Pioneer in eye research

The Institute of Ophthalmology is now known locally and internationally not only for its valuable contribution to Philippine ophthalmology through research and publication, but also for having produced the pillars of Philippine ophthalmology.

THE IDEA of a Philippine eye-research institute evolved in response to the problem of blindness in the country. To Dr. Geminiano T. de Ocampo, there was a need for an institute to study blindness among Filipinos, utilizing the basic laboratories—pathology, microbiology, biochemistry, and other scientific disciplines— to understand the disease process in the eye and its relation to the whole human-body system.1

The Philippine Eye Research Institute was created on June 19, 1965, through Republic Act 4593, to undertake and promote research on eye health and eye diseases in the Philippines. It was formally established by the University of the Philippines (UP) Board of Regents on October 22, 1966. As the premier eyeresearch center in the Philippines, it was tasked to:

1. undertake clinical, applied, and epidemiological investigations on eye diseases;
2. conduct basic studies on different eye diseases;
3. perform the research functions of the UP Department of Ophthalmology;
4. collaborate with scientific researchers in other fields of medicine;
5. provide stimulation and assistance to ophthalmic research elsewhere in the country;
6. cooperate with scientific research activities here and abroad; and
7. formulate plans, activities, or proposals and recommend policies, procedures, rules, and regulations for adoption by the Board of Regents consistent with its powers and effective operation.

What started as a small study group interested in corneal diseases and corneal transplantation has now become an organized study group engaged in basic ophthalmologic research and involved in national eye health programs. The Philippine Eye Research Institute consolidated and directed the research activities of the Department of Ophthalmology under a separate program and management. These were pursued more aggressively and systematically, complementing the ophthalmic teaching of the university’s medical students and ophthalmology residents. The first building near the Department housed the support laboratories—Experimental Ophthalmic Pathology, Experimental Ophthalmic Surgery including the Animal House, Ocular Microbiology and Immunology, Biochemistry, Ophthalmic Photography, and Administration. The ophthalmic equipment was donated by the Rockefeller Foundation through Dr. Lucien Gregg. The Institute opened its doors in June 1967 with Dr. de Ocampo as acting director.

The Institute developed and pursued its research agenda and that of the Department. It developed research programs, facilities, and expertise. Concerns included studies on corneal diseases and corneal preservation, ocular infection, cataract, diabetic retinopathy, glaucoma, malnutrition blindness/ xerophthalmia, motility, uveitis, and retinoblastoma among other areas. Through the years, the Institute was able to upgrade its facilities and ophthalmic equipment and acquire funding for its research. It acquired the first argon laser in the Philippines from the National Science and Development Board for research on diabetic retinopathy; the first Konan SP 5500 Specular Microscope with cell analyzer for in vivo studies of corneal endothelium from Don Emilio T. Yap; the top-of-the-line Zeiss fundus camera with computer, and Fluron fluorophotometer for posteriorsegment studies from former senator Orlando Mercado.

The Institute collaborated with other agencies in the pursuit of new knowledge in the promotion of eye health and prevention of blindness. Among the tie-ups were those with Helen Keller International in 1974–76 for the Vitamin A Deficiency/Xerophthalmia Project, and with IMPACT UK and IMPACT Philippines in 1991–93 for the Cataract Backlog Management Project– Sight Restoration in the Philippines.

The commitment of the Institute to Philippine ophthalmology and to the World Health Organization was to define and characterize eye health and the blindness problem in Filipinos.2 As the national eye research center, the Institute was designated to take the lead role in planning and formulating eye-health policies. In cooperation with other nongovernment organizations, it formulated and published the National Sight Plan in 1979. It joined the global interest on blindness prevention by initiating and developing the program on Preventive/Public Health Ophthalmology and Primary Eye Care. As part of program development, it enhanced its expertise by sending two researchers to training courses abroad (Dr. Rossina Ramirez to Baltimore, Maryland, for a one-year fellowship in Preventive Ophthalmology and Dr. Evangeline Santos to London for a six-month course on Community Eye Health). At the same time, Dr. Salvador R. Salceda became a member of the World Health Organization’s advisory group on Blindness Prevention and the organizing committee of the Public Health Ophthalmology course in Korat, Thailand. The Institute’s commitment to blindness prevention in the Philippines is now defined and is provided by its researchers with expertise on the program.

The Institute assessed the blindness problem through the first population-based blindness survey,3 which was done simultaneously with the National Nutrition Survey. The results provided an organized epidemiology database on local blindness, a prerequisite to the development of a national program on blindness prevention. The survey showed that cataract was the single largest remediable cause of blindness among Filipinos. The Institute did 2 more blindness surveys with the Department of Health.4, 5 The results served as the basis for the development of prevention of blindness and eye-health programs.

After more than 35 years, the graduate program in ophthalmology is now a reality. The UP Board of Regents recently approved the Diploma in Preventive Ophthalmology, which is being offered by both the Institute and the Department of Ophthalmology and Visual Sciences of the UP College of Medicine. The new course aims to train Eye MDs on the promotion of eye health and prevention of blindness appropriate to our needs and resources. Another program aimed at delivering eye-health services in underserved areas is the Modified Residency Training Program in Ophthalmology.6 The program is the contribution of the Institute and the Department to the campaign for reduction of blindness prevalence in the country by providing appropriate ophthalmic care, services, and manpower.

The Institute of Ophthalmology is now known locally and internationally not only for its valuable contribution to Philippine ophthalmology through research and publication, but also for having produced the pillars of Philippine ophthalmology.7 Among them are:

• Dr. Geminiano T. de Ocampo, National Scientist (Medicine) and founding director of the Institute whose contributions to Philippine ophthalmology, particularly on ocular diseases, are immeasurable.
• Dr. Salvador R. Salceda, director of the Institute for more than 20 years and noted for his commitment to the study of fungal ulcer and the prevention of blindness in Filipinos.
• Dr. Roberto N. Sunga, expert in optics acknowledged for his PERI Color Test, a screening tool for night blindness in early xerophthalmia; he introduced visual aids to visually disabled Filipinos.
• Dr. Vitaliano B. Bernardino Jr., who established the Ophthalmic Pathology Section of the Institute.
• Dr. Alejandro S. de Leon, for his valuable input in the formulation of the National Sight Plan and the Department of Health’s Prevention of Blindness.
• Dr. Romeo V. Fajardo, for his studies on uveitis in Filipinos and his contribution to ophthalmic literature by spearheading the publication of the first local Textbook of Ophthalmology and as founding editor of the PHILIPPINE JOURNAL OF OPHTHALMOLOGY.
• Dr. Romeo B. Espiritu, for his studies on retinoblastoma in Filipino children.
• Dr. Pacifico V. de Ocampo Jr., expert in fluorescein angiography, for his studies on diabetic retinopathy in Filipinos and for setting up the Institute’s retina program and acquiring the first argon laser in the Philippines.
• Dr. Mario J. Valenton, for his studies on ocular infection and for setting up the first External Disease Clinic together with Dr. Salceda.
• Mrs. Lilia Flor C. Nievera, for her studies on ocular microbiology in Filipinos.

Membership in the International Union of Nutritional Sciences was granted to Dr. Salvador R. Salceda and Dr. Rossina Lydia A. Ramirez in recognition of their research on vitamin-A deficiency. Likewise, Dr. Ramirez introduced and formalized the teaching of Ophthalmic Epidemiology and Biostatistics, an essential requisite in eye research. Dr. Evangeline O. Santos was awarded by the Asia-Pacific Academy of Ophthalmology for her work on the prevention of blindness in the Philippines.

After 40 years, the Institute has characterized ocular diseases and their diagnosis and treatment in Filipinos. It has conducted three population-based blindness surveys, which assessed the blindness problem in the Philippines and served as the basis for the development of eye-health and preventive ophthalmology programs. With several awards for published and communicated research papers, and recognitions given to its researchers for their contributions to ophthalmology, the Institute is indeed the national center for eye research.

Under its present director, Dr. Manuel B. Agulto, the Institute of Ophthalmology continues to be the research arm of the Department of Ophthalmology and Visual Sciences located at the newly established Sentro Oftalmologico Jose Rizal located within the Philippine General Hospital compound. As stated in RA 4593, the Institute and the Department together play the lead role in Philippine ophthalmology in pursuit of a common agenda—eye health for all Filipinos.