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August 2001

Norman Henry Ashton, CBE, DSC(Lond), FRCP, FRCS, FRCPath, FRCOphth, FRS, KSTJ (1913-2000)

Arch Ophthalmol. 2001;119(8):1229-1230. doi:10.1001/archopht.119.8.1229

Last year began with the loss of a very dear friend and colleague who had been an internationally renowned leader in ophthalmic pathology, Professor Norman H. Ashton of London (England). Of humble origins, young Norman left school at age 16 years to begin working as a laboratory assistant in a West London hospital.1 Subsequently, the head of the laboratory further encouraged Ashton's interest in medicine, suggesting that he train to be a doctor. According to Alec Garner, MD, PhD, some initially considered that suggestion to have been made in jest, since "going to University wasn't something the Ashtons did." Nevertheless, Ashton did "read medicine" at King's College London and Westminster Hospital Medical School (London). After qualifying by age 26 years, Ashton specialized in pathology and was appointed a pathologist at the Kent and Canterbury Hospital from 1941 to 1945. He then served in the Royal Army Medical Corps in West Africa and Egypt from 1945 to 1947.

Figure 1.
Norman Ashton at the start of
his tenure as Director of the Department of Pathology at the Institute of
Ophthalmology at Moorfields.

Norman Ashton at the start of his tenure as Director of the Department of Pathology at the Institute of Ophthalmology at Moorfields.

Figure 2.
A recent photo of Norman Ashton
taken shortly before his death in January 2000.

A recent photo of Norman Ashton taken shortly before his death in January 2000.

When Ashton returned to London following the end of World War II, Sir Stewart Duke-Elder was completing his staffing of the new Institute of Ophthalmology at Moorfields Hospital (London) where he was director of research. Sir Steward selected Norman Ashton as head of the pathology department despite his lack of any special training or experience in ophthalmic pathology. That was the insight of a genius headhunter! Ashton began his tenure as the first director of the Department of Pathology at the Institute of Ophthalmology in 1948. During nearly a century before that, the most exalted position in the English-speaking world for an ophthalmic pathologist had been the joint position of pathologist curator and librarian at Moorfields Hospital, held by such notable figures as Edward Treacher Collins, Sir J. Herbert Parsons, George Coats, and Edward Nettleship.2 These gentlemen were clinical ophthalmologists who earned their living in their practice of ophthalmology while contributing their time and interest in ocular pathology to Moorfields Hospital on a part-time basis. The new full-time position of head of the department of pathology at the Institute of Ophthalmology was the first of its kind in England.1,2 From the beginning of his tenure, Ashton provided a comprehensive service encompassing all of the major pathology disciplines required for diagnostic histopathology and research, including experimental pathology. Not only did his laboratory provide the clinical laboratory and anatomic pathology services for Moorfields Hospital, but also consultation services for all of the British Isles and, in fact, the entire British Empire, which afforded Ashton and his staff the opportunity to study ocular involvement in various exotic diseases. During his 30-year tenure before reaching the mandatory retirement age of 65 years, Ashton established his worldwide reputation as the leading experimentalist in ophthalmic pathology, with major contributions toward understanding the pathogenesis of the retinopathy of prematurity, diabetic and hypertensive retinopathy, the nature of cotton-wool spots, and the pathogenesis of primary open-angle glaucoma. He attracted many well-trained general pathologists for prolonged periods of training in ophthalmic pathology, one of whom (Alec Garner) became Ashton's successor as director of the department of pathology when he retired in 1978.

Ashton had no peers when it came to incorporating his remarkable talents in the arts with his professional activities in ophthalmic pathology. He was a talented painter in oils and applied that artistry to his research preparations. His command of the English language was awesome, and when coupled with his eloquence, charm, and wit, put him in great demand for after-dinner speeches and for participation in national and international meetings of ophthalmologists and pathologists. The legendary Bob Hope augmented Ashton's celebrity in the after-dinner public speaking arena when they shared the stage as speakers at a dedication of a new research wing for the Wilmer Institute. Ashton spoke first and so delighted the audience with his humor as well as his serious commentaries about the importance of scientific studies and research to the progress of ophthalmology, that the prolonged applause prompted Bob Hope to complain that he had not been warned that he was to share the platform with a "funny eye doctor"! Many who witnessed that performance left uncertain as to which of the two had been the more entertaining performer. However, as Garner has stated, Ashton had been much more than an entertainer on that occasion, for his speech stressed the importance of research and his disapproval of medical research that did not have an end point of relevance to patient care.1

According to the current directors of the Institute of Ophthalmology (Adam Sillito, PhD, and Phil Luthert, PhD),3 Ashton's legacy comprises not only the results of his own research but also the structures he has left behind. His clear thinking was central to the creation of the current Institute of Ophthalmology building on a joint site with Moorfields Eye Hospital. And by pivotal contributions to the establishment and growth of the national charity Fight for Sight (London), he ensured that the current generation of researchers would be in a position to carry on where he left off. Garner expressed similar thoughts,1 stating that Ashton's "commitment to the Institute was total." Success in research is determined not only by ideas but the availability of resources to pursue them and Norman threw himself heart and soul into supplementing the Institute's research funds. He was a key element in creating and working for Fight for Sight, a charity primarily devoted to supporting the research activities of the Institute. In this he was far from self-seeking; very little of the money he helped raise supported his own department. This selfless commitment was further demonstrated in his taking up the chairmanship of the charity after stepping down from his position as the chairman of pathology in 1978. His role in making it possible for the Institute to move to more adequate premises next to Moorfields Eye Hospital and then to expand the facilities was recognized in naming the newest development, open only last year, the Ashton Wing.

In 1959 Norman Ashton had been the first European guest of honor at the annual meeting of the American Ophthalmic Pathology Club, and 2 years later Ry Anderson of Copenhagen, Denmark, was similarly honored. Both were greatly impressed and stimulated by several of the unique features of this meeting, which had no counterpart in Europe. This led Ashton to propose, with the assistance of Anderson and Willem Manschot of the Netherlands, the development of a similar organization, the European Ophthalmic Pathology Society.4 Despite the fact that at its first meeting at the Royal College of Surgeons in London in 1962, many of the participants were unable to make their presentations in English, and some of the founding members had not previously met, all were in agreement that the meeting was a huge success and that Norman Ashton deserved special credit for making it possible. Accordingly, he was unaminously elected President for the period 1962-1965 and subsequently designated Life President in 1965.

Ashton was widely recognized and fittingly acclaimed. He received the Proctor Gold Medal (1957), Doyne Lecture Medal (1960), Bowman Lecture Medal (1963), Donders Lecture Medal (1967), William MacKenzie Memorial Lecture Medal (1967), Baron C. Ver Heyden de Lancey Medical Art Society Prize (1978), Gonin Gold Medal (1978), and Jules Stein Award (1981). He was elected Fellow of the Royal Society of London (1971), Honorary Fellow of the Royal Society of Medicine (1979), Honorary Member of the American Ophthalmologic Society (1989), and Honorary Fellow of the Royal College of Pathologists, London (1992). In 1976 Ashton was appointed by Her Majesty the Queen, as Commander of the Order of the British Empire. Amazingly, Norman Ashton, who was a pathologist, not an ophthalmologist, was made President of the Ophthalmological Societies of the United Kingdom, presiding over its Centenary Meeting of 1980. What an expression of affection as well as appreciation for what this great pathologist had done for ophthalmology! He was selected to be the Helen Keller Prize Laureate for 1998, awarded for vision research at a ceremony usually held at the annual meeting of the Association for Research in Vision (Rockville, Md), but owing to Professor Ashton's deteriorating state of health, the Helen Keller Foundation arranged to have its presentation take place during the 1998 Oxford Ophthalmological Congress in Oxford, England.

Although, as Alec Garner stated, Norman Ashton may not have been "born with a silver spoon in his mouth," his parents certainly endowed him with a remarkable set of genes, which he exploited in remarkable ways, one of which was his role in establishing and then running the European Ophthalmic Pathology Society. Having recently returned from the 2001 Joint Meeting of the European Ophthalmic Pathology Society with the Verhoeff-Zimmerman Society in Zurich, Switzerland, I know that Norman Ashton would have been very proud of the continued progress that the Europeans have made with their society.

Garner  A Norman Henry Ashton.  Presented at: Memorial service for Norman Henry Ashton May 9, 2000 London, England.
Albert  DM The development of ophthalmic pathology: Norman Ashton. Albert  DMEdwards  DD The History of Ophthalmology. Cambridge, Mass Blackwell Science1996;100- 101
Sillito  ALuthert  P Norman Henry Ashton, CBE, DSC (Lond), FRCP, FRCS, FRCPATH, FRCOPHTH, FRS, KSTJ [obituary].  Br J Ophthalmol. 2000;84443Crossref
Zimmerman  LE The European Ophthalmic Pathology Society.  Arch Ophthalmol. 1962;68157- 158Crossref