Investigating ophthalmology with translational science: the Weisenfeld Lecture.

The Mildred Weisenfeld award truly is a magnificent honor to have been bestowed on me. Self-consciously, I can’t deny the suitability of the honor, even if the merit in my case can be questioned, and I warm to the task of explaining its aptness. Mildred Weisenfeld, a retinitis pigmentosa sufferer from her teens, is known to the ARVO community for her unstinting and visionary energy in fund-raising, and support for ophthalmic and visual science. This energy was directed not so much with a view to helping relieve the suffering of visually impaired individuals, itself a noble cause, but toward supporting research into the causes of blindness so that new therapies could be discovered to prevent vision loss. She was, indeed, frustrated to realize that in the United States, and almost certainly worldwide, focussed research activity of this nature was scant. It was due partly to her efforts that the National Eye Institute (NEI) now stands where it does, providing support for vision scientists in the United States and beyond, and the ARVO fellowship is indebted to her. Such dedicated Institutions are not available to other nations. Specifically, Mildred Weisenfeld was addressing the problem of translational science, although this relabeling of an existing but growing activity came into effect only recently. Insightful clinicians for years have understood that developments in science have direct bearing on better ways to treat their patients. Indeed, historically medical scientific discoveries frequently were made by medical doctors, and famous examples abound in all fields of medicine, not least in Ophthalmology. Names, such as Helmholz, von Graefe, Donders, Bowman, Friedenwald, and Duke-Elder, spring to mind. However, many of these ground-breakers were active during the 19 and early 20 centuries, and in recent years the nonclinical professional basic scientist, whose trade is Big Science, has edged out the patient-oriented Clinician Scientist. This unintended, and possibly self-inflicted exclusion has been felt for nearly 30 years, not only in ophthalmology, but in all fields, as articulated in an editorial from 1983. Evidence that such effects are real is difficult to find, but one measure has been the concern raised in recent years regarding the low numbers of NEI grants awarded to MD versus PhD qualified applicants.