Ophthalmoscope or Augenspiegel?

We read with great interest the article by C. Richard Keeler titled"The Ophthalmoscope in the Lifetime of Hermann von Helmholtz."¹ Mr Keeler describes in detail the 1851 invention of the ophthalmoscope and puts it into the appropriate historical perspective of the ophthalmological world of the 19th century.

We would like to add one fact to this story that might be of interest to your readers. When Helmholtz first described his instrument, he called it an Augenspiegel, ² and from 1851 to 1854 the German-speaking pioneers of ophthalmoscopy (Helmholtz, Ruete, Coccius, Stellwag, Liebreich, Jaeger, and others) used the words Augenspiegel (eye mirror) and Augenspiegeln (eye mirroring). Augenspiegel was an old word from the Middle Ages; it had been used for "eyeglasses" by both Zwingli(1484-1531) and Paracelsus (1493-1541) long before Helmholtz chose to use it as the name of an instrument designed to view the fundus of the living eye. The word ophthalmoscope was first introduced by Maressal de Marsilly from Calais, France, in 1852 and was used for an instrument constructed by Nachet and Follin, which was a modification of the Augenspiegel by Helmholtz.³ Until then, the term ophthalmoscopy had been used for the plain macroscopic examination of the exterior of the eye. The Greek ophthalmologist Andreas Anagnostakis (1826-1897), however, was the first to use the term ophthalmoscope for the Augenspiegel of Helmholtz and published the first systematic study on ophthalmoscopy in the French language in 1854.⁴ Anagnostakis, who was the first director of the newly founded University Eye Hospital of Athens (the Ophthalmiatreion), visited von Graefe's clinic in Berlin, Germany, in 1853 and saw that Helmholtz's Augenspiegel was being widely used. He then designed a version that gathered light with a small concave mirror and had a central viewing hole, a modification of Ruete's indirect Augenspiegel.⁵ His instrument was made by the Soleil company in France, and it was called an ophthalmoscope, a word derived from the Greek words oφθαλµóσ(ophthalmos = eye) and 𝛔κoπóσ(skopos = observer). After the publication of the description of this popular instrument in 1854, the words ophthalmoscope and ophthalmoscopy increased in popularity until they were adopted by the international ophthalmological community. They have been in general use throughout the world ever since.