EMANUEL ROSEN

Dr Emanuel Rosen FRCS, FRCOphth, was the joint recipient of the inaugural UKISCRS Lifetime Achievement Awards at the XXXVI UKISCRS Congress in Manchester, and was praised for his innovative and visionary career, which included setting up the specialist cataract treatment centre in Manchester and a prestigious record in ophthalmology photography and academia. Dr Rosen, a past president of the ESCRS and chair of the society's Publications Committee, gave a fascinating perspective on his half a century in active ophthalmic clinical practice.

Early days

His first exposure to ophthalmology was as a medical student in 1958 when he undertook an anaesthetic rotation. Back then the ophthalmologist in his hospital was attired in a pinstripe suit and wore a magnifying headband loupe, and there was an open fire in theatre. Dr Rosen became an SHO in 1964, at a time when ophthalmology was “crude” with poor tools and limited pharmacopeia for glaucoma, for example, and no microscopes for surgery. He said he had a hunch that ophthalmology could be a land of opportunity, not knowing what the future held. ¨Ophthalmology was a Cinderella specialty in 1964,” he noted, adding that a “surgical and ophthalmic apprenticeship with lots of practical experience” best described the training he received.

Photography

Dr Rosen spoke in depth about his other great love – photography, which he combined to great success in his ophthalmic career. His entry into ophthalmology immediately attracted him to photographic applications in retinal disorders, which he said was fortunate timing because of imaging developments in the field in the 1960s. Dr Rosen became custodian of the retinal camera at his hospital and adapted it for the then newly described technique of fundus fluorescein angiography (FFA), thus allowing him to utilise his growing interest in retinal disorders through photographic applications developing fast systems for angiography many years before the digital age

“It was fascinating revealing the detail of vascular pathology in diabetic retinopathy, for example, the clarity of the pathology, seeing the thickening of arterial walls with narrowing of caliber and non-perfusion of the retina,” he explained, showing the audience some of his original images. In 1968 having collected an extensive portfolio of retinal disorders photographed through the medium of angiography, he produced the first English language textbook on FFA, entitled Fluorescence Photography of the Eye.

Evolution

Dr Rosen described the evolution of various ophthalmic procedures and technologies over his career, including vitrectomy, the development of cataract surgery and IOLs, which he described as a “career changer” for him personally, and eventually phacoemulsification surgery. Concluding, Dr Rosen said the evolution of ophthalmic practice between 1964 and 2013 “has seen a progress beyond science fiction, it has been phenomenal”. Clinicians now practice evidencebased ophthalmology, there are multiple ophthalmic expert sub-specialties and the standard of ophthalmic care is outstanding, he stated, praising the development of various technologies like the latest IOLs, tomography, topography and femtosecond laser: “Looking to 2063; can the next 50 years be as productive?”