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JAMA Revisited
June 11, 2019


JAMA. 2019;321(22):2248. doi:10.1001/jama.2018.15374

Originally Published June 15, 1889 | JAMA. 1889;12(24):846- 847.

The ophthalmoscope, at one time considered as nothing but an interesting scientific toy, has become an indispensable instrument in physical diagnosis. Its history is a succession of triumphs. The wonderful progress made within the last thirty years in ophthalmology is altogether due to this instrument. By its means the neurologist has been able to penetrate the mystery which enshrouded many cases of brain and spinal disease, and our knowledge of kidney diseases, secured from the ophthalmoscope a valuable contribution when it revealed the existence and nature of the various forms of ocular disturbances concomitant with and due to nephritic disorders. In view of these facts should not the use of so important an instrument be thoroughly taught in our medical colleges? Should not every physician be equipped not with the instrument alone, but with the knowledge and experience necessary for its practical use. Yet how far we are from this state of things. How few of our graduates know how to "throw light into the eye," and of these how small the number who know what they see in the field thus illuminated. If these men only knew enough to know what they don't know, the case would not be so bad, but ignorance is proverbially arrogant, and hence the mistakes of the ignorant are prone to escape correction. It is really humiliating to witness a graduated physician attempting to examine an eye while the light reflected from the mirror is seen illuminating the wall beyond the patient's head, and how often serious blunders in diagnosis occur is best known to those who have had an opportunity to watch graduates at work with this instrument.