60 years of organized ophthalmology Mission accomplished, vision fulfilled

Salvador R. Salceda, MD

THE PHILIPPINE Academy of Ophthalmology (PAO) is celebrating the 60th anniversary of organized Ophthalmology in the country. The occasion provides Filipino eye physicians and the public many opportunities. It is a time, as planned, for socially relevant activities that accrue to the understanding, appreciation, and possession of functionally useful eyes. The celebration can be a time for reexamination of roles and reflection on responsibilities in light of a great medical paradox—that the many who are poor and disadvantaged continue to be strangers to the great progress in ophthalmic science and technology. Finally, the occasion may be a time of remembrances of the early beginnings of the medical specialty and of its Filipino pioneers in the country. Importance of sight Sight is important. As much as 80 percent of our learning and work processes are performed with the help of sight. Along with the other four senses—touch, taste,
smell, and hearing—sight is our window to the empirical world. Through these senses, we are inextricably bound to what is outside of us. And if reality is what we experience, the visual images we construct, store in, and retrieve from our “memory bank” contribute to the pool that is our total experience. These images link us to our past, anchor us to our present, and perhaps provide us glimpses of our future. The eye is our organ of sight. It is like a spherical camera consisting of a focusing lens system and a film that captures to the last and finest detail that which comes to us via the visible light. It has evolved through millions of years, from a simple dot of pigment on the surface skin of the simplest invertebrates to the pair of globes that became, for the first time, frontally placed in the heads of our simian ancestors. There, side by side in perfect partnership, they give us a field of vision with breadth and depth as if to admonish us to be comprehensive and profound. And through some mysterious ways science has yet to fully unravel, we see our world not in the drabness of white and black, of light and shadows, but in the lushness of colors that along with form, aesthetics and visual art use as powerful tools to express and to arouse human emotions. Our eyes have served and continue to serve us well. From our first conscious act to cease being a mere figure in the horizon to our willful acts of shaping that
horizon, we rely on our eyes. From the more mundane concerns required by our daily lives to survive to our ennobling and edifying achievements, we use our eyes. Verbal thought has its uses. But it is imperfect, language itself is inadequate. Indeed, a picture is worth a thousand words, a wise man said.

Brief history Ophthalmology came to the Philippines early. It was taught in the medical school of the University of Santo Tomas (UST) in 1871. An eye dispensary was opened in San Juan de Dios Hospital in 1906. No less than Dr. Jose P. Rizal, after his training in Europe, practiced the specialty in the Philippines from 1887 to 1896. America may have introduced the EENT tradition in the Philippines, but it was supportive of the development of Ophthalmology in the country. With increasing opportunities for training in the USA, complementing
those in Europe, many Filipino physicians pursued Ophthalmology as a specialty. The return of these new specialists presaged the creation of the Eye Departments, which were crucial instrumentalities for the teaching. These and the organization of the eye societies, the institutionalization of the capacity for scientific research, the scientific journals, eye banks, blindness prevention societies, and others contributed to the formative and consolidation stages of the specialty. The development of Ophthalmology as a separate specialty in the Philippines was Dr. Geminiano de Ocampo’s apostolate. Weaning Ophthalmology from Otolaryngology at a time the EENT tradition was already firmly institutionalized in the teaching institutions and by professional specialty society was not easy and would take more than a decade to achieve. The 1950s were propitious years for Ophthalmology. The Philippine Eye Bank for Sight Restoration was organized in 1951 as mandated by Republic Act No. 349. Dr. de Ocampo established the first eye hospital in Manila in 1952. President Ramon Magsaysay issued Proclamation No. 49 in July 1954, mandating the yearly observance of National Sight Saving Week. In 1958, the National Society for the Prevention of Blindness was organized to take charge of the observance from the Philippine Eye Bank. In September 1958, during the 18th International Congress of Ophthalmology in Brussels, the Asia-Pacific Academy of Ophthalmology was organized with Dr. de Ocampo as its first president. The Academy brought into one organization the eye societies of the member countries in the region. It assigned the Philippines to host the first congress in Manila in 1960. Even more significant to the growth of Ophthalmology in the Philippines was the creation of eye departments in the medical schools and in their training hospitals. In 1954, the Manila Central University established the first eye department for its medical school and training hospital with Dr. Edgardo Caparas as chairman. In 1961, the eye section of the EENT Department of the PGH, the training hospital of the UP College of Medicine, was formally converted to a separate department by the University’s Board of Regents with Dr. Geminiano de Ocampo as the first chairman.

The UST Medical School became the third educational institution to have a separate eye department in 1984 with Dr. Cosme Naval as chairman. More would follow. Not only were eye departments created by separating existing EENT departments, but by organizing new ones in medical schools and training hospitals that were later established. Essential to the growth and development of Ophthalmology is the need for an instrumentality that facilitates the exchange and sharing of knowledge and expertise in the spirit of collegiality and brotherhood. On November 25, 1945, 24 practicing Filipino EENT physicians gathered at the old North General Hospital along España Street in Manila and organized the Philippine Ophthalmological and Otolaryngological Society (POOS), the first medical specialty to be formed in the country and officially recognized and affiliated with the Philippine Medical Association. The Society’s main goal was to contribute to the growth and development of the specialty. It established an EENT Library; published a journal, the POOS Bulletin in 1946 which became the Philippine Journal of Ophthalmology and Otolaryngology in 1955; held regular scientific meetings often with foreign specialists; and created a Qualifying Board in 1950, which was reorganized into the Philippine Board of Ophthalmology and Otolaryngology in 1954 to certify to the competency of the practitioners. By the end of the 1950s, Filipino ophthalmology practitioners considered a separate eye society essential to the growth of the specialty in the country. With the organization of the Asia-Pacific Academy of Ophthalmology in 1958 and the designation of the Philippines as host of the Academy’s first congress in Manila in 1960, the decision to establish an eye society became so compelling that Filipino ophthalmologists did create not one but two eye societies: the Philippine Ophthalmological Society (POS) on October 24, 1958 and the Ophthalmological Society of the Philippines (OSP) on November 25, 1958. Each group firmly believed that its society was the true eye society in the country. With the help of Dr. Conrado Banzon as POOS president, and the selflessness of the incumbent presidents of the OSP and POS, Dr. Manuel Hechanova and Dr. Liborio Mangubat, respectively, these two societies would merge into the Philippine Society of Ophthalmology (PSO) in 1970. A new constitution and by-laws were formulated and ratified with the election of new officers. The POOS that gave birth to the OSP would transform itself into the Philippine Academy of Ophthalmology and Otolaryngology (PAOO) in 1970 to perform roles complementary to those of the PSO and the Philippine Society of Otolaryngology and Broncho-esophagology in the area of graduate, postgraduate, and continuing education and training.  In 1971, the Society designated the PHILIPPINE JOURNALOF OPHTHALMOLOGY as its official journal for the scientific works of Filipino ophthalmologists. Starting as the Section of Ophthalmology in the Philippine Journal of Surgery and Surgical Specialties, then as the Transaction of the Philippine Ophthalmological Society, it finally became the PHILIPPINE JOURNAL OF OPHTHALMOLOGY in 1969 with Dr. Romeo Fajardo as editor in chief.

In 1974, the Society supported the 1966 initiative of the University of the Philippines-Philippine General Hospital (UP-PGH) Department of Ophthalmology to publish an ophthalmology textbook for medical students and general medical practitioners. Completed in 1980 and authored by Drs. Romeo Fajardo, Romeo Espiritu, and Cosme Naval with a host of other Filipino ophthalmologists, the Textbook of Ophthalmology helped standardize the teaching of the specialty in undergraduate medicine. The PAOO institutionalized the program of graduate, postgraduate, and continuing education in the specialty. It conducted seminars, symposiums, instructional courses, and workshops on selected topics in ophthalmology with Filipino and foreign faculties and experts. It also established the Jose P. Rizal Memorial Lectureship in Ophthalmology in 1955 to give recognition to Filipino and foreign ophthalmologists who contribute to the growth and development of the specialty in the Philippines. The PSO also organized its own lectureship, the Luis Santos Memorial Lecture, in 1978, which was given by the outgoing president of the society. In 1971, it created the Philippine Board of Ophthalmology with the functions of accrediting ophthalmology residency training programs and certifying through examinations those completing the training. It laid down the appropriate guidelines for eye departments wanting to organize training programs. It also welcomed the initiative of the UP-PGH Department of Ophthalmology to organize the Basic Courses in Ophthalmology and the Seminars on Clinical and Surgical Ophthalmology for all eye residents in the country. In December 1995, the PAOO and the PSO merged to form the national eye society, the Philippine Academy of Ophthalmology (PAO), an organization distinct from the Philippine Academy of Otolaryngology. This new era was marked by tangible camaraderie among the different officers and members of the Academy that was not seen before. As the Filipino ophthalmologists increased in number and grew ever conscious of their expanding responsibilities, professionally and morally, they committed themselves collectively to help address the problem of eye health and blindness in the country. The commitment took the form of socially oriented projects and activities that address the lack of access to needed
eye health-care services among the disadvantaged. National Blindness Prevention Program
Filipino ophthalmologists have always been prodigious in their work to help address blindness as a public health problem. With the optometric and civic groups, they conduct public information on eye care and sight preservation. They provide direct ophthalmic and optometric services to indigents and in places where the government does not have the needed facilities and services. In the past, much of the work on blindness prevention of these organizations were uncoordinated for lack of a common plan. The annual observance of Sight Saving Week and the activities of the National Society for the Prevention of Blindness, at best, increased
awareness on the importance of sight but created expectations for needed services that could not be met adequately. All of these changed with the merger of the two ophthalmologic societies into PAO, whose vision is “that every Filipino will have access to quality and affordable eye care; no Filipino will succumb to preventable blindness.” The Academy seeks to influence the formulation and implementation of eye-health policies; to uphold the technical and ethical standards of ophthalmology as a profession; to assume full moral responsibility for the reduction and prevention of remediable blindness; to lead in information dissemination and public education on primary eye care and preventable eye diseases; and to protect and promote the professional needs of its members and to ensure continuing medical education. The Academy has actively participated over the years in various community projects and missions to different parts of the country in the hope of eradicating blindness from preventable causes and providing quality care in areas where medical assistance is lacking. It upholds the aims of the national prevention of blindness program in reducing blindness prevalence rate from 1.07% to 0.5% with no community or province having a rate greater than 1.0% by the year 2000. It also seeks to reduce the cataract backlog by 50% within 5 years and the prevalence of Vitamin A deficiency to 0.4%. In 1999, the Asia Pacific Congress of Ophthalmology was held in Manila for the second time with more than 1,000 local and foreign participants. The convention was considered a success with many distinguished foreign and local speakers giving seminars and workshops. This was followed in 2003 by the first PAO-SERI meeting held in collaboration with the Singapore Eye Research Institute, with emphasis on basic and clinical research. As the Academy moves onward to becoming internationally recognized for its services to fellow countrymen and contributions to world ophthalmology, the upcoming PAO-AAO international meeting in November where “Asia meets America” is sure to bring in many international renowned speakers and foreign delegates alike in a convention guaranteed to meet the minds of the best and provide many fruitful discussions on the problems encountered in ophthalmology.