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Special Article
July 13, 2009

The Charles L. Schepens LectureSustaining a Vision

Author Affiliations

Author Affiliations: Baylor College of Medicine, Houston, Texas.

Arch Ophthalmol. 2009;127(7):921-922. doi:10.1001/archophthalmol.2009.155

Great men and women leave behind more than an accumulation of accomplishments and innovations—their legacy includes both challenges and encouragement for those who follow. Charles Schepens' greatest contribution to ophthalmology was the vastly improved method for observation of the fundus periphery with binocular indirect ophthalmoscopy and scleral depression that he developed and disseminated throughout our profession. He made substantial contributions to retinal surgery as well, and was a strong and effective advocate for fundamental and applied research on vitreo-retinal disorders. At the conclusion of a chapter on the history of retinal detachment written toward the end of his career, he voiced his frustration with the slow pace of our progress in developing methods for the prevention of retinal breaks.1 To ensure that Schepens's accomplishments are remembered and his vision perpetuated, the Retina Research Foundation and the Schepens International Society have established the Charles L. Schepens, MD, Lecture, inaugurated in 2008. The initial lecture was given by Harvey A. Lincoff, MD,1 and is included in the pages of this journal. The purposes of the Schepens Lecture are to honor the past, to celebrate the present, and to facilitate future progress.

Honor the past

The history of ophthalmology, as in other disciplines, is reflected in the life stories of the men and women who were its principal innovators, leaders, and teachers. One of Schepens's strengths, in fact, was his thorough acquired knowledge and erudition regarding the history of his field. Charles Schepens's life was important, and has been reviewed in biographies, histories, and memoirs, one of the most perceptive of the latter being that by Dr Lincoff.1 In an earlier age, bronze or marble statues were erected to remember major figures, and indeed, a bronze of Schepens stands in the Schepens Retina Associates Foundation office. Statues are static, however, and do not perpetuate ideas, but I believe that an endowed, named lecture is a particularly effective and meaningful way to sustain and communicate his vision. David Parke, MD, President of the American Academy of Ophthalmology, predicted in his introduction of Dr Lincoff that this lectureship may become “the main event at the Retina Subspecialty Day in all future years.” We indeed hope that in time it will take its place with other important lectures in ophthalmology, such as the Academy of Ophthalmology's Edward Jackson Memorial Lecture and the Association for Research in Vision and Ophthalmology's Friedenwald Lecture.

Celebrate the present

How quickly the present merges with the past and the future becomes the present. The binocular indirect ophthalmoscope that illuminated the fundi of Schepens's early patients now sits on permanent display in the Smithsonian Institute in Washington, DC, and, as Lincoff points out, “ . . . the blindness from a retinal detachment that was frequent before the emergence of Jules Gonin in 1929 became rare since the emergence of Charles Schepens in 1950.”1 Research that Dr Schepens foresaw and encouraged has permitted major refinements in instrumentation for the study and management of vitreo-retinal disorders. More of these disorders are now amenable to treatment, and such treatment has become less burdensome to the patient.

In this spirit of progress, we hope the Charles L. Schepens Lecture will enhance continuity between past pioneers and present-day clinicians, clinician-scientists, and basic scientists, and that it will encourage innovative approaches on the part of those entering these disciplines.

Facilitate future progress

Happily, Charles Schepens lived to see the dawning of what promises to be the greatest era of retinal research. It will include the introduction of additional generations of increasingly effective antiangiogenic agents for the treatment of eye disease, continuing progress in defining the genetic basis of eye disease and use of this knowledge in developing more specific and effective therapies, and fulfillment of the exciting promise that stem cell research holds. With the tools and knowledge that this research will provide, we can expect an age in which the emphasis is on disease prevention rather than therapy. In all of this, the basic scientist will play an increasingly prominent role. Fostering translational research and facilitating communication between scientists and clinicians becomes critical. We see a role here for the Schepens Lecture. The selection of speakers will be by a committee representing the Retina Society, the Macula Society, the American Society of Retinal Specialists, and the Gonin Society. This ensures an ongoing conversation between these organizations. The generous endowment of the lectureship ensures its stability.

Charles Schepens noted, “Great inventions are seldom the result of a totally new concept. They are nearly always based on previous thinking that somehow did not mature to its fullest potential.”2 In his own career, he elevated ophthalmoscopy to a new level and advanced and perfected the treatment of retinal detachment. Dr Schepens applied new technologies to existing methods. He organized, helped fund, and inspired translational and basic science research on the retina. As a teacher, he shared his knowledge and insights through one of the earliest modern retina fellowships. The sponsors of this new lecture seek to have it reflect and build on these ideas and ideals and thus contribute to the continuing advancement of knowledge of the retina and its diseases.

Correspondence: Alice R. McPherson, MD, Baylor College of Medicine, 7200 E Cambridge St, Houston, TX 77030 (alicem@bcm.tmc.edu).

Submitted for Publication: March 3, 2009; final revision received March 3, 2009; accepted March 4, 2009.

Financial Disclosure: None reported.

Lincoff  H The evolution of retinal surgery: a personal story.  Arch Ophthalmol 2009;127 (7) 923- 928Article
Schepens  CLChedid  NG Retinal detachment: historical perspectives. Albert  DMJakobiec  FA Principles and Practice of Ophthalmology. 2 Philadelphia, PA WB Saunders Co1994;1265