PURPOSE:To explore the contributions of individuals and corporate manufacturers to the design of artificial intraocular lenses (IOLs) conferred through patents. PERSPECTIVE:Historical review and analysis of IOL patents from 1950 through 2000. METHODS:The annual number of IOL patents granted to individuals and companies was obtained from an international database on intellectual property. Trends in patents issued in the United States and internationally were compared with lens use from 1950 through 2000. Patent trends were compared with lenses approved for commercial marketing by the Food and Drug Administration (FDA) from 1978 through 2000. RESULTS:From 1970 through 2000, the United States granted 855 patents for IOLs, far greater than the 316 patents issued internationally during the same period. Patents in the United States granted to individuals were merely 6% less than those issued to companies (404 vs 430); only 2.5% (21) were conferred to universities. Beginning in 1989, there was a marked shift in the number of patent rights to corporations rather than individuals. CONCLUSIONS:Using patents as a surrogate for creativity in IOL development, the United States played a leading role in artificial lens design. Patents for IOLs first increased when the FDA was authorized to classify them as Class III medical devices, whereas the majority of ownerships shifted from individuals to companies after 1989. The near simultaneous rise in patentable lens innovations with IOL surgery maturating to the standard of care suggests both phenomena were products of earlier transformative events.

Robert Foster Kennedy (1884-1952) was an Irish-born neurologist who in 1911 described the association of frontal lobe tumor with unilateral optic atrophy and contralateral papilledema. After immigrating to America he became a respected neurologist who at the height of his career became President of the American Neurological Association. He is less known for his views on eugenics and advocacy of euthanasia for children with birth defects. In 1939 he initially proposed his support for state-sanctioned euthanasia in Collier's magazine, a popular family periodical. Two years later he discussed his proposal at a national medical meeting when credible reports about German laws on euthanasia and racial hygiene were circulating in Europe and the United States. The atrocities during the war never moved Kennedy to publicly alter his position on mercy killing. This paper reviews how opinions have changed toward eugenics, and considers when eponyms should be abandoned.

Medical biography can introduce healthcare providers to clinically relevant subjects that are rarely encountered in traditional curricula. Maria Theresia von Paradis (1759-1824), the blind musical prodigy, faced doubt about her reputation because of a brief and questionable recovery of sight at the age of 18 years. Her story serves as an example of how extraordinary circumstances can be met with skepticism. Her miraculous return of vision 15 years after going blind was mediated and exploited in public demonstrations by Franz Mesmer, a promoter of the theory of animal magnetism. Maria's sight was lost a second time in 1778 just before Mesmer was driven from medical practice as a charlatan. Although the cause of her visual disability will never be known, it deviates from patterns of functional (hysterical) vision loss by its early age of onset, severity, and length of affliction. Paradis's early proficiency in playing musical instruments raises questions about savant syndrome, autism, feigned disability, and how the early loss of vision influences aspects of cognitive development.

In 1876, Bennett George Johns, a minister and chaplain at the school for the blind in St George's Field, published Blind People: Their Works and Ways; with Sketches of the Lives of Some Famous Blind Men. The book provided a window into the lives of the blind in Victorian England, with an emphasis on their education-or lack thereof. Johns was an observer of the blind and sympathetic to their plight. His depictions of schools were dispassionate, yet gently argued for improvement. Rather than rely on pity, he emphasized the benefits of institutionalized life and recounted the extraordinary achievements of four blind men. The creation of heroic historical figures had traditionally been employed to venerate political, military, or religious personages. Its use in shaping public perception of blindness was novel. This paper explores Johns's book as an early example of the innocent, myth-building of the blind and considers whether the process is always harmless.

The 17th and 18th centuries witnessed an intellectual movement known as the Enlightenment that made possible future revolutions such as the scientific. No person better characterizes the Enlightenment than Voltaire (1696–1976) who, in his book Philosophical Letters published in 1734, venerated the liberalism of English institutions while criticizing the ancien régime of France. He was convinced that the personal freedom the English enjoyed was responsible for their country's success, pointing to inoculation for smallpox and advances in science as evidence. His choice of smallpox inoculation and science as exemplars of empiricism, which maintained that knowledge is obtained through sensory experience, is revealing as it pinpoints political flashpoints that persist to this day. This paper explores how inoculation and science were employed by Voltaire to advance his political idea of liberty.

Conjunctivitis, or inflammation of the mucosal covering the anterior third of sclera and inner eyelid, is a common clinical condition of varied causation. Most cases are self-limited due to infection or allergy and rarely necessitate biopsy. Inflammation of the conjunctiva, however, is one of the most common principal histopathologic diagnoses rendered when the tissue is biopsied. In the context of conjunctivitis, biopsy is usually performed when inflammation is chronic and recalcitrant to therapy, has clinically atypical features, or requires an etiologic diagnosis when one cannot be reached through other laboratory methods. The exclusion of ocular surface neoplasia in a chronically inflamed conjunctiva is a common justification for biopsy. When inflammation is the principal histopathology finding, it is desirable-whenever feasible-to establish the cause. This brief review provides a guide in how histologic findings of an inflamed conjunctiva can direct the clinical evaluation towards an etiologic diagnosis.

Purpose:The aim of this study was to describe how an early 20th-century American celebrity attempted to influence public perception of ophthalmic neonatorum.Methods:This study reviews the editorial written by Helen Keller in the 1909 Ladies' Home Journal and related historical documents about the prevention of blindness from neonatal conjunctivitis.Results:Although blind, deaf, and nulliparous, Helen Keller at the age of 29 sensed that the newborn children of many American women were being denied preventative treatment for ophthalmia neonatorum. In her editorial in the Ladies' Home Journal discussing the complications of venereal disease she urged women to become proactive in matters of personal and family health care.Conclusions:Helen Keller viewed blindness from ophthalmia neonatorum as a failure of the American health care system. Her solution was to impart women with enough knowledge to seek care from educated medical professionals. The observation that many women and their children were receiving substandard care reflected a fundamental problem with disparities in the delivery of perinatal health care. Her insights are as relevant today as they were in 1909.

After arriving at the University of Königsberg in 1849, Hermann von Helmholtz started investigating the trichromatic hypothesis of color perception proposed by Thomas Young. Four years later in 1853, he was invited to lecture to the German Society and used the opportunity to criticize harshly Johann Goethe's Theory of Color published in 1810. Offending a revered member of the German society was an odd method of introducing the study of color to a learned audience, but the content and tone of the lecture suggested Helmholtz was more concerned about dispelling misconceptions of experimental science than in imparting knowledge on the nature of color. By 1860, Helmholtz's color-mixing experiments provided further evidence for the trichromatic hypothesis. Goethe's ideas about color resonated intuitively with generations of artists, but the imperviousness of his theory to experimental testing set it apart from the arena of science.

In the early 1820s, a Yorkshire boarding school was devastated by an outbreak of blinding ophthalmia. The cause of the epidemic was-in all likelihood-trachoma, then known as Egyptian ophthalmia. The headmaster of the Yorkshire school, William Shaw, was sued for gross negligence by 2 families whose sons went blind during the outbreak. The epidemic and trial would play a role in creating one of the literature's most notorious fictional characters. Eighteen years after the trial, Charles Dickens modeled the vile schoolmaster Wackford Squeers in Nicholas Nickleby after Shaw, whose reputation and career would later be ruined by his thinly disguised portrayal in the novel. The original boarding school epidemic took place while London's first eye hospital was moving to Lower Moorfields, an institution that 17 years earlier was established primarily to cope with Egyptian ophthalmia. We explore trachoma's wide-ranging impact on pre-Victorian England, from inspiring an enduring literary villain to the creation of a renowned eye hospital.