Part 1 of this column recounted that the Christiansburg Ophthalmologist J. Stephen Hudgins MD had received part of his training under Dr. David Apple at the Medical University of South Carolina in Charleston, and in 1989 had met there with Sir Harold Ridley (1906-2001), when that pioneer ophthalmologic surgeon received an honorary degree.
The accompanying picture shows the cover of David J. Apple’s 2006 biography of Ridley. The subheadings of the book’s title summarize Ridley’s life: he fought for sight and he changed the world so that millions were healed from cataracts.
The well-known Stonehenge monument, near where Ridley lived in Salisbury, is behind him. The fighter pilot who became a Ridley patient is the short man in the center of the lower picture.
Ridley’s father was an eye surgeon, and in the 1930s, Ridley himself embarked on a similar career in London hospitals. World War II in Europe broke out in 1939, and the summer of 1940 over southern England saw the clash of the German Luftwaffe and the Royal Air Force, in what is now called the Battle-of-Britain.
In August 1940, a Hurricane fighter pilot who had scrambled in haste and forgotten his goggles had his cockpit canopy shattered by enemy fire.
Fragments from the canopy got into both his eyes. One eye was permanently blind. The other was eventually saved after a long series of operations by Ridley over the following eight years.
During these eight years, Ridley concluded (contrary to prevailing medical opinion that held that any foreign object in the eye was disastrous) that fighter plane canopy fragments were inert and safe in an eye. Thus, by 1948, Ridley had for several years been thinking about a “revolutionary operation that offered a ‘new lens for old,'” with the replacement lens being made from the Perspex or Plexiglas of fighter plane canopies. Ridley finally undertook his first eye lens replacement surgery in November 1949.
Ridley’s new intraocular lenses met immediate fierce and enduring professional opposition. A prominent critic the operation said it “…offends the first principle of ophthalmic surgery and could cause malignant disease.”
A professor of ophthalmology asserted: “As long as I remain in charge of this department no implant will ever be done.”
Three decades passed before professional resistance to plastic lens implantation diminished and the procedure began to become the standard treatment for cataracts.
During that time many other surgeons contributed improvements to cataract surgery. In 1979 overt recognition for Ridley finally came from the American Society of Cataract and Refractive Surgery when 4,000 practicing ophthalmologists signed and presented to him in San Francisco a large leather-bound book titled “A Salute to Dr. David Ridley.”
Of this event Ridley wrote: “By 1979 in San Francisco it was evident that implants were at last beginning to be an accepted part of ophthalmic surgery.”
At about this time Dr. D. J. Apple began to specialize in the development of intraocular lenses and undertook to study the early work of Ridley. This study turned Apple into a champion of Ridley and eventually into Ridley’s biographer. Subsequently, during the 1980s and 1990s, Apple (and many other eye surgeons) introduced huge improvements into the methods of cataract surgery.
These developments in surgical procedures are only properly appreciated by medical experts. However, some general evolutionary trends in implantation are evident even to a layperson.
Weight reduction in the replacement lens has been very significant; early lenses weighed as much as eight times more than modern lenses.
Modern foldable plastic lenses that can be inserted through a small eye incision and unwrapped into place have improved the surgical procedure, and the technique called phacoemulsification (that uses sonic energy to prepare the lens cavity to receive the new lens) has made possible the modern era of incisions for foldable lenses.
Late in life, Ridley’s remarkable contributions finally began to receive recognition in England. In 1986, just before his 80th birthday, he was honored with a fellowship in the Royal Society (FRS).
This highly prestigious science society has numbered among its members Isaac Newton, Charles Darwin and the recently deceased Stephen Hawking. In the ultimate English accolade, Ridley was finally knighted Feb. 9, 2000 at Buckingham Palace in London to become Sir Harold—at the age of 93, just 15 months before his death.
Whenever this columnist receives a routine eye examination from Dr. Hudgins, he reflects on the amazing history of eye surgery.
The columnist is a most grateful beneficiary of that history as transmitted via Dr. Hudgins.
Jim Glanville is a retired chemist living in Blacksburg. He has been publishing and lecturing for more than a decade about the history of Southwest Virginia.