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October 2006

Charles L. Schepens, MD (1912-2006)

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Copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2006

Arch Ophthalmol. 2006;124(10):1512-1513. doi:10.1001/archopht.124.10.1512

On March 28, 2006, at age 94, following a massive coma-producing stroke on March 25, 2006, Dr Charles L. Schepens quietly passed away ending a most remarkable career in ophthalmology that spanned over 70 productive years. His life also exemplified a participation in the broader world.

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Charles L. Schepens, MD

Born in Mouscron, Belgium, in 1912, he was the son of a general practitioner whose 4 sons all became physicians. Ophthalmology was to be his prime field of interest on graduation from medical school in Ghent in 1935 given his capabilities in both mathematics and optics. He had postgraduate training with Henricus J. M. Weve, MD, of Utrecht, Holland, who was well known for his skill in retina surgery. At the onset of World War II Dr Schepens was a captain in the Belgian Air Force Medical Corps, but he left his post to avoid capture by the Germans. (He was absolved of desertion 20 years later by the Belgian government.) After 2 close calls with the gestapo, he left Belgium with his family and under the alias Jacques Pérot ultimately took over a previously dormant lumber mill in the foothills of the Pyrenees mountains separating France and Spain. In collusion with a shepherd in the mountains, he facilitated the transporting into Spain of allied airmen, important personages and others escaping the occupation, and documents of consequence.

The moment of truth occurred when one of the millworkers came in with a foreign body embedded in the cornea of his eye. Should he extract it on the spot or send him to a distant hospital with questionable ophthalmic expertise? Although the safe course would have been to send the man out, his sight would likely have been forfeited. Dr Schepens elected to remove the foreign body with the knowledge that local gossip would alert the gestapo. As a result, he left the country and after a hairbreadth escape arrived in London. While there, he developed the concepts and instrumentation that eventually became the binocular indirect ophthalmoscope, with its stereoscopic viewing system and self-contained light source. With this technology, a dynamic, 3-dimensional view of the fundus periphery to the ora serrata was made possible. This viewing system and the ensuing surgical innovations, primarily the scleral buckling procedure, improved the surgical success rate for repairing detached retinas from 40% to 90%. Emigrating to Boston, Mass, in 1947, he developed a program to achieve 3 goals: (1) a training program to promulgate his ideas and techniques, (2) the development of a practice of a sufficient clinical base of patients with detached retinas, and (3) a research organization to advance diagnostic capabilities and to investigate the underlying causes of vitreoretinal disease.

In 1949, he founded the Retina Service at the Massachusetts Eye & Ear Infirmary where he developed a postgraduate fellowship program in retinal surgery that has been the fountainhead for the training of over 90% of American retina specialists. This was achieved by forming a private practice group, the Retina Associates, that was able to provide training to almost 200 fellows from throughout the nation and the world. His techniques of examination and surgery became the gold standard for retinal care.

In 1950 Dr Schepens founded the Retina Foundation, which focused its research on causal factors of retinal detachment and modes of enhancing diagnosis and treatment of retinal diseases. In time, the scope and focus of research evolved into basic long-term research along with clinically oriented research with a shorter time frame. The Schepens Eye Research Institute, now the nation's largest independent eye institute, has as its prime responsibility performing laboratory and animal research pertaining to the retina. The Schepens Retina Associates Foundation provides patient care and carries out clinical research with a potential for solving retina problems in the near future.

With the development of a broad-based surgical fellowship and multifaceted research program, Dr Schepens not only changed the clinical care of detached retinas but also significantly enhanced the diagnostic capabilities of ophthalmologists. His background in optics and mathematics led him to envision the clinical worth of 4 innovative instruments: the first monochromatic green laser, the first wide-angle (140°) camera, the scanning laser ophthalmoscope, and the laser Doppler flow meter. He supported their clinical development both intellectually and financially. Dr Schepens was a focused, prodigious worker, with a virtually unsurpassed work ethic, who performed operations until he was 78 and came to the office and saw patients once weekly until this past January. Even at home he continued writing and planning for the future. One of his new interests was the relationship between subtle changes in the eye and the development of Alzheimer's disease.

While focused on large issues, he still retained a compassion for individuals. Many letters from patients attest to his personal concern and warmth for their problems, both ophthalmic and otherwise. Former fellows almost universally have remembrances of kindnesses and unsolicited help from their mentor.

Beyond ophthalmology, he was very knowledgeable in history, science, mathematics, and world geography, as well as knowing the art and theater worlds. He was “a Renaissance man,” being fluent in English, French, and Dutch and was able to converse in several other languages.

Recognition of his achievements has been worldwide. In 2001 the American Society of Cataract and Refractive Surgery named him one of the 10 most influential ophthalmologists of the 20th century. Also, in 2001, the Harvard Medical School established the Charles L. Schepens Professorship in Ophthalmology. In 2003, the American Academy of Ophthalmology awarded him the Laureate Award, its most prestigious commendation. He was 1 of its 3 inaugural recipients.

In addition to authoring 4 books and almost 400 scientific articles, he quietly encouraged the publication of many contributions to the ophthalmic literature by former fellows and other young ophthalmologists. He also counseled graduates of the Retina Associates fellowship program to participate broadly in advancing the care and research pertaining to retinal disease and also encouraged graduates to start their own fellowship program by stimulating them to become apostles of his techniques. He helped found the Retina Society and the Schepens International Society both of which have been very successful in promulgating new ideas.

He had unswerving, dedicated support from his remarkable wife of 69 years, Cette Schepens, that allowed him to proceed toward his goals with minimal distraction. He is also survived by his son Luc and 3 daughters, Claire Delori, Bernadette Butler, and Catherine Wainer.

On March 21, 2006, he received the award, Knight of the French Legion of Honor in Boston at the French consulate by the Consul General François Gauthier. This recognized both his intrepid World War II activities in the underground and his subsequent stellar professional attainments, which impacted greatly on French ophthalmology, as well as everywhere else in the world. He responded to this great honor with a 5-minute thank you. This was the only time I have ever perceived a tear in his eye. This honor only a few days prior to our losing him seemed an iconic end to a true icon.

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Correspondence: Dr McMeel, Schepens Retina Associates Foundation, 1 Autumn St, Sixth Floor, Boston, MA 02215-5301 (