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Frank B. Walsh (1895-1978), recognized as the founder of neuro-ophthalmology, would be the best person to guide you through this eye-opening exhibit (1). Much of his career was spent working as a neuro-opthalmologist at Johns Hopkins, and he also wrote the book Clinical Neuro-Opthalmology (the first neuro-ophthalmology textbook) describing his case reports and analysis of diseases affecting the nervous system through the eye (2). As a significant contributor to the field, he would be able to discuss the history and intersections of ophthalmology and neuroscience that have contributed to neuro-ophthalmology today.

Sources:

(1) https://novel.utah.edu/Walsh/career.php

(2) https://www.sciencedirect.com/science/article/pii/0090301985903258?via%3Dihub

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Medieval arab physicians and scientists have presented unique interests and innovations in the field of ophthalmology that have greatly contributed to the advancement of visual neuroscience. Ammar ibn Ali al-Mawsili is an Iraqi Arab renowned ophthalmologist who invented the cataract operation via suction (1). He detailed his new procedure in his book titled Kitâb al-Muntakhab fî ‘ilâj al-‘ayn (Book of Choices in the Treatment of Eye Diseases), which additionally described six case histories for cataract removal (2).

The standard at the time prior to Ammar’s new technique was known as a “couching” cataract operation, in which a needle or probe was inserted at the edge of the cornea to push the lens aside. Ammar disapproved of this procedure because of the detrimental side effects associated with it, and instead decided to make an incision in the conjunctiva behind the limbus where the cornea and conjunctiva join (2). A copper or gold hollow needle was then used to suck the cataract (3). The previous standard was to have patients lie on their backs for multiple days to avoid cataract migration, yet with Ammar’s procedure, patients did not need to do so as they could see immediately (2). The image above is a painting of him performing his innovative suction method in Mosul, Iraq in ca. 1000 (1).

This artifact shines a light on the impact Arabic cultures and Middle Eastern scholars like Ammar had on the progressing knowledge and understanding of vision that has increased success rates for this now common procedure. Ammar Al-Mawsili was the first to describe cataracts as the blurring of the lens, and the procedures he performed are considered some of the first successful extraction operations (4).

Sources:

(1) https://islaminindonesia.wordpress.com/2014/03/23/ammar/

(2) https://journals.sagepub.com/doi/10.1177/1553350615618289?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

(3) Origins of Neuroscience: A History of Explorations Into Brain Function. By Stanley Finger

(4) https://www.researchgate.net/publication/367006523_The_first_cataract_extraction_operations

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As procedures to improve eyesight advanced, so did our understanding of the brain and eye anatomy. Andreas Vesalius, also known as the father of modern anatomy, wrote a series of books called De humani corporis fabrica (Of the Structure of the Human Body) in 1543 in Switzerland (1). Within Book VII, he contradicted many of his predecessors by drawing the optic nerves as not hollow. This was because after examining the optic nerves in animal dissections and executed humans, he did not observe holes within the optic nerves (2). He did continue to place the lens in the center of the eye, did not show eye chambers in the correct proportion, and did still believe that each optic nerve went from the eye to the same side of the brain (2). The image above is Vesalius’s depiction of the base of the brain, including the optic nerve, published in De humani corporis fabrica (3).

While we know that Vesalius was not the first to complete illustrate anatomy, his work was some of the most influential pieces in our understanding of the anatomy of the eye, brain, and many other structures. Despite some errors that were later corrected, he accompanied his text with pictures that have played a significant step in strengthening the field of vision in neuroscience.

Sources:
(1) https://www.britannica.com/biography/Andreas-Vesalius#ref97183

(2) Origins of Neuroscience: A History of Explorations Into Brain Function. By Stanley Finger

(3) Then there were 12: The illustrated cranial nerves from Vesalius to Soemmerring. By Catherine E. Storey

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In 1668, Edme Mariotte discovered the blind spot, also known as Mariotte’s spot. He provided the first public description of the blind spot, supported by demonstrations and experimentation. By moving a small coin around and noticing that when it is placed in the blind spot, the coin disappears from vision. This demonstration was presented to the French Royal Court (1).

Mariotte was also the first to explain why the blind spot does not hinder our sight He explained that because eyes have quick movements and do not look at a single point in the visual field for a long time, and because we mainly see with both eyes rather than just one, the retinal vessels and blind spot do not block our vision (1).

The image above is a copy of the illustration that appears in Mariotte’s work Ouevres de Mariotte published in 1717 in France (2). This discovery is significant because it provided further insight into neurophysiology. Marriotte also contributed to optics and color perception that have advanced our understanding of how the eye works, but is often overlooked.

Sources:
(1) https://pubmed.ncbi.nlm.nih.gov/17574069/#:~:text=Abstract,perception%20is%20less%20well%20remembered

(2) http://www.princeton.edu/~hos/mike/texts/mariotte/mariotte.html

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Shortly after Vesalius’s wealth of anatomy illustrations were published comes insight on specifics within the field of ophthalmology through the publication of Ophthalmodouleia by George Bartisch. Bartisch, also referred to as the father of ophthalmology, wrote the first German book on ocular disease and surgery which was published in 1583 in Germany. The book was laid out in a unique fashion, including diagrams and drawings that were layered into flaps to replicate a “dissection” displaying the depth of anatomy of the eye. His work covers a myriad of topics related to opthalmology, including cataracts, trauma, and other diseases of the eye through 92 woodcuts (1).

The gif above is from page in Georg Bartisch's Ophthalmodouleia that displays the flaps lifted up to show the different layers (2). Not only is this method of demonstrating knowledge and educating the public extremely beneficial to the anatomy of the brain, but it also focuses on the steps required to diagnose or understand symptoms of eye disorders that can greatly benefit the public.

Sources:

https://library.uthscsa.edu/2015/01/george-bartisch-an-inventive-look-into-ophthalmodouleia/

https://slate.com/human-interest/2015/05/history-of-surgery-georg-bartisch-s-ophthalmodouleia.html

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Marriotte was not the only one who made prominent discoveries of the anatomy and physiology of the eye. Samuel Thomas von Soemmerring, a renown neuro-anatomist, was widely recognized for classifying the cranial nerves into twelve pairs in 1778 and discovering the macula in the retina of the human eye in 1791 (1). He observed the fovea and macula in the eyes of those who drowned earlier, and also observed the retinal structures of 50+ people. Soemmering also noted that the macula changed color depending on age. He found that it was pale yellow in children, rich yellow in adolescents, and back to pale yellow for older adults (2).

The image above is Soemmerring’s diagram of the retina displaying the macula lutea he observed in 1791 in Germany (2). Many of his observations remained unknown for years until a paper with his unexpected discoveries was submitted in 1795 (2). Soemmerring’s investigations on the brain and nervous system made him an impactful anatomist who helped advance scientific knowledge of the eye and nerves.

Sources:
(1) https://www.sciencedirect.com/topics/medicine-and-dentistry/macula-of-retina

(2) Origins of Neuroscience: A History of Explorations Into Brain Function. By Stanley Finger

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Today, we have a medical subspecialty that joins the forces of neurology and ophthalmology, pioneered by Frank B. Walsh. Neuro-ophthalmologists treat a number of neurological diseases with visual symptoms, such as eye movement concerns or vision loss from underlying issues with connections in the brain (1).

The image displayed above shows optic neuritis, or the inflammation of the optic nerve, which can lead to pain around the eye and drastic worsening of vision (2). Optic neuritis is one of the many diseases one would see neuro-ophthalmologists for. It could occur on its own or in conjunction with another underlying neurological disease like multiple sclerosis (1). Having doctors who are specialized in this field can help patients navigate nerve dysfunction or other neurological issues related to issues of the eye.

Throughout history, we have seen such tremendous innovation and the spreading of scientific knowledge that has brought scientists and healthcare professionals and scientists to research these specific ailments and provide more precise and personalized care within neuro-ophthalmology.

Sources:

(1) https://neurology.msu.edu/patient-care/neuro-ophthamology

(2) https://aapos.org/glossary/optic-neuritis