Muscae volitantes: A 19th-century precursor of visual snow syndrome?

PURPOSE

Visual snow syndrome comprises a whole-field static-like visual disturbance, with increased awareness of entopic phenomena, an inability to suppress the 'just seen' and photophobia. Visual snow syndrome is often associated with other problems such as headache, tinnitus, and anxiety. The earliest reported case of a patient experiencing symptoms consistent with visual snow syndrome dates only to 1995. This paper seeks to find patterns of experience in the medical literature of the past that are reminiscent of visual snow syndrome, to challenge the view that it is in any sense a novel disorder. Descriptions of subjective visual sensations such as experienced by patients suffering from visual snow syndrome were sought in treatises, textbooks and other literature generated by leading figures in 19th-century ophthalmology, physiology and physics.

CONCLUSION

While retrospective diagnosis of modern illness categories in historical medical literature is an enterprise fraught with pitfalls, it is nonetheless possible to see patterns of experience in the 19th-century medical literature that are strongly reminiscent of visual snow syndrome.

100th anniversary of Acta Ophthalmologica

The Year 2023 is particularly important for Acta Ophthalmologica journal. It is an anniversary year, as Acta Ophthalmologica celebrates its 100th anniversary. The journal was founded by Konrad Kristian Karl (K.K.K) Lundsgaard in 1923. The goal was to present the clinical and experimental achievements of the ophthalmological communities of the Nordic countries. With the passage of time and increasing interest from scientific communities in other countries, it has become one of the most visible ophthalmology journals in the world. Acta Ophthalmologica publishes a wide variety of high-quality ophthalmological papers. Here, we present the activities of Acta Ophthalmologica over the past 100 years.

[Visual acuity charts in the Russian Empire, the USSR and modern Russia]

Visual acuity is the quantitative parameter of the visual system characterizing its functional spatial resolution. Special test charts are commonly used for visual acuity assessment. The development of foreign tests for visual acuity is comprehensively covered in the literature, while the history of improving visual acuity charts in modern Russia, the USSR, and in the territory of the Russian Empire is only considered fragmentarily. In particular, there are almost no mentions of D.A. Sivtsev's work on proper letter-signs selection, and of A.A. Kryukov's tests. The purpose of this article is to review the history of developing visual acuity assessment methods in the Russian Empire, the USSR and modern Russia. One of the first sets of tests for visual acuity assessment available in the Russian Empire was developed by A.A. Kryukov; it was republished several times, but some criticism of the test can be encountered in the literature of that period. Subsequently, a task of developing a more accurate method was presented, which was implemented in the form of several editions of the visual acuity charts by D.A. Sivtsev and S.S. Golovin. The authors put a lot of effort into selecting the letters for the most reliable results of visual acuity assessment, excluded some unsuccessful characters (Cyrillic letters 'Ж' and 'Ю') and changed the size levels of the chart (the lines corresponding to the visual acuity levels of 1.25 and 1.5 were substituted by 1.5 and 2.0). Around the same period, A. Holina's chart appeared in print, but due to its poor structure the chart did not gain popularity, although it had a number of advantages. The review also considers some modern tests: the RORBA chart (named after the authors Rosenbaum, Ovechkin, Roslyakov, Bershanskiy, Aizenshtat), the vanishing optotypes by S.A. Koskin et al., the three-bar optotypes by the Institute for Information Transmission Problems (IITP), and the "Quartet" optotypes. Despite a large number of options, the search for the best method of measuring visual acuity for various medical and scientific tasks continues.

Carl Theodor, Duke in Bavaria (1839-1909): A royal ophthalmologist

Carl Theodor (1839-1909), a royal Duke in the ruling house of the Kingdom of Bavaria, was born to a life of wealth, privilege, and leisure. As was usual for sons of the nobility, he trained as a military officer. He fought in the Franco-Prussian War (1870-1871) and was decorated for his service in battle. Inspired by the tragedies he observed during the War, he decided to become a physician and received his medical degree from the Ludwig Maximilian University in Munich. After working in general medicine, he embarked on an extensive post-graduate program of study in ophthalmology. Starting in 1880, he practiced ophthalmology full time and devoted his life to his patients. He performed most of his work gratis and he personally underwrote most of the costs for his practice. His wife, the Duchess Marie José (1857-1943), a princess of the royal house of Portugal, was as committed to his medical career and philanthropy as he was, and she served as his assistant in the clinic and the operating room. Her untiring support made it possible for Carl Theodor to maintain his busy schedule. After his death, she established a Foundation to administer his clinic and operating facility in Munich.

José Morón was the first to introduce the retinal light photocoagulation

Regarding the early history of laser, it is generally accepted that the technique of retinal light photocoagulation was first pioneered by Gerd Meyer-Schwickerath in 1949. The renowned German ophthalmologist developed the technique to obtain clinically useful results and is worldwide considered the father of retinal photocoagulation. Nevertheless, we believe that the Spanish ophthalmologist José Morón (Seville, 1918-2000) was really the author of the first known experience of therapeutic photocoagulation of the retina, because he had previously used a similar technique in rabbit and human eyes in 1945 and 1946, respectively. These experiences already appeared in his doctoral dissertation, which was defended in Madrid in 1946, almost three years before the pioneering presentation of Meyer-Schwickerath. Despite this, Morón was permanently forgotten in the history of retinal photocoagulation. We would like to highlight his earlier experimental studies and reclaim the figure of this Spanish ophthalmologist, which deserves international recognition. This case is an example of a common phenomenon that inventors of new ideas are often not cited appropriately.

Chrysippus and the First Known Description of Cataract Surgery

Although the origin of cataract surgery is unknown, the earliest identified mention of cataract surgery comes from Chrysippus in the 3rd century B.C.E. This historical review analyses this first description of cataract surgery from both philosophical and linguistic perspectives, within the original context in which early cataract surgeries were performed, as well as within the context of contemporary medical knowledge.

À la recherche de la vision « normale » : mesurer l'acuité visuelle au XIXe siècle

This article aims to reconstruct and analyze debates centring on normal eye and vision standards during the second half of the 19^th century in Europe. It particularly addresses the creation of ophthalmology charts, one of the main tools for measuring visual acuity. Having briefly described the historical context in which modern eye charts were developed, we will present the better known examples of these and their characteristics. We will then analyze ophthalmologists' debates about what constitutes a normal eye and normal vision, and show the discrepancy between established definitions and clinical studies. Finally, we will consider the issue of measuring eyesight while focusing, on the one hand, on specialists' desire to create a standardized framework to measure visual acuity and, on the other hand, on the multiple hurdles that hindered achieving that goal.

[The 180th anniversary of the birthday of professor E.V. Adamyuk - founder of Kazan School of Ophthalmology (sourced from 'The Russian Annals of Ophthalmology' journal archives)]

The article is dedicated to the works of E.V. Adamyuk (1839-1906) - founder of the Kazan School of Ophthalmology, a professor of the Imperial Kazan University; he published in the specialized journal 'The Russian Annals of Ophthalmology' ('Vestnik oftal'mologii') in the late XIX - early XX centuries. In respect of his great scientific and clinical experience, as well as his high prestige among both Russian and foreign colleagues, he was included in the editorial board of the journal from its very first issue, which was published in 1884. His wide range of knowledge in various fields of medical science allowed professor E.V. Adamyuk over 20 years (1886-1906) of consistent participation in the journal activity by publishing his clinical observations and scientific discussions about etiology, pathogenesis and treatment methods of a number of eye diseases (trachoma, glaucoma, cataracts, retinal and optic nerve pathologies, etc.), many of which are still instructive and relevant to this day. Professor E.V. Adamyuk's scientific heritage preserved in his publications in 'The Russian Annals of Ophthalmology' is without doubts an invaluable contribution to the formation and development of ophthalmological science.

[Discoveries of Giulio Cesare Aranzi]

The article provides a Russian translation of the 19th chapter of the work of Italian anatomist and surgeon Giulio Cesare Aranzi (Julius Caesar Arantius, 1530-1589) 'Observationes anatomicae', which describes his discoveries in the anatomy of the organ of vision: detection of m. levator palpebrae superioris and disproving of the then prevailing statement concerning the origin of external muscles of the eye from the dura mater. The article also gives a brief biography.

Von Helmholtz's ophthalmometer: historical review and experience with one of the last surviving original devices

Hermann von Helmholtz (1821-1894) was one of the most important scientists of the nineteenth century in optics and ophthalmology. One of his significant contributions in the field of vision sciences was the invention of the ophthalmometer in 1850, which was the precursor of the keratometers still used in clinical practice today. However, this development tends to be little recognized, and to be overshadowed by others of the achievements of this singular scientist. This review describes the historical setting behind the von Helmholtz's ophthalmometer and its mechanism. We also describe the modifications that were later made to the design. We report on our experience measuring a living human cornea with one of the last surviving devices in the world. The ophthalmometer by von Helmholtz marked the beginning of an era in the ophthalmology of the late nineteenth century, and although its original design was not broadly used in the clinical practice, and later abandoned, it opened the way for the development of practical systems very similar to the ones that we use even today.

David Kasner, MD, and the Road to Pars Plana Vitrectomy

David Kasner, MD (1927-2001), used his extensive dissections of eye bank eyes and experiences in teaching cataract surgery to resident physicians to realize that excision of vitreous when present in the anterior chamber of eyes undergoing cataract surgery was preferable to prior intraoperative procedures. Noting that eyes tolerated his maneuvers, he then performed planned subtotal open-sky vitrectomies; first on a traumatized eye in 1961, then on two eyes of patients with amyloidosis (1966-1967). The success of these operations was noted by others, most particularly Robert Machemer, MD. Kasner's work directly led to further surgical developments, including closed pars plana vitrectomy.

James Moores Ball: Ophthalmologist, medical historian, bibliophile

James Moores Ball (1862-1929) was an ophthalmologist in St. Louis, Missouri, who excelled as a medical historian and collector of rare and historic books about the history of anatomy. During his lifetime, he was best known as the author of a comprehensive, authoritative, and popular textbook titled Modern Ophthalmology First published in 1904, there were five further editions. Ball was very interested in the history of anatomy and wrote two books on this subject, the first being a biography of Andreas Vesalius, one of the earliest in English, and the second a history of the resurrection men or grave robbers who sold corpses to professors of anatomy and surgery for teaching purposes. His legacy today is the 470 volumes of his personal library, which are now in the Archives and Rare Books department of the Becker Medical Library of the Washington University School of Medicine. These texts are one of their major collections, concentrating on the history of anatomy, beginning with a first edition of Vesalius's De Humani Corporis Fabrica and holding many important and beautiful landmark volumes of anatomical atlases.

What was Glaucoma Called Before the 20th Century?

Glaucoma involves a characteristic optic neuropathy, often with elevated intraocular pressure. Before 1850, poor vision with a normal eye appearance, as occurs in primary open-angle glaucoma, was termed amaurosis, gutta serena, or black cataract. Few observers noted palpable hardness of the eye in amaurosis. On the other hand, angle-closure glaucoma can produce a green or gray pupil, and therefore was called, variously, glaucoma (derived from the Greek for glaucous, a nonspecific term connoting blue, green, or light gray) and viriditate oculi. Angle closure, with palpable hardness of the eye, mydriasis, and anterior prominence of the lens, was described in greater detail in the 18th and 19th centuries. The introduction of the ophthalmoscope in 1850 permitted the visualization of the excavated optic neuropathy in eyes with a normal or with a dilated greenish-gray pupil. Physicians developed a better appreciation of the role of intraocular pressure in both conditions, which became subsumed under the rubric “glaucoma”.

Carl Friedrich Richard Foerster (1825-1902) - the inventor of perimeter and photometer

Carl Friedrich Richard Foerster (1825-1902) was a German who was born in the Polish city Leszno. He studied medicine at the Medical Faculty of Breslau (now Wroclaw, Poland) University, and later in Heidelberg and Berlin. From 1855, he worked in Breslau, where he established in 1857 the first ophthalmology clinic. Later, he became a professor in ophthalmology, the first director of the Department of Ophthalmology at the University of Breslau, and even the rector of this University. Forster did many pioneering works on visual fields, invented a photometer and the first perimeter, known for many years as the Foerster perimeter. Moreover, he studied night blindness, visual field changes due to different pathologies, and many eye diseases, including glaucoma, cataract, retinal and choroidal diseases.

The early history of glaucoma: the glaucous eye (800 BC to 1050 AD)

To the ancient Greeks, glaukos occasionally described diseased eyes, but more typically described healthy irides, which were glaucous (light blue, gray, or green). During the Hippocratic period, a pathologic glaukos pupil indicated a media opacity that was not dark. Although not emphasized by present-day ophthalmologists, the pupil in acute angle closure may appear somewhat green, as the mid-dilated pupil exposes the cataractous lens. The ancient Greeks would probably have described a (normal) green iris or (diseased) green pupil as glaukos. During the early Common Era, eye pain, a glaucous hue, pupil irregularities, and absence of light perception indicated a poor prognosis with couching. Galen associated the glaucous hue with a large, anterior, or hard crystalline lens. Medieval Arabic authors translated glaukos as zarqaa, which also commonly described light irides. Ibn Sina (otherwise known as Avicenna) wrote that the zarqaa hue could occur due to anterior prominence of the lens and could occur in an acquired manner. The disease defined by the glaucous pupil in antiquity is ultimately indeterminate, as the complete syndrome of acute angle closure was not described. Nonetheless, it is intriguing that the glaucous pupil connoted a poor prognosis, and came to be associated with a large, anterior, or hard crystalline lens.

Hermenegildo Arruga (1886-1972): a versatile ophthalmologist who simplified cerclage to retinal surgery

Hermenegildo Arruga Liró (1886-1972) was a versatile Spanish ophthalmologist who specialized in retinal surgery. He designed numerous surgical instruments and introduced significant improvements in ophthalmic surgical techniques. Thus, he was among the first ophthalmologists to advocate the intracapsular cataract extraction. Furthermore, he refined several surgical procedures such as dacryocystorhinostomy, corneal transplantation, evisceroenucleation and pterygium excision. Arruga perfected Gonin's operation and contributed significantly for retinal detachment surgery to be put in place. Later, he adopted the injection of air at the end of surgery. In the 1950s, Arruga simplified the technique of equatorial cerclage using a suture to encircle the equator of the eye.

An ancient explanation of presbyopia based on binocular vision

Presbyopia, understood as the age-related loss of ability to clearly see near objects, was known to ancient Greeks. However, few references to it can be found in ancient manuscripts. A relevant discussion on presbyopia appears in a book called Symposiacs written by Lucius Mestrius Plutarchus around 100 A.C. In this work, Plutarch provided four explanations of presbyopia, associated with different theories of vision. One of the explanations is particularly interesting as it is based on a binocular theory of vision. In this theory, vision is produced when visual rays, emanating from the eyes, form visual cones that impinge on the objects to be seen. Visual rays coming from old people's eyes, it was supposed, are weaker than those from younger people's eyes; so the theory, to be logically coherent, implies that this effect is compensated by the increase in light intensity due to the overlapping, at a certain distance, of the visual cones coming from both eyes. Thus, it benefits the reader to move the reading text further away from the eyes in order to increase the fusion area of both visual cones. The historical hypothesis taking into consideration that the astronomer Hipparchus of Nicaea was the source of Plutarch's explanation of the theory is discussed.

Gerhard Henrik Armauer Hansen (1841-1912)--100 years anniversary tribute

2012 marks the 100th year of death of Gerhard Henrik Armauer Hansen (1841-1912), who discovered Mycobacterium leprae, but also gave the first systematic scientific work on the leprosy of the eye. The article reviews his life and scientific achievements with special regard to eye and ophthalmology.

Wiley Post, around the world with no stereopsis

In 1933, famed aviator Wiley Post (1898-1935) was the first pilot to fly around the world solo. In addition, during one of his many stratospheric flights, he discovered the jet stream. What makes his accomplishments even more remarkable is that he did this monocularly, having lost his left eye from traumatic endophthalmitis following an oil rig accident. He underwent a period of self-imposed visual training to maximize his depth perception, and then accomplished what no one had before.

The history of scientific concepts of vision in relation to Ludwik Fleck's thought-styles

The aim of the article is to assess the usefulness of Ludwik Fleck's theory of thought-styles for the history of ophthalmology. On the basis of Fleck's ideas, the authors attempt to analyse the development of concepts of vision. They enumerate three styles in the history of ophthalmology: humoral, iatromechanical and micro-tissue. In conclusion, they state that the history of evolution of the concept of vision should be considered not only from the perspective of achievements of individual scientists but also with the addition of the social 'mood' that prevailed in a given historical period.