Visionaries
(Reprinted from January-December 1991 Issues of Review of Optometry)
Copyright 1999 Review of Optometry

By Rob Murphy, Senior Clinical Editor

Frederick Boger: A Salute to Optometry's Catalyst
Charles Prentice: Hail to the 'Father of Optometry'
Andrew J. Cross: The Legacy of a 'Grand Old Man'
William Feinbloom, O.D.: The Father of Low Vision
A.M. Skeffington, O.D.: The Father of Behavioral Optometry
Irvin M. Borish, O.D.: Optometry's Living Legend
Dr. Charles Sheard: Father of the Four-year O.D. Degree
Henry Hofstetter, O.D., Ph.D.: Optometry's Ambassador to the World
David Janney, O.D.; John Casto, O.D.: Two TPA Pioneers
Norman E. Wallis, Ph.D., O.D.: A Navigator of Change
Alden N. Haffner, O.D., Ph.D.: The Prince of New York
Henry B. Peters, O.D.: The Peters' Principle: UAB's Success

Frederick Boger: A Salute to Optometry's Catalyst
He never once performed a refraction nor dispensed a pair of eyeglasses. Yet he was one of optometry's most influential early figures: Frederick Boger, the enterprising publisher whose efforts helped foster the birth of modern optometry. This is a salute to Mr. Boger. It is the first in a yearlong series called "Visionaries," profiling the key players in optometry's past 100 years.

Mr. Boger's goals were education and organization. In 1891 he founded The Optician, the first optometric journal in the United States. A century later, Mr. Boger's legacy persists with each issue of his brainchild, now called Review of Optometry

His legacy persists as well in the ongoing organizational and legislative efforts of state and national optometric associations.

Mr. Boger helped establish the forerunner of today's New York State Optometric Association. And it was Boger who in 1895 first sounded the call for a national organization of refracting opticians. Along with a handful of others, Mr. Boger himself stepped forward in 1898 to help organize what is now the American Optometric Association. The publisher served as the organization's first Secretary.

By the time Mr. Boger died in 1936, what had been a poorly educated, unregulated, and disorganized population of opticians had evolved into a thriving vision care profession. Much of the credit goes to Frederick Boger.

Charles Prentice: Hail to the 'Father of Optometry'
Charles Prentice's pioneering studies in optics earned him the praise of prominent ophthalmologists at home and abroad. But his status as a leading refracting optician also inspired contempt among medical doctors who regarded Mr. Prentice's trade as a threat to medicine.

Like him or not, turn-of-the-century eye doctors could hardly deny Mr. Prentice's monumental impact on vision care. The man AOA dubbed the "Father of Optometry" is the subject of this month's "Visionaries," a yearlong series on influential people in optometry's past.

Trained as a mechanical engineer in Germany, Mr. Prentice applied his knowledge of math and physics to the field of optics. In 1890, his papers on the "Law of Decentration" and "A Metric System of Numbering and Measuring Prisms" won him a worldwide reputation as a brilliant innovator.

In addition to his scientific endeavors, Mr. Prentice spearheaded efforts to organize, regulate, and educate O.D.s in the profession's nascence.

Mr. Prentice and a handful of others formed the Optical Society of the State of New York in 1895, in part to counter M.D.s who accused refracting opticians of violating medical practice laws.

In 1896, Mr. Prentice drafted and lobbied for a bill that eventually became New York State's optometry law. Mr. Prentice successfully argued that fitting glasses constituted the treatment of light, not disease, and so did not infringe upon medicine's purview.

In 1910, Mr. Prentice persuaded Columbia University to establish an optometry program. He devised the curriculum, chose instructors, and lectured frequently.

A 1929 editorial in The Optometric Weekly noted, "It is the achievements of men like Charles Prentice that have made present day optometry possible." An editorial in today's press might say the same.

Andrew J. Cross: The Legacy of a 'Grand Old Man'
His wide-ranging interests led to such disparate inventions as an automatic railroad switch and a new type of bath cabinet. Yet it's for his innovations in sight-testing techniques and his role as an educator and leader of the fledgling optometric profession that today's O.D.s owe a debt to Andrew Jay Cross.

Mr. Cross was dubbed the "Grand Old Man of Optometry." He is most famous for devising an improved method of skiametry. As a practicing refracting optician around the turn of the century, Mr. Cross had grown dissatisfied with static skiametry, which had been in wide use for more than 40 years. That technique, which required cycloplegia to mitigate accommodation, was time-consuming and discomforting for the patient.

Instead, Mr. Cross developed dynamic skiametry. This method of retinoscopy, in which the patient focused on a near object of fixation, required no drugs, making it quick and convenient.

That the technique is still in use today would be no surprise to Mr. Cross, who wrote: "I am fully convinced that this is to be one of the great optometrical tests of the future."

Mr. Cross was also among a handful of New York opticians whose legislative, educational, and organizational initiatives laid the foundations of modern optometry.

In 1895, Mr. Cross helped form the Optical Society of the State of New York, the country's first optometric organization. A few years later, he was a founding member of what would become the American Optometric Association, and later served as the group's second president.

Mr. Cross and his colleagues introduced the nation's first optometry bill in the New York state legislature in 1896. After years of lobbying efforts, the bill finally became law in 1908.

When the "Grand Old Man" died in 1925, then AOA president T.H. Martin praised Mr. Cross's "…tireless efforts to elevate the profession that was his very life." During its 1926 Congress in San Francisco, AOA erected a bronze memorial at the base of a giant California Sequoia tree, with the simple inscription: "Andrew J. Cross, Pioneer Optometrist."

William Feinbloom, O.D.: The Father of Low Vision
Even as he lay in a hospital bed suffering from a heart ailment in 1983, William Feinbloom, O.D., continued to seek new ways to help partially sighted patients. His colleague Richard Brilliant, O.D., recalls receiving calls at the time from the recuperating 79-year-old to discuss a new type of bioptric lens.

That kind of dedication characterized the career of the man widely regarded as the "father" of low vision optometry. Dr. Feinbloom died in 1985 at age 81.

The Brooklyn-born son of a self-educated optometrist, Dr. Feinbloom helped out at his father's practice from age 3. After obtaining a degree at age 19 from the Columbia School of Optometry, Dr. Feinbloom went on to receive degrees in physics, math, biophysics and visual psychology.

He spent the rest of his life putting that training to good use. While working at a medical clinic in 1932, Dr. Feinbloom took a personal interest in an elderly, vision-impaired patient for whom no available therapy was effective. Using an astronomer's telescope as a model, he developed a 3X telescopic lens small enough to mount in spectacle frames.

The device restored the man's functional vision. The patient, a Catholic missionary, later described this "miracle" during a visit to Pope Pius XI, who in turn sent a special blessing to Dr. Feinbloom.

Over the next five decades, Dr. Feinbloom's reputation as an innovator of optical devices for the sight-impaired grew. Among his low vision inventions: the "Camera Lens," the "Honeybee Lens," and the "New Horizons Lens." In addition, Dr. Feinbloom held the patent for the first contact lens.

His innovations resulted from "clinical work and many failures," Dr. Feinbloom said in a 1983 interview. "Each failure taught me a new need and was nurtured in my unconscious until somehow it gave birth to a new development."

Feinbloom prot??Randall Jose, O.D., lauds him for his prowess at promoting low vision optometry to the public and for his patient management skills. Says Dr. Jose: "He was artful in motivating people to participate in their own rehabilitation."

Today, millions of low vision patients worldwide owe at least an indirect debt to the tenacity and ingenuity of Dr. William Feinbloom.

A.M. Skeffington, O.D.: The Father of Behavioral Optometry
In his youth, an insatiable curiosity prompted A.M. Skeffington to drop out of high school and later divinity school. The Kansas City, Mo., native found himself frustrated by his teachers' inability or unwillingness to answer his many questions.

"I had a geometry teacher who knew all the answers and none of the questions," he later wrote. "When I'd ask her a question, she'd become unhappy and uncomfortable with me."

Dr. Skeffington never stopped asking questions, a trait that made him one of the premier educators in optometry. Says former colleague Robert Kraskin, O.D.: "He always came up with the right questions that provided insight both for himself and for his colleagues."

His disciples today virtually deify Dr. Skeffington, the man largely responsible for developing and promoting behavioral optometry. His work earns him a place among optometry's "visionaries" of the past 100 years.

Dr. Skeffington's early career path included some unlikely turns. Before earning an optometry degree at the Needles Institute in 1917, he worked at a variety of jobs in Montana, wrangling cattle and herding sheep among them.

After optometry school, Dr. Skeffington set up a private practice in Kearny, Neb. Convinced that conventional exam procedures provided an incomplete assessment of vision, Dr. Skeffington developed an alternative and, to some, controversial approach. Vision, as he saw it, was a learned behavior which could be modified through environmental influences

"He systematized the evaluation of visual information processing," says former colleague J. Baxter Swartwout, O.D., "We have multiple visual skills, yet visual abilities have been boiled down to 20/20. He said 'This is not so,' and brought about a method of evaluation based on 21 different findings. These are evaluated not on the strength of one or another, but rather on the relationships among them."

Dr. Swartwout is president of the Optometric Extension Program (O.E.P.) a continuing education and research institute established in 1928 by Dr. Skeffington and his colleague, E.B. Alexander, O.D. With 3,500 members worldwide, the O.E.P. thrives as a legacy to Dr. Skeffington, its director of education from 1928 until his death in 1976.

Irvin M. Borish, O.D.: Optometry's Living Legend
Working days as a newspaper reporter, Margaret Mitchell wrote Gone With the Wind  in her spare time over a 10-year period. Working days as a private practitioner, Irvin M. Borish, O.D., wrote in his spare time a tome no less impressive and arguably more influential: Clinical Refraction, still regarded as the quintessential optometric text some 43 years after its first printing.

Dr. Borish, who turned 78 in January 1991, no longer burns the midnight oil until 3 a.m., as he did many nights while writing his 1,400-page classic over a seven-year period. But his dizzying travel and lecture schedule these days coupled with endless writing projects still betray his tireless energy and single-minded devotion to the profession.

The former literature student and part-time actor has for years been a force behind optometry's expansion into primary care. Even today, Dr. Borish sounds the call for progress: "You need to decide: Do you want to move forward or do you want to stay where you are?"

Dr. Borish counts among his greatest achievements his role in starting the Indiana University School of Optometry in 1951. Says Dr. Borish, "It came at a critical time. In those days there were just three independent optometry schools. And then Columbia closed its school, which would have been devastating to optometry." The Indiana school "enhanced optometry's status and image," he says.

The 1934 graduate of Northern Illinois College of Optometry now lives in Deerfield Beach, Fla., with his wife of 55 years, Beatrice. When he's not jetting around the world—he made a Far East swing last year to work on a condensed translation of Clinical Refraction—Dr. Borish enjoys oil painting (landscapes) and gardening (roses, vegetables).

But his heart still belongs to optometry. Says Dr. Borish, "When you've given so many years and have been so devoted, you can't just give up."

Dr. Charles Sheard: Father of the Four-year O.D. Degree
Among his achievements were an artificial voice box and a photo-electric device that gauged the concentration of a substance in a solution.

But in optometric circles, Dr. Charles Sheard is best known for establishing the nation's first four-year optometric degree program.

Launched in 1915 at Ohio State University, the program became "…a major milestone in optometric history," wrote Frederick Hebberd, O.D., former dean of the O.S.U. College of Optometry.

A Princeton-trained physicist, Dr. Sheard came to O.S.U. in 1907, where he cultivated an interest in physiological and ophthalmic optics. With the backing of the Ohio State Optical Association, he persuaded O.S.U. to establish a two-year program in applied optics.

Convinced, however, that a four-year program would elevate optometry to a true profession, Dr. Sheard again found himself lobbying school administrators. "Is Ohio State to wait until other colleges have such degree programs and then fall into line, or shall it be the leader?" he argued.

The son of a Methodist minister, Dr. Sheard had lofty standards for the profession. "He sometimes criticized optometry for not having high enough standards," Dr. Hebberd says. "He said what he thought and sized things up very accurately."

Today, the front-line status of optometry as a health care profession owes much to Dr. Charles Sheard's prescience and exacting standards.

Henry Hofstetter, O.D., Ph.D.: Optometry's Ambassador to the World
It's a long way from teaching in a one-room schoolhouse to worldwide recognition as one of optometry's leaders. Along the way, Henry Hofstetter, O.D., Ph.D., left his mark on the profession at home and abroad.

The former elementary school teacher has visited more than 40 countries over the years, meeting with leading optometrists, visiting practices and spreading the "gospel" of American optometry. "I think of him as an ambassador for optometry and visual science," said the late Glenn A. Fry, O.D., Ph.D.

Studying under Dr. Fry, Dr. Hofstetter was the first in the country to earn a doctorate in physiological optics. That, along with the publication of his influential Optometry: Professional, Economic, and Legal Aspects (1948), earned him a widespread reputation. Says Gordon G. Heath, O.D., Ph.D., who succeeded Dr. Hofstetter as director at Indiana University. "The book made him a household word in the profession. He was very much in demand as a lecturer."

He was also sought as an administrator. The same year his book was published, Dr. Hofstetter, then 34, was named dean of the Los Angeles College of Optometry.

When an Indiana University selection committee was looking for someone to head its nascent optometry program in 1952, Dr. Hofstetter topped the list. Says selection committee member Irvin M. Borish, O.D., "No one else had his credentials."

Establishing a new optometry program presented its share of challenges. "There was no formula on how to go about it," Dr. Hofstetter says. "I had to design the curriculum, hire the faculty, order equipment. I also wanted to start a graduate program." Dr. Borish lauds Dr. Hofstetter's efforts in these early years. "He built up a phenomenally able faculty," Borish says.'

Although nominally retired, Dr. Hofstetter remains active. Among his many projects are two that enable him to indulge his interests in linguistics and history: He's co-editing a fifth edition of the popular Dictionary of Visual Science and editing the Optometric Historical Society's newsletter.

And when not engaged in professional activities, the longtime Hoosier fan continues to indulge another passion: He's a regular at Indiana University football and basketball games.

David Janney, O.D.; John Casto, O.D.: Two TPA Pioneers

David Janney, O.D.

John Casto, O.D.

March 3, 1976, marked a milestone in modern optometric history. The West Virginia Legislature that day overrode Gov. Arch Moore's veto of a bill allowing O.D.s to prescribe therapeutic drugs. Optometry had its first TPA law.

Today O.D.s in West Virginia and all other TPA states owe a debt to the two men most responsible for getting that law passed: Dave Janney, O.D., then-president of the West Virginia Optometric Association, and John Casto, O.D., then the legislative committee chairman and president-elect.

The legislative victory was "…a result of a lengthy, well-financed and beautifully orchestrated lobbying effort by the optometrists," a West Virginia ophthalmologist conceded in Medical Economics shortly after the law passed. "The optometrists caught us napping and overwhelmed us."

Drs. Janney and Casto spearheaded the lobbying blitz. They convinced legislators that a broader optometry law was necessary in a state where people in rural communities had little access to eye care.

The WVOA obtained the support of Norman Wallis, O.D., then-president of Pennsylvania College of Optometry, and Spurgeon Eure, O.D., then-president of Southern College of Optometry. They testified that West Virginia O.D.s indeed had the necessary training to prescribe TPAs.

What's more, Drs. Janney and Casto recruited two influential legislators to sponsor the bill: Senate President William Brotherton and House Judiciary Committee chairman Albert "Boonie" Sommerville. "Bills don't get passed because of their merits," Dr. Janney, now 55, says. "Bills get passed by who you know and who's pushing them."

Drs. Janney and Casto agree that the grass-roots lobbying campaign was the key to the passage of the bill. "I don't think any successful legislative effort can be achieved without a total commitment from the optometric body in the state," Dr. Casto, also 55, says.

By the time West Virginia ophthalmologists awoke to the WVOA's legislative strategy, it was too late. The O.D.s had lined up enough votes to carry the state House and Senate by comfortable margins and then override the governor's veto. "[The M.D.s] thought that all they had to do was show up and everyone would bow to their wishes," Dr. Casto says.

The M.D.s challenged the law in the courts but failed. Since then 14 separate repeal efforts have bogged down in legislative committees and have never come to a vote.

These days, passage of a new TPA law is more or less universally applauded by the nation's O.D.s. But West Virginia's law was denounced at the time by many prominent optometrists who saw it as an incursion into ophthalmology's purview. Others thought it would derail their own efforts to get DPA legislation.

Dr. Janney looks back and scoffs at such attitudes. "I think it was something that needed to be done, whether it was us or somebody else," he says. "If we hadn't done it, I don't know where we would be today."

Norman E. Wallis, Ph.D., O.D.: A Navigator of Change
His plans for a naval career were thwarted by an eye injury at age 15. Instead, Norman E. Wallis, Ph.D., O.D., became an optometric educator, administrator and one of the most influential figures the profession has seen in the past two decades.

As president of the Pennsylvania College of Optometry and later as executive director of the National Board of Examiners in Optometry, Dr. Wallis helped raise the standards of the profession and broaden the scope of practice.

The British native came to PCO in 1972. "He changed the entire institution from one that was stagnant to one that achieved leadership in optometric education," says Thomas L. Lewis, O.D., Ph.D., current president of PCO.

Dr. Wallis recruited talented educators, altered the curriculum to integrate material among various courses, encouraged faculty research and started an externship program.

He personally lobbied for and won a $3.8 million federal grant to fund The Eye Institute at PCO, a multi-disciplinary teaching clinic founded in 1978. The 65-exam-room facility now accommodates more than 70,000 patient visits a year.

At PCO, Dr. Wallis also established a continuing education program which over the years provided pharmaceutical training to some 15,000 O.D.s in 25 states. "He felt it was the responsibility of the institution to bring the education out into the field," says Leon Candeub, O.D., who headed the program. This training, and in many instances Dr. Wallis' personal efforts, helped get pharmaceutical bills passed in 23 states. 

When he took over at the National Board in 1980, Dr. Wallis worked closely with an external review committee that proposed changes to the much-criticized testing body. The most profound of these was a new approach which grades candidates according to a predetermined standard rather than a curve. "The issue is not whether you are better than so-and-so but whether you are competent," says Leon J. Gross, Ph.D., testing expert for the National Board. 

Forty-nine of the 54 states and possessions of the United States now use the written board exams. And last year the board administered for the first time a practical exam for 10 states. In 1993 the exams will be changed to include the treatment of eye disease.

"We as a profession should look at what the public needs as opposed to our professional desires," says Dr. Wallis. Largely thanks to Dr. Wallis, optometry now addresses those needs better than it did 20 years ago.

Alden N. Haffner, O.D., Ph.D.: The Prince of New York
The closing of Columbia University's optometry program in 1956 left New York state, in the words of Alden N. Haffner, O.D., Ph.D., a "debtor state," dependent upon other states to educate its O.D.s. With the founding of the State University of New York College of Optometry 15 years later, Dr. Haffner erased that debt and brought optometric education back to the Empire State.

For this and his many other contributions to optometry, the 63-year-old Brooklyn native has earned a place among the profession's "visionaries" of the past 100 years.

A spirit of community service has guided Dr. Haffner's efforts since his days at the Optometric Center of New York. Following Army service, Dr. Haffner took over the financially ailing clinic in 1957 and turned it into a thriving patient care, continuing education and research institution.

He established ties with the city's health and welfare agencies and the philanthropic community to provide eye care for indigent patients. "That built a spirit of public service, of the institution fulfilling an important mission," Dr. Haffner says.

In the late 1960s Dr. Haffner lobbied to establish an optometry college in association with the clinic. Undaunted after several dead ends, his efforts came to fruition in 1971 when the state Legislature mandated a new optometry college within the state university system.

Within four months Dr. Haffner and his staff obtained a federal grant, assembled a faculty, established a curriculum, set up a library and recruited the first class of  22 students. "Those were very heady times," he says.

His administrative acumen eventually caught the eye of  SUNY's top brass in Albany. In 1978 they recruited Dr. Haffner to oversee the university's health sciences programs. As a vice chancellor of the world's largest university system (over 400,000 students), he oversaw research, graduate studies and professional programs. In 1987 he returned to the optometry school and resumed the role of president.

Dr. Haffner now exhorts optometry's best and brightest to pursue policy-making roles. "It is important for optometrists who have professional backgrounds in administration, public health, business, finance, public policy to become deeply involved in bureaucracies where public policy is made," he says.

New York is no longer a "debtor state." For that, O.D.s of the Empire State—and all other states as well—are indebted to Alden N. Haffner.

Henry B. Peters, O.D.: The Peters' Principle: UAB's Success
Sometimes an institution is so closely identified with one individual that its achievements must be considered his as well. Such is the case with the University of Alabama at Birmingham School of Optometry, a leader in optometric education largely thanks to founding dean Henry B. Peters, O.D.

The 75-year-old Oakland, Calif. native, who retired as dean in 1986, has left an indelible legacy at UAB. For this and his other contributions to optometry—most notably the landmark Orinda Study establishing criteria for school vision screening—Dr. Peters takes his place among the profession's "visionaries" of the past 100 years. This is the final installment of the year-long series paying tribute to optometry's most influential figures.

Dr. Peters' early years in practice were interrupted by World War II, during which he served as a tactical radar officer in the South Pacific. After the war he returned to private practice and a teaching post at the University of California at Berkeley School of Optometry.

Dr. Peters catapulted to national prominence in 1959 with the publication of Vision Screening for Elementary Schools: The Orinda Study. Co-authored by Dr. Peters and two others, the six-year interdisciplinary study detailed clinical criteria—regarding visual acuity, refractive error, pathology and binocular coordination—used to evaluate vision screening. These criteria are still widely applied. "Whenever you talk about vision screening you refer back to the Orinda Study," says Alden N. Haffner, O.D., Ph.D., president of the State University of New York College of Optometry.

Dr. Peters was assistant dean at Berkeley in 1969 when he was tapped to launch an optometry program at UAB. "They gave him an office and a secretary, and basically said 'Good luck,' says long-time UAB faculty member Robert N. Kleinstein, O.D., Ph.D.

Dr. Peters brought a blueprint for success that made luck largely irrelevant. He recruited a faculty that today includes many of the profession's most prominent educators. He established a strong clinical program that, among other successes, launched the nation's first Veterans Administration optometry clinic. UAB's research program (total 1991 funding: $1.5 million) is among the nation's most productive.

All of these strengths can be traced to Dr. Peters' efforts. "I have exceeded my most grandiose dreams," he says. Optometry could use more such dreamers.