Teaching retinal surgery.

It was in 1953 that Sir Stewart asked me to undertake some work in the field of retinal detachments at the Institute of Ophthalmology. The scene of retinal work at that time was one of small islands of individual professional excellence in an ocean of professional ignorance and much apathy about the subject. The giants at that time, Weve of Utrecht, Shapland of London, Pischel of San Francisco, Schepens of Boston, and Paufique of Lyons, dominated other surgeons in their capability to produce cures for their patients with retinal detachments. No one could approach their results and unfortunately little was being done to disseminate their methods. It was interesting to note at that time the different methods of ophthalmoscopy used in the various countries, which certainly had a bearing on the relative successes ofindividual treatments. On the continent of Europe, the standard method was monocular indirect ophthalmoscopy, using exceedingly bright sources of illumination. In the U.S.A. indirect ophthalmoscopy was again the method of choice, reflecting the countries of origin of the surgeons involved. In Boston, there was developing the stereoscopic improved method of binocular indirect ophthalmoscopy which was later to sweep the world as the standard method of examination in this type of work. In England, direct ophthalmoscopy was used almost exclusively and only succeeded because of the incredible experience and powers of observation of the one man making a singular success of this type of work. From a diagnostic unit at the Institute the work spread to a retinal surgery unit at Moorfields Eye Hospital, City Road, with beds at a separate unit at Highgate, North London.