Ophthalmology and Visual Sciences

  • A Brief History of Ophthalmology at the University of Iowa

    In 1925, Cecil Starling O'Brien was hired as the head of the newly autonomous Department of Ophthalmology at the University of Iowa. Prior to 1925 it had been the first "E" in the EENT (Eye, Ear, Nose and Throat) clinic. In 1925, it was considered to be quite progressive for Iowa to have a full time professor of ophthalmology, and having an entire department of The College of Medicine devoted to a little organ like the eye was very unusual.

    At the time O'Brien started, plans were underway to build the new University of Iowa Hospital on the west side of the Iowa River in Iowa City. Its gothic tower, finished in 1928, became a landmark in Iowa City and can still be seen peeking out amongst the buildings that have been added to the hospital over the decades.

    The tradition of morning rounds, started by O'Brien, used by Braley, Blodi, Phelps, and Weingeist, is still followed and upheld by Carter. However, O'Brien's three year program that accepted only one resident per year, has expanded to a program that accepts five residents and about 12 fellows each year and the faculty has increased from three to forty-two and includes not only physicians, but basic science researchers.

    C.S. O'Brien Portrait by Lee AllenIn 1928 the department's few offices and the in-patients were housed on the second floor of the new general hospital. During his years at Iowa, O'Brien added faculty to educate new ophthalmologists about the basic and clinical sciences of ophthalmology. In 1937 Lee Allen was hired to draw the fundus of the eye. With encouragement from Dr. O'Brien, Allen developed a number of photographic and gonioscopic techniques and published them in the ophthalmic literature. O'Brien also hired Peter Salit, a biochemist interested in cataract formation, and Phillips Thygeson who was interested in the microbiology of the eye.

    O'Brien was elected by the American Board of Ophthalmology to be a director in 1937. This was clear recognition that he had built a distinguished department in the corn fields of Iowa and that he was a national leader in the training of ophthalmologists. He served on the board until 1950.

    The eye department had outgrown its space by 1946. Lee Allen and Dr. O'Brien worked together to plan the new space. The work was completed in 1949, just before O'Brien left.

    The newly remodeled and expanded space in 1949 was an improvement. The new Clinic area was a 24 by 40 foot room. Each resident was provided with a small desk and a chair for the patient to sit in. The Snellen eye charts were on the south wall and the 20 foot line was marked on the floor with a piece of adhesive tape. There were two examining chairs with head rests in the clinic, each with a nearby equipment stand. These two chairs were used in the event that an eyelid needed to be everted, a conjunctiva needed to be cultured, or perhaps a lacrimal duct probed. The "dark room" was a 12 by 20 foot room just beyond the back wall of the clinic. It had four slit lamps with stools, a keratometer and a table-mounted binocular ophthalmoscope. Later, a cot was added for indirect ophthalmoscopy. There were four 20 foot refraction lanes with plywood partitions that did not reach the ceiling. The 12 by 24 foot sun porch at the south end of the ward was converted into a department library by bricking up most of the windows and lining the walls with bookcases. Lectures for the residents were given in this room.

    When Dr. O'Brien announced his intentions to retire in 1949, the department was soon in turmoil. By the time Alson E. Braley took over as head of the department in 1950, he was left with one faculty member, P.J. Leinfelder, who had been one of Braley's teachers when he had been a resident at Iowa under O'Brien.

    Braley's first task was to build up the teaching faculty by gathering a group of ophthalmic sub-specialists. Under Dr. Braley, Lee Allen returned from New Orleans to continue his distinguished career as artist, photographer, inventor, and ocularist. The list of faculty added under Braley reads like a Who's Who in Ophthalmology: Frederick Blodi in ocular pathology, Herman Burian and Gunther von Noorden in pediatric ophthalmology, Paul Boeder in optics, Edward C. Ferguson and Robert C. Watzke in retinal surgery, and Mansour Armaly in glaucoma. Dr. Braley also founded the Iowa Eye Bank in 1955, one of the first in the nation, and brought corneal transplants to Iowa.

    Alson E. Braley P.J. Leinfelder Robert C. Watzke

    As the department grew, it was no longer possible to follow the Chief from bed to bed each morning as had been the custom established under O'Brien. So Dr. Braley chose to hold Morning Rounds in the clinic and have the patients come to him. Morning Rounds continue to this day as an important part of the teaching program with residents telling the clinical story of patients seen in the clinic and lively discussions between residents, fellows, and faculty.

    In 1967, Dr. Braley retired and Dr. Frederick Blodi was chosen as his replacement. Dr. Blodi, born, reared, and trained in Austria, came to the United States after World War II and met Dr. Braley when they were both at Columbia in New York. Braley recruited Dr. Blodi to teach ophthalmic pathology at Iowa.

    Dr. Blodi continued adding faculty. During his first decade as head, there was also a considerable amount of construction. In 1970, the new general clinic area and the Braley Conference Room were completed and in 1971, the new C. S. O'Brien Library was built. In 1973 a neuro-ophthalmology clinic was added. In 1974 and 1975, the pediatric and oculoplastic clincs were completed.

    In the fall of 1983, Dr. Blodi decided to pass the reins of the department to someone else and in 1984, the Dean announced that the new head would be Charles Phelps, a well respected glaucoma specialist who had been a resident at Iowa. Unfortunately, shortly after he took charge, Dr. Phelps was diagnosed with a malignant throat cancer and died in 1985. Despite his illness, Dr. Phelps served the department well, adding 5 new faculty members in this short time.

    F. C. Blodi  Charles D. Phelps Thomas A. Weingeist

    In 1986, Thomas A. Weingeist was named the new head. After finishing his Ph.D. in Anatomy at Columbia in New York, Dr. Weingeist finished his MD at Iowa and stayed on through his ophthalmology residency and retina fellowship before joining the faculty in 1976.

    Dr. Weingeist's first decade as head ended spectacularly with the move of the department into the brand new facility, The Eye Institute opened on the ground floor of the new Pomerantz Family Pavilion at the southernmost end of the medical center on February 19, 1996.

    With the move into this new space of nearly 60,000 square feet, the eye department has been improved and modernized. In the new facility are 10 sub-specialty areas with a total of 54 examination rooms that are equipped with the latest in current instrument technology. The Ophthalmic Procedure Suite has three rooms for minor surgery. One of these rooms is in frequent use by the oculoplastic service and has an overhead video recording system. Rooms off of the retina and glaucoma sub-specialty clinic are also equipped with lasers, one is used for laser refractive surgery. The Blodi conference room is on the first floor and is used daily by various committees and working groups. The lower level has the O'Brien Library where residents and staff can study, prepare presentations, and do computer searches. The new Braley Auditorium, where Morning Rounds, resident lectures, and conferences are presented, is equipped with up-to-date computer, video and audio and is connected with fiber-optics for teleconferencing.

    After nearly twenty years as Head, Dr. Weingeist stepped down in order give himself more time to pursue his research and clinical work and on January 1, 2006, Keith D. Carter became Department Head.

    Keith Carter

    The tradition of morning rounds, started by O'Brien, used by Braley, Blodi, Phelps, and Weingeist, is still followed and upheld by Carter. However, O'Brien's three year program that accepted only one resident per year, has expanded to a program that accepts five residents and about 12 fellows each year and the faculty has increased from three to forty-two and includes not only physicians, but basic science researchers.