A RICH HISTORY

There is hardly a European country with as rich a history in medicine and ophthalmology as Greece. Democritus first described the eye around 450BC. Later, Hippocrates of Kos, Herophilus of Chalcedon, Erasistratus of Chios (who firstly described the retina) and Galen contributed greatly to the development of eye anatomy and pathology.

In modern times, Greek ophthalmologists have also been responsible for many important innovations.

ANDREAS ANAGNOSTAKIS (1826–1897)

Prof Andreas Anagnostakis was famous for the modification of the ophthalmoscope, which led to a great advancement in the design and use of the original ophthalmoscope invented by Hermann von Helmholtz.

Born in 1826 on the small island of Antikythera in Greece, he graduated from the medical faculty of Athens University in 1849, after which he pursued his training in Paris and Berlin, under Prof Desmarres and Prof Von Graefe respectively.

His modification of the original Augenspiegel von Helmholtz was published in 1854 in the French language. His instrument was called the ‘ophthalmoscope’, a word derived from the Greek words ‘οφθαλμÏŒς’ (ophthalmos = eye) and ‘σκοπÏŒς’ (skopos = observer).

It was hand-held, gathered light with a small concave mirror and had a central viewing hole. This publication was also the first systematic study in ophthalmoscopy including descriptions and illustrations of the normal and pathological retina. Since then the word ophthalmoscope and ophthalmoscopy increased in popularity until they were adopted in the international ophthalmological community.

Anagnostakis returned to Greece in 1854 and became the first director of the newly founded University Eye Hospital in Athens (Ophthalmiatreion). In his classical work Study in Optics by the Ancient Greeks, published in 1879, he noted that the ancient Greeks were generally successful in the interpretation of natural phenomena and natural laws despite the lack of support by experiment or practical application.

Studying the ancient writings he found, for example the basic law governing the reflection of light when the reflected ray lies in the plane of incidence of the incident ray, the knowledge of the focus and the straight lines under which the objects reflected in flat and spherical mirrors are seen.

In his other work The Medicine of Aristophanes, published in 1891, he investigated every medical subject mentioned in Aristophanes’ plays. In The Antiseptic Methods of the Ancients, published in 1889, Anagnostakis proved the great extent of the ancient medical knowledge concerning asepsis and antisepsis as presented in the work of Hippocrates, Galen and Paulus Aeginitis.

BENEDIKTOS ADAMANTIADES (1875–1962)

Dr Benediktos Adamantiades was another famous Greek ophthalmologist. Born in 1875 in Proussa, Asia Minor (now known as Bursa, Tukrey), he studied medicine in the University of Athens and had the chance to attend the lectures of Prof Anagnostakis, which aroused his interest in ophthalmology.

After his graduation in 1896, he had to work as a general practitioner in Proussa for about 10 years due to financial problems, before leaving for Paris, where he specialised in ophthalmology. After World War One he returned to Proussa and was elected president of the Greek community of the city, where he became involved with the re-establishment of Greek health administration and Greek language schools for minors and adults.

Later, he started to practise as an ophthalmologist in Athens, and in 1924 he was appointed Director of Ophthalmology at the Department of the Refugee Hospital of Athens.

During the annual meeting of the Medical Society of Athens on 15 November 1930, Adamantiades presented “A case of relapsing iritis with hypopyon”, a 20-year-old man, with the three cardinal signs of a new clinical entity, the nowadays so-called Adamantiades-Behcet disease (recurrent iritis, genital ulcers and arthritis). In 1946, Adamantiades reported on two further patients and defined thrombophlebitis as the fourth major sign of this disease. The first classification of the disease was also presented by Adamantiades in 1953, when he described the ocular, mucocutaneous and systemic forms in a systemic review.

He pointed out that the disease can occur for years as a monosymptomatic or oligosymptomatic disorder and that eye involvement and severe prognosis are more common by men than women.

In 1958, he published his last work on the neurologic complications of this disease. Apart from Adamantiades-Behcet disease, Adamantiades described the interstitial keratitis in trachomatic patients as a bacterial infection, and worked on marginal corneal degeneration, posterior vitreous detachment, the measurement of ocular pressure, as well as the pathogenesis of glaucoma.

Andrzej Grzybowski MD, PhD:

Department of Ophthalmology, Poznan City Hospital, Poland; Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland; Department of Ophthalmology,

Dr  Olympia Kostopoulou, MD

Klinikum Chemnitz, Academic Hospital of the Universities of Leipzig and Dresden, Germany