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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., (Copyright © 2018 Elsevier Inc. All rights reserved.)

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., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Medical historians identify the mid-20th century as the time when the scientific and medical communities acknowledged the existence of autoimmune disease. Several conditions including sympathetic ophthalmia and endophthalmitis phacoanaphylactica, however, were proposed as autoimmune disorders much earlier. During the first half of the century, autoimmune disease was viewed as biologically implausible. Paul Ehrlich coined the term horror autotoxicus to emphasize that autoimmunity would contradict nature's aversion to self-injury. The discoveries of allergy and anaphylaxis were the first clues that the immune system was capable of self-harm. A major obstacle to comprehending the pathogenesis of autoimmunity was how the immune system distinguishes foreign from self, a process eventually understood in the context of immune tolerance. Investigators of sympathetic ophthalmia and endophthalmitis phacoanaphylactica were positioned to invalidate horror autotoxicus but lacked sufficiently convincing experimental and clinical evidence to accomplish the task. Seminal studies of chronic thyroiditis and a series of clinical laboratory breakthroughs led to the general acceptance of autoimmune disease in the 1950s. The travails encountered by ophthalmic investigators offer insights into the how medical ideas take shape. We review the contributions of ocular immunology to the conceptual development of autoimmune disease and explore the reasons why the concept caught on slowly., (Copyright © 2016 Elsevier Inc. All rights reserved.)

An outbreak of cataracts in 1935 caused by dinitrophenol (DNP), the active ingredient of popular diet pills, highlighted the inability of the U.S. Food and Drug Administration (FDA) to prevent harmful drugs from entering the marketplace. Just two years earlier, the FDA used horrific images of ocular surface injury caused by cosmetics at the World's Fair in Chicago to garner public support for legislative reform. The FDA had to walk a fine line between a public awareness campaign and lobbying Congress while lawmakers debated the need for consumer protection. The cataract outbreak of 1935 was conspicuous in the medical literature during the height of New Deal legislation, but questions persist as to how much it affected passage of the proposed Food, Drug, and Cosmetic Act (of 1938). The legislation languished in committee for years. The cataract outbreak probably had little impact on the eventual outcome, but medical opinion concerning the safety of DNP may have contributed to the voluntary withdrawal of the diet drug from the market. We review the DNP cataract outbreak and examine it in context of the challenges facing regulatory reform at that time., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Samuel Johnson, the acclaimed author of the Dictionary of the English Language, survived childhood scrofula with impaired sight and hearing. The cause of his scrofula has been attributed to bovine tuberculosis, but mycobacterial infection does not satisfactorily account for the peculiar features of Johnson's eye disorder or his hearing loss. The subject of numerous biographies, Johnson may have the most scrutinized medical history of all time. Medical detectives, hampered by the vagueness of 18(th)-century diagnosis, suspect that phlyctenular eye disease related to tuberculosis was the reason for his visual impairment. Pediatric brucellosis can also explain childhood scrofula associated with visual and auditory disabilities, but it may be difficult to reconcile any single diagnosis given the uncertainties surrounding Johnson's medical and ocular histories., (Copyright © 2012 Elsevier Inc. All rights reserved.)

The reliability of clinical methods is often taken for granted. There is considerable evidence, however, that variability of clinical measurements, interpretations, and judgements are greater than commonly thought. Inconsistency of clinical methods has profound and widespread implications in clinical practice. The inferential capacity of measurements depends on accuracy and reproducibility. Appropriate medical decisions cannot be reached without accurate and reliable data. This review will examine the conceptual relationship of reliability, accuracy, and validity. The role of observer reliability in ophthalmic test measurements and interpretations will be addressed in the context of three case reports.

Purpose: To describe four patients who developed cystoid macular edema shortly after onset of treatment with latanoprost., Method: Retrospective review of medical records of patients with open-angle glaucoma who developed cystoid macular edema shortly after starting latanoprost., Results: The use of topical latanoprost was temporally related to the development of cystoid macular edema in four patients (six eyes; two aphakic eyes and four pseudophakic eyes). Cystoid macular edema resolved in all patients after latanoprost was discontinued., Conclusions: Cystoid macular edema is a potential complication of latanoprost therapy. Further observations are needed to determine if the risk of cystoid macular edema is limited to or greatest in patients who are pseudophakic or aphakic.

Clinical manifestations of Wegener's granulomatosis are nonspecific and indistinguishable from a variety of neoplastic, infectious, and inflammatory diseases. Ophthalmic disease is the presenting feature in nearly one sixth of patients with Wegener's granulomatosis and will ultimately develop in a majority. The discovery of antineutrophil cytoplasmic antibodies, particularly antiproteinase-3, has changed the clinical approach to evaluating patients suspected of having Wegener's granulomatosis. These antibodies are distinguished from other related autoantibodies because they produce a coarse granular pattern of cytoplasmic staining on indirect immunofluorescence with ethanol-fixed neutrophils. Treatment of Wegener's granulomatosis with oral cyclophosphamide and corticosteroids has decreased morbidity and improved survival, but side effects from long-term immunosuppressive therapy are common and sometimes serious. The effectiveness of trimethoprim-sulfamethoxazole in decreasing the number and severity of recurrences of Wegener's granulomatosis is being investigated. It remains to be determined if wide use of trimethoprim-sulfamethoxazole in limited Wegener's granulomatosis could further improve the quality of life for some patients.