THE INFLUENCE OF THE VIENNA SCHOOL OF OPHTHALMOLOGY ON THE BEGINNINGS OF MODERN OPHTHALMOLOGY IN CROATIA / UTJECAJ BECKE OFTALMOLOSKE SKOLE NA POCETKE SUVREMENE OFTALMOLOGIJE U HRVATSKOJ

The founder of the Vienna School of Ophthalmology was Prof. Dr. Georg Joseph Beer, who founded the First University Eye Clinic in the Vienna General Hospital in 1812. Prof. Ferdinand von Arlt led it for 27 years from 1856 to 1883. As the First Eye Clinic became too small, the Second University Eye Clinic was founded in 1883 at the same hospital in Vienna. Since 1885 it had been led for 30 years by Prof. Ernst Fuchs. Many well-known ophthalmologists were leading those Viennese eye clinics. However, Arlt and Fuchs were the main representatives of the Vienna School of Ophthalmology, which was always characterised by the high standards in the diagnosis and therapy of eye diseases. Many Croatian ophthalmologists were educated by them or their students, and later they established eye departments in the major cities in Croatia and transmitted acquired knowledge and experience. The first eye departments in Croatia were formed at the turn of the 19th and 20th century. The First University Eye Clinic in Croatia started to work in Zagreb in 1923. Our ophthalmologists transmitted the organisation of the clinics as they existed in Vienna, and that was the matrix form of all European clinics at that time. Therefore, the tradition of the Vienna School of Ophthalmology was passed on to the next generations. The paper also gives short biographies of Viennese and Croatian ophthalmologists and their mutual relations in education and work.

Dr. Juan Santos Fernández Hernández. Eminente Oftalmólogo matancero / Dr. Juan Santos Fernández Hernández. Eminent Matanzas Ophthalmologist

El doctor Juan Santos Fernández Hernández, una de las más prominentes figuras médicas de Cuba, destacado en la medicina y cirugía oftalmológica, realizó, por primera vez en la Isla, complejas operaciones oftálmicas. Fue autor de un gran número de artículos e informes científicos y es considerado uno de los más prolíficos autores cubanos del siglo XIX. El objetivo de este trabajo fue describir mediante una síntesis biográfica los principales logros del Dr. Juan Santos Fernández Hernández. El nombre de este galeno aparece entre las personalidades médicas cubanas más distinguidas de todos los tiempos por su saber y su civismo, por su abnegación y perseverancia, por su valiosa contribución al progreso de la ciencia y la cultura nacional (AU).

Doctor Juan Santos Fernandez Hernandez is one of the most prominent medical figures in Cuba, outstanding in ophthalmological medicine and surgery. He made, for the first time on the Island, complex ophthalmic operations. He was the author of a large number of articles and scientific reports and is considered one of the most prolific Cuban authors of the nineteenth century. The objective of this work is to describe through a biographical synthesis, the main achievements of Dr. Juan Santos Fernandez Hernandez. The name of this doctor appears among the most distinguished Cuban medical personalities of all times due to his knowledge and his civics, for his dedication and perseverance, for his valuable contribution to the progress of national science and culture (AU).

Apuntes históricos de la práctica de la Oftalmología en Matanzas / Historical notes about Ophthalmology' practice in Matanzas

Se narran los sucesos históricos más relevantes de la práctica de la especialidad de Oftalmología en la provincia de Matanzas y los relacionados con la formación de profesionales a partir de la década del 70 del siglo XX. Al utilizar el método de la narración histórica, se propició la reflexión sobre los propios acontecimientos y su relación con el contexto socio-económico al momento en que estos se produjeron; destacándolos como los antecedes y factores favorecedores del desarrollo de la Oftalmología en Matanzas. Este trabajo se realizó no sólo para narrar de manera cronológica la historia desde los inicios y creciente práctica local de la especialidad, sino también, como a manera de testimonio para las actuales y futuras generaciones, de cómo tributaron los profesionales, las instituciones y los propios eventos, al avance científico y al impacto social de la especialidad en Matanzas. Se concluye, que el comienzo del esplendor de la práctica de la Oftalmología en la provincia de Matanzas, se enmarca a la década del 70 del siglo pasado; y a los inicios del siglo XXI al de mayor desarrollo acumulado. Todo este salto de calidad en el tiempo y en el espacio, ha sido posible, gracias a las políticas de salud y educacionales implementadas por el Ministerio de Salud Pública del país (AU).

The authors recount the most relevant historical facts of the Ophthalmology practice in the province of Matanzas and those related to professionals´ training from the seventies of the XX century. Using the method of historical recount helped the reflection on the proper facts and their relation to the socio-economic context at the moment they took place, highlighting them as antecedents and factor favoring the development of Ophthalmology in Matanzas. The current paper was written not only to recount in a chronological way the history from the beginning and growing local practice of the specialty, but also as a testimony for the current and future generations to know how the professionals, institutions and events contributed to the scientific advance and to the social impact of the specialty in Matanzas. It is concluded that the beginning of the splendor of Ophthalmology practice in the province of Matanzas falls within the decade of the seventies of the past century, and the beginning of the XXI century is the time of the bigger accumulated development. All this quality jump in the time and space has been possible thanks to health and educational politics implemented by the Ministry og Public Health of the country (AU).

Albrecht von Graefe in the present, the past, and the future.

Albrecht von Graefe (1828-1870) is the founder of this archive (1854) and the founder of modern ophthalmology. In 2020, the anniversary of his death will be observed for the 150th time. The "German Ophthalmological Society" (DOG), also a Graefe foundation (1857), has therefore proclaimed a "Graefe year." In Berlin, his hometown, several Graefe-monuments exist. Ophthalmology owes Albrecht von Graefe numerous first discoveries such as excavation of the optic disc in glaucoma (1855), iridectomy in glaucoma (1857), or central artery occlusion (1859). But his after-effects are not only based on his clinical and scientific merits but also on his extraordinary, fascinating personality, which can be characterized by his spirit of internationality, friendship, self-criticism, love of truth, and modesty. Graefe became a myth not only because of his early death but also because he had apart from great successes, to accept human misfortunes at the same time. Albrecht von Graefe can be regarded as the conscience of ophthalmology in Germany.

Albrecht von Graefe (1828-1870) and his contributions to the development of ophthalmology.

PURPOSE: The aim of this article is to show Albrecht von Graefe's contributions to the development of ophthalmology on the occasion of the 150th anniversary of his death. He is regarded as the greatest ophthalmologist of the 19th century. Modern and scientific ophthalmology owes its beginning to him. METHODS: Extensive literature research is made and contacts with institutions for history of medicine as well as medico-historians in the field of ophthalmology. RESULTS: His contributions to ophthalmology were multiple. Von Graefe was the first to introduce iridectomy in acute glaucoma treatment, initiated visual field testing and developed the first tonometer. He made the first classification of glaucoma. Von Graefe was the ophthalmologist who created a special knife for cataract surgery. He was also the first to use Helmholtz' ophthalmoscope. He founded the first ophthalmological society in the world and the second ophthalmology journal which has been published continously up to now. In 1852 he founded famous private eye clinic in Berlin, where he treated many eye patients and educated many prominent ophthalmologists. At the age of 29 he became associate professor of ophthalmology, the first with such a title in Germany. CONCLUSION: Albrecht von Graefe was founder of modern ophthalmology and separated it from surgery. Graefe's contacts, correspondency and meetings at ophthalmological congresses with his teachers, assistants, collegaues also contributed to international co-operation and internationalization in ophthalmology. Although Albrecht von Graefe died before 150 years, he still provokes great admiration and respect in the world of ophthalmology.

Francis I. Proctor, MD and his wife Elizabeth C. Proctor: Their lives and legacy.

The Francis I. Proctor Foundation for Research in Ophthalmology is internationally recognized for its research in the fields of ocular inflammatory and infectious diseases. Although the name of one of its founders, Francis I. Proctor, MD (1864-1936) is memorialized, the legacy of his wife, Elizabeth C. Proctor (1882-1975) is not as well known. They were both full partners in this endeavor. Francis, a successful and wealthy ophthalmologist, retired to Santa Fe, New Mexico. After their marriage, they became interested in the problem of blinding trachoma, then an endemic problem on the Native American Indian reservations. The couple selected Phillips Thygeson, MD (1903-2002), a young ophthalmologist with an interest in infectious diseases, as their lead investigator. Using their own funds, the Proctors paid for Thygeson and themselves to study trachoma in Egypt, and then establish a trachoma research laboratory in Arizona where the causative agent of trachoma was identified. Not only did the Proctors fund these studies, they also studied bacteriology so they could help in the laboratory themselves. After Francis' death, Elizabeth endowed the Foundation in 1947 and continued to support it. She also established the Proctor Medal for The Association for Research in Vision and Ophthalmology.

William Wallace (1860-1940): British ophthalmologist and classical music composer.

William Wallace (1860-1940) received the degrees MB, MCh, and MD from the University of Glasgow, and qualified as an ophthalmologist in 1888. Even as he was training in eye surgery, he was already composing music, and Wallace became more attracted to the ear than to the eye and abandoned medicine to become a classical music composer. He never practiced ophthalmology after 1889, except during First World War when he volunteered to serve in the Royal Army Medical Corps. He studied briefly at the Royal Academy of Music in London, but was mostly self-taught. Wallace was influenced by the music of Franz Liszt and Richard Wagner, and thus became a champion for late Romantic music. He wrote many types of music: his most successful were symphonic or tone poems. He was a playwright, music critic, translator, artist, and advocate for composers' copyright interests in Parliament. After the War, he never again composed but held important positions in organized music such as Professor of Harmony and Composition at the Royal Academy of Music. Only about 30% of his compositions were performed or published in his lifetime, but recently, there has been increased interest in performing and recording his music.

Adrianus Spigelius' (1578 - 1625) Ocular Anatomy.

The aim was to study Adriaan van den Spiegel's ideas on ocular anatomy. He is better known by his Latinized name as Adrianus Spigelius (1578 - 1625). He was a Flemish physician and anatomist who lived and worked in Padua, where in 1605 he was elected to be Professor of Anatomy and Surgery. Chapter IX of book ten of Spigelius' work on human anatomy, entitled De humani corporis fabrica libri X tabulis aere icisis exornati (1627) was devoted to an anatomical description of the eye. Corresponding to contemporary ideas of the production of knowledge Spigelius endeavoured to enhance Andreas Vesalius' (1514-1564) anatomy, he did not repeat his predecessor's theories of ocular anatomy. He conceptualised that the eye has six muscles, five tunics and three humors, while he gave a brief description of ocular physiology combining anatomy and the functional role of the anatomic ocular parts. CONCLUSION: He managed to correct Vesalius' errors and to present ocular anatomy with original notes, which so far, have been ignored and are highlighted now.

Places where Famous Ophthalmologist Albrecht Von Graefe Lived and Worked in Berlin

Many things are said and written about famous ophthalmologist Albrecht von Graefe. This work gives detailed description of the places where he lived and practiced ophthalmology in Berlin, because very little was written about it and never in one paper. Von Graefe was born in 1828 in villa Finkenherd in the north-west part of Tiergarten in Berlin. He lived in Behrenstrasse, one of the fashionable streets in Berlin, where he began his ophthalmological practice in 1850. Later, in 1852 he founded a famous private eye clinic in Karlstrasse 46 where he treated numerous eye patients and educated many prominent ophthalmologists and surgeons. Several times he had changed his residence addresses. Among other places, he also stayed in Unter den Linden Avenue and Bellevuestrasse near Potsdamer Platz. In 1868 he became the head of the eye clinic in the Charité Hospital. Since then he lived in a spacious house on Viktoriastrasse until his death in 1870. Although Albrecht von Graefe lived only 42 years, he travelled a lot, but most of his life he spent in the city of Berlin. Graefe made many contributions to ophthalmology being considered the "father of glaucoma" and the nestor of modern ophthalmology.

Tadeusz Krwawicz, MD: The inventor of cryosurgery in ophthalmology.

Tadeusz Krwawicz (1910-1988) pioneered the use of cryosurgery in, as ophthalmology. The idea arose in 1959 while experimenting because on lyophilization to store corneas and lenses for transplantation it was difficult to remove the lens without damage the capsule was usually torn. Subsequent experiments on rabbits revealed that touching the lens with a wire cooled to 203°K (-70°C) resulted in firm attachment of the lens capsule and subcapsular masses. A cryoextractor was developed and employed for clinical use in cataract extraction, likewise in intumescent cataracts and lens subluxation. Cataract surgery utilizing cryoextraction led to substantial progress to ophthalmology by reducing the number of complications, particularly capsule rupture, and resulted in achieving better outcome compared to other methods. This surgery soon and for almost 20 years became a routine method used all around the world in cataract removal. Simultaneously, Krwawicz developed techniques for corneal refractive surgery-partial lamellar removal of the corneal stroma and temporary interlaminar introduction of a plastic disk in order to change the corneal curvature. Krwawicz presented other ophthalmic interests-his research concerned immunology, histology, histochemistry, biochemistry of ocular tissue, and mainly corneal and experimental surgery with a particular focus on the pathology of the cornea.

First look into the eye.

PURPOSE: Until Helmholtz's discovery of the ophthalmoscope, it was not possible to visualize the posterior pole of the eye in a living subject. The aim of this work is to emphasize the importance of the invention of the ophthalmoscope because the new era in ophthalmology began with it. METHODS: Available literature concerning this topic was studied, especially by getting in contact with institutes for history of medicine as well as medico-historians in Germany and other countries. RESULTS: Hermann von Helmholtz, German physician and physicist, presented and published his invention of the ophthalmoscope in 1851. Albrecht von Graefe was the first to use ophthalmoscope routinely. He said: 'Helmholtz has opened a new world to us'. The first ophthalmoscope was not easy to use. Some ophthalmologists even thought that ophthalmoscopy is harmful for the eye, particularly for a diseased eye. First, it was used in Germany (A von Graefe), Austria (E Jäger), and Netherlands (FC Donders). In England, it was used only at Moorfields till 1855 (W Bowman). At the First International Congress of Ophthalmology in Brussels 1857, the importance of ophthalmoscopy was stressed. FC Donders said that every view with the ophthalmoscope into the living eye was a new discovery. Among retinal diseases, first were discovered pigment retinopathy (FC Donders) and retinal detachment (A Coccius) in 1853. CONCLUSION: Helmholtz inaugurated modern era in ophthalmology with his magnificant instrument which revolutionized the development of ophthalmology. Von Graefe popularized it. Because of the new findings, ophthalmology was definitely separated from surgery in the middle of 19th century.

Mortimer Frank, Johann Ludwig Choulant, and the history of anatomical illustration.

Mortimer Frank (1874-1919) was an ophthalmologist in Chicago, Illinois. He published a number of papers on the history of medicine, and was secretary of the Chicago Society of the History of Medicine and editor of their Bulletin. His major contribution to the history of medicine relates to the history of anatomical illustration. The classic book on that subject had been published in 1852 in German by the physician and historian, Johann Ludwig Choulant (1791-1861). However, by Frank's time this text was both out dated and out of print. Frank took on the tremendous project of translating Choulant's German text into English as History and Bibliography of Anatomic Illustration in Its Relation to Anatomic Science and The Graphic Arts. He improved Choulant's text with the results of his and other scholars' research, greatly enlarging the text. Frank supplemented the original book with a biography of Choulant, essays on anatomists not considered in the original text, and an essay on the history of anatomical illustration prior to those authors discussed by Choulant. This book, now referred to as Choulant/Frank, has been reprinted several times, and is still useful as a reference in this field, though some of its research is now dated.

Horacio Ferrer Díaz, médico, combatiente y escritor matancero / Horacio Ferrer Díaz, physician, fighter and writer from Matanzas

El estudio descriptivo de personalidades de la provincia debe formar parte de un proyecto para enriquecer el conocimiento de todos los profesionales matanceros vinculados con las ciencias médicas y la historia, que a su vez serán los que preparen a los estudiantes de las ciencias médicas para su formación integral. Esta es la razón fundamental por la que seleccionamos al eminente médico Horacio Ferrer Díaz, que en el siglo xix prestigió el terruño. Fue un notable galeno, especializado en oftalmología, quien combinó su desempeño profesional con las actividades revolucionarias en defensa de la independencia de Cuba. Fue inventor de un aparato para estudiar la retina y otro para extraer la catarata al vacío y de una mesa giratoria de reconocimiento única en el mundo. Publicó "La Fonometría antes y después de la operación de catarata", y fue el primero que operó un paciente con desprendimiento de retina en Cuba. Hijo de la tierra unionense, Ferrer Díaz debe ser recordado por siempre por sus aportes médicos y su gran activismo político en las filas mambisas, donde adquiere grados militares, y en contra del gobierno de Machado y la dictadura de Batista después. El recuento de la historia en las guerras independentistas queda plasmado para todos los cubanos en su obra Con el rifle al hombro, escrita en su ancianidad (AU).

The descriptive study of the province's personalities should be a part of a project to enhance the knowledge of all Matanzasan professional related with the medical sciences and the history, who are in their turn the ones who are going to train the medical sciences students for their comprehensive education. That is the main reason of choosing the personality of the eminent doctor Horacio Ferrer Díaz, who gave prestige to our native province. He was a notable physician, specialized in Ophthalmology, who combined his professional performance with the revolutionary activities in defense of the Cuban independence. He was the inventor of a device to study the retina and another to vacuum extract the cataract, and a rotating table of examination that was unique in the world. He published "Photometry before and after the cataract surgery" and was the first one who operated a patient with retinal detachment in Cuba. A son of the region of Union, Ferrer Díaz should be recollected forever because of his medical contributions and his great political activism at the service of the independence fighters against the Spanish colonialism, where he obtained military ranks, and against the government of Gerardo Machado and Batista's dictatorship later. The recount of independent wars was reflected in his work With the rifle on the shoulder, written in his old age (AU).

Horacio Ferrer Díaz, médico, combatiente y escritor matancero / Horacio Ferrer Díaz, physician, fighter and writer from Matanzas

El estudio descriptivo de personalidades de la provincia debe formar parte de un proyecto para enriquecer el conocimiento de todos los profesionales matanceros vinculados con las ciencias médicas y la historia, que a su vez serán los que preparen a los estudiantes de las ciencias médicas para su formación integral. Esta es la razón fundamental por la que seleccionamos al eminente médico Horacio Ferrer Díaz, que en el siglo xix prestigió el terruño. Fue un notable galeno, especializado en oftalmología, quien combinó su desempeño profesional con las actividades revolucionarias en defensa de la independencia de Cuba. Fue inventor de un aparato para estudiar la retina y otro para extraer la catarata al vacío y de una mesa giratoria de reconocimiento única en el mundo. Publicó "La Fonometría antes y después de la operación de catarata", y fue el primero que operó un paciente con desprendimiento de retina en Cuba. Hijo de la tierra unionense, Ferrer Díaz debe ser recordado por siempre por sus aportes médicos y su gran activismo político en las filas mambisas, donde adquiere grados militares, y en contra del gobierno de Machado y la dictadura de Batista después. El recuento de la historia en las guerras independentistas queda plasmado para todos los cubanos en su obra Con el rifle al hombro, escrita en su ancianidad (AU).

The descriptive study of the province's personalities should be a part of a project to enhance the knowledge of all Matanzasan professional related with the medical sciences and the history, who are in their turn the ones who are going to train the medical sciences students for their comprehensive education. That is the main reason of choosing the personality of the eminent doctor Horacio Ferrer Díaz, who gave prestige to our native province. He was a notable physician, specialized in Ophthalmology, who combined his professional performance with the revolutionary activities in defense of the Cuban independence. He was the inventor of a device to study the retina and another to vacuum extract the cataract, and a rotating table of examination that was unique in the world. He published "Photometry before and after the cataract surgery" and was the first one who operated a patient with retinal detachment in Cuba. A son of the region of Union, Ferrer Díaz should be recollected forever because of his medical contributions and his great political activism at the service of the independence fighters against the Spanish colonialism, where he obtained military ranks, and against the government of Gerardo Machado and Batista's dictatorship later. The recount of independent wars was reflected in his work With the rifle on the shoulder, written in his old age (AU).

Exfoliation Syndrome: A Historical Perspective.

The discoverer of exfoliation was John Lindberg of Helsinki, Finland. He conducted his research as a young ophthalmology resident with the aim of elucidating 2 types of age-related degenerations of the iris and presenting it as an academic thesis. To this end, he had to construct a slit lamp, because they were not commercially available. During this investigation, he paid attention to greyish flakes and fringes on the anterior lens capsule and the pupillary border, which had not been previously described. His material consisted of 202 patients. The findings were recorded by time-consuming skillful drawings. His conclusions that the condition was age-related and often linked to chronic glaucoma and cataract are still valid today. The work was accepted as an academic thesis at the University of Helsinki in 1917.