9th-century Islamic scholar, Ali ibn Sahl ibn Rabban al-Tabari (838-870 CE). METHODS: The investigation delved into al-Tabari's writings, particularly "Firdous al-Hikma," to extract insights into his approach to addressing reduced vision in one eye.Additionally, the study examined subsequent advancements in occlusion therapy by scholars such as Thabit ibn Qurrah and Rhazes, building upon al-Tabari'sfoundational work. RESULTS: Al-Tabari's reports contain significant insights into occlusion therapy for amblyopia, predating commonly attributed origins of the treatment. Within "Firdous al-Hikma," he outlines methods for addressing reduced vision, advocating for the covering of the healthier eye to promote the function of the weaker eye. These findings highlight the pioneering efforts of al-Tabari and his contemporaries in the Islamic civilization and challenge the conventional narrative surrounding the history of occlusion therapy. Subsequent advancements by scholars such as Thabit ibn Qurrah and Rhazes expanded upon al-Tabari's work, advocating for similar therapeutic approaches within the Islamic civilization. Their contributions further solidified the practice of occlusion therapy, laying the groundwork for its continued evolution and refinement in subsequent centuries. DISCUSSION: Al-Tabari's contributions to occlusion therapy underscore the rich heritage of scientific inquiry in theIslamic civilization during the medieval period. This historical perspective sheds light on the diverse contributions to medical knowledge and practice outside of Western contexts and emphasizes the importance of recognizing and honoring these contributions in the broader history of medicine.

The history of the Ostschweizerische Pleoptik und Orthoptik Schule in St. Gallen.

In judging the achievements of Alfred Bangerter in treatment and research of amblyopia it is easy to conclude that his pleoptic exercises have been forgotten because occlusion therapy is more effective and cheaper. However, Bangerter introduced the visuscope to determine the point of fixation directly on the retina, he started the first "school" (exercise treatment facility) for pleoptics and orthoptics in St. Gallen only 18 years after Mary Maddox did so in London and he started a training program for orthoptists. In 1957 the Genossenschaft Ostschweizerische Pleoptik-und Orthoptik-Schule, the OPOS Society, was founded, that in the following years built a clinic especially for the treatment of amblyopia. The idea was to treat children not in a clinic but in a home for children that offered optimal treatment but also adequate lodging and care for the children with amblyopia. The Cantonal government contributed by donating a right to build on the premises of the Cantonal Hospital. The new OPOS Clinic measured more than 500 square meters, had 4 floors and a cellar, and contained outpatient treatment facilities, two operating theatres, patient bedrooms, pleoptic and orthoptic exercise rooms with many devices and classrooms for orthoptic students. There were 56 beds for children. After Bangerter retired as chief physician of the Eye Clinic in 1974, he continued and expanded his clinical and surgical activity in the OPOS Clinic next to the Eye Clinic. After his successor in the OPOS Clinic retired in 1987, the OPOS Foundation sold the OPOS Clinic to the Canton that reintegrated it into the Eye Clinic. In the meantime, Bangerter had continued to pursue his ideal of amblyopia treatment and built a new clinic in Heiden in the neighbouring Canton Appenzell Ausserrhoden, for pleoptics, orthoptics, strabismus surgery, plastic eye surgery, but also for controversial treatments for macular degeneration and other retinal disorders. This Rosenberg Clinic opened in 1982 but Bangerter already stepped down in April 1983 and opened a day clinic in the Rosenbergstrasse in St. Gallen some years later instead. Strangely enough, one of the reasons he had moved to the Rosenberg Clinic was that he insisted on lengthy clinical stays for the treatment of amblyopia, but exactly that was one of the main causes of financial problems.

Lights and darks of a picture. The life of Giovanni Francesco Barbieri, "il Guercino" - the squinter.

PURPOSE: To be cross-eyed is a wide-spread dysfunction of the eye and squinting is currently regarded as unattractive. However, in ancient times, societies saw squinting as a sign of piety or even beauty. Even Venus was depicted heterophoric quite often. The most famous artist who was cross-eyed was Giovanni Francesco Barbieri (*08.02.1591; †22.12.1666, both Italy). His nickname was "Il Guercino" which means "the squinter." This article reflects on vision and art from the perspective of a cross-eyed person. METHODS: Life and work of Giovanni Francesco Barbieri was analyzed and interpreted based on selective literature research of books and journal articles via PubMed, Google Scholar, and Google. RESULTS: As squinters use mostly only one eye as the other eye is amblyopic, it could be expected that their paintings would be more or less two dimensional. Already at the age of seven, Barbieri showed great talent in drawing and painting. At age 17, he started his education at the famous Bologna school. Barbieri was very productive, leaving behind, at his death,106 large altarpieces and 144 other paintings. During his lifetime, he was well accepted, sought after, and quite wealthy. In analyzing a selection of Barbieri's work, one is amazed at how detailed the artist was in depicting chiaroscuro in his paintings to present a three-dimensional picture. CONCLUSIONS: Barbieri did not make a secret of the dysfunction of his eyes. In contrast, he showed his squinting eye distinctly in his famous self-portrait from ca. 1635. It can be assumed that "Il Guercino" was so detailed in studying light and shadow with his one eye that he could compensate for his amblyopic eye. By this, Barbieri could create pictures with an amazing degree of variations of light and shadow.

What Did They Know Then? A Journey Among the Giants of the Past.

Dr. Richard Scobee has the honorary title "The Father of American Orthoptics." In addition to his numerous accomplishments in his academic career, he had hobbies that included collecting historical stamps. In tribute to his love of things past, this lecture will delve into the remote history of ophthalmology, to see what eminent pioneers knew and wrote about eye muscle disorders and binocular vision in their treatises. Our journey will include eight personalities and their works, ranging from the 7th century through to the early 19th century, and will encompass Europe, the Middle East, Great Britain, and North America. Analyzing the writings of these masters affords glimpses into the knowledge base and philosophies that were prevalent in different centuries. Many of these individuals were innovators who pushed the boundaries of knowledge. Some of them made advances using intuition and reason, mainly through case experience and case studies, while others used the scientific method to gain new information. In many cases, the words written by these luminaries centuries ago still resonate with us today and guide us in our everyday practices. It is hoped that this journey will be enlightening for orthoptists, ophthalmologists, and allied health personnel, and confirm, as in many areas of science, that we truly stand on the shoulders of giants, the masters from the recent and the distant past.

[Montesquieu visually impaired, then blind (January 1689- February 1755)]. / Montesquieu malvoyant, puis aveugle.

The correspondence of Montesquieu published by the Oxford Foundation informs about visual disorders of the founder of the socio-political science. The examination of his bust's face done by J.B. Lemoyne reveals a divergent squint of the left eye; the one with which he fold that he only could see big objects. This amblyopia was a premature and prolonged embarrassment. During the last ten years of his life, from 1748, date of publication of the Esprit des lois up to his death in 1755 he was blind because of the cataract of the other eye. He has not able to bust in surgery, while the French surgeon Jacques Daviel already proceeded to the extraction of the lens as we do it nowadays.

Tobacco optic neuropathy (TON) - the historical and present concept of the disease.

This article reviews the historical and current concepts of 'tobacco optic neuropathy' (TON) a rare disorder of optic nerve function related to the toxic effects of an unidentified constituent of tobacco. It is considered to be an entity distinct from that often described as 'tobacco-alcohol amblyopia', a disorder better described as a nutritional optic neuropathy. It is suggested that 'tobacco-alcohol amblyopia' is an inappropriate term, because the condition to which it refers is not an amblyopia, and there is little evidence to implicate a toxic effect of either tobacco or alcohol in the pathogenesis of that disorder.

Charlie Brown, amblyopia, and me: A (not so short) personal history of the past forty years of diagnosing and treating amblyopia.

INTRODUCTION: During the past forty-plus years there have been many advances in our understanding of amblyopia. It has been my privilege to be able to have a close relationship with many of the people that made these contributions. It is the purpose of this paper to trace these changes as they developed from 1965 to the present. AMBLYOPIA THROUGH THE DECADES: 1950s and 1960s: Beginning with the introduction of electrodes that could record from a single cell in the mammalian visual cortex, researchers began to map out the normal physiology of the visual cortex, the lateral geniculate bodies and the retinal ganglion cells. Amblyopia, especially stimulus deprivation amblyopia, became a focus of many of these studies. As more and more information became available, clinicians began to understand the problems that they had been facing in such cases as congenital cataracts, unilateral congenital corneal opacities, etc. This led to a significant change in our approach to such cases with emphasis on earlier and earlier intervention to achieve better visual results. 1970S and 1980S: Scientific studies of patients using techniques such as Contrast Sensitivity Function, Teller Acuity Cards, and Neutral Density filters allowed us to begin to look at development of vision in infants, to characterize the differences between the various types of amblyopia and to better understand the need for amblyopia treatment. At about the same time, interest in vision screening in children allowed us to detect amblyopia at an earlier time of life, which then gave us a better chance of successful treatment. 1990S and the 21ST century: Arenewed interest in developing evidence-based results in keeping with the rest of the scientific medical community led to large multicenter trials looking at different modes of amblyopia treatment with the result of a wider armamentarium available to the practitioner. CONCLUSION: While there have been many improvements in our knowledge of the etiology of amblyopia and its treatment, we still find that it is the practitioner, the orthoptist, the patient's family, and the child that make the final difference in success or failure. However, our ability to explain what and why we are doing has made this job easier and given us the tools we need to feel confident in our approach to this still common condition.

Sir Nicholas Harold Lloyd Ridley: 10 July 1906 - 25 May 2001.

Sir Harold Ridley invented and refined the modern miracle of replacing lenses obscured by cataracts with plastic optical lenses, thus rendering a complete cataract cure. This operation, broadly termed the cataract-intraocular lens (IOL) operation, has since brought sight to many millions of people throughout the world, and continues to improve the quality of life of more than 10 million patients worldwide each year. Ridley not only launched this powerful and irreversible forward movement in the field of ophthalmology and the visual sciences, but through it he also helped give birth to the exciting and new field of artificial biodevice implantation as well as transplantation techniques now applied to many other organs and tissues of the body. He has therefore been credited with healing to create the relatively new specialty of biomedical engineering. Few of the millions of patients worldwide who now enjoy the benefits of the modern cataract - IOL operation are aware of the origin of this innovation. Indeed, few eye care professionals - even ophthalmic surgeons who implant them almost daily - are aware of the origin of the IOL - an invention that, as Harold himself liked to say, 'cured aphakia'. (The word aphakia comes from teh Greek, meaning absence of lens, the situation that occurs when a cataractous lens is surgically removed.)

[The development of research on the effect of tobacco consumption on the visual organ over the last 200 years]. / Rozwój badan wplywu tytoniu na narzad wzroku w ostatnich 200 latach.

The purpose of the paper is to assess the development of research in the area of tobacco-related ocular diseases during the last 200 years. Although the first papers about the toxic effect of tobacco on the eye appeared in the beginnings of the XVIIth century, the real interest in this issue arose in the second half of the XIX century. Toxic neuropathy, often called tobacco amblyopia, was recognized as the most common ocular disease related to the use of tobacco. This disorder was described in hundreds of case histories by the most famous Polish and foreign ophthalmologists, for instance Szokalski, Galezowski, and Sichel, Forster, Eales, DeSchweinitz, Uthoff, Gunn. In the XXth century, and particularly, in its second half, the incidence of tobacco amblyopia decreased, although the consumption of tobacco steadily increased in the same period. This phenomenon confirmed the conviction of the heterogeneous ethiopathogenesis of this disorder, including also alcohol intoxication, malnutrition, and especially vitamin deficiency. At the end of the XXth and at the beginning of the XXIst centuries evidence has been growing that tobacco smoking is a very serious risk factor in cataract, glaucoma, retinal vascular diseases, and most of all age-related macular degeneration. Although the incidence of toxic tobacco amblyopia is much lower than previously, tobacco smoking still remains the most powerful risk factor conducive to various eye diseases. Moreover, smoking being one of the most dangerous risk factors is at the same time the easiest one to eliminate in the prevention and treatment of eye diseases and blindness all over the world.

The history of research into the disorders of reading and accommodation in strabismic amblyopia.

During the past 150 years, research on amblyopia and nystagmus has developed in five different waves (W1-W5). Amblyopia was initially regarded to be enigmatic and believed to be related to eccentric fixation (W1, after 1850); later, it was ascribed to disorders in refraction or accommodation (W2, around 1900). After 1900 (W3), phylogenetic explanations appeared, and after 1945 (W4) concepts based on successful orthoptic practice came to the fore. Since 1965 (W5), research on amblyopia has been guided by modern insights into neuroanatomy and neurophysiology. In contrast to amblyopia, nystagmus has always been a well-defined symptomatic entity. Even though amblyopia and nystagmus are both symptoms of strabismus, their understanding has therefore developed along different paths. In juvenile strabismus, defects in binocularity lead to monolateral amblyopia, while defects in contour vision lead to bilateral nystagmus. In the present paper, these five waves of amblyopia research are described in more detail, with particular attention to the concepts of adaptation, visual fields, and sensory and motor functions as related to disorders in reading and accommodation.