Samantha Williamson
Chicago, Illinois, United States

The direct ophthalmoscope debuted in Germany in 1851, ushering in the modern era of ophthalmology. Seven years later, the introduction of the laryngoscope allowed direct visualization of the airway. In 1858, on the heel of these discoveries, Edward Holmes, a Massachusetts native who had trained in Vienna and Berlin, opened the doors of the Chicago Charitable Eye and Ear Infirmary. Dedicated to serving the burgeoning, underserved population in the city, the institution represented one of the first in America focused on the disciplines of ophthalmology and otolaryngology. The Illinois Eye and Ear Infirmary (IEEI), as it is now known, has been a clinical and research leader for over 150 years.

Initially operated as a philanthropic organization out of a single room on Clark Street, the Infirmary expanded significantly during and after the Civil War by meeting the needs of veterans from Illinois and bordering states. Buoyed by state and federal subsidies, Holmes moved the institution to larger quarters, only to have them destroyed in the Great Fire of 1871.¹ As the opening of Rush Medical College and Cook County Hospital established the Illinois Medical District, the Infirmary settled nearby at the corner of Peoria and Adams.² The rebuilt facility boarded 100 patients, housed several operating rooms, and, notable for its time, provided equipment for one of the first eye pathology laboratories in the country. In the 1880s, the Infirmary assumed the critical role of medical education, training both students of the newly-opened College of Physicians and Surgeons, the precursor of today’s medical school at the University of Illinois, and its own residents.² Twenty-two surgeons saw nearly 1200 patients in 1874. By 1900, the staff at the Infirmary treated over 15,000 patients per year.¹

In the early twentieth century, trachoma, an infectious and potentially blinding conjunctivitis caused by Chlamydia trachomatis, was endemic throughout the state of Illinois. E.V.L Brown, a University of Illinois physician, mapped the incidence in each county near the turn of the century, and founded the first trachoma clinic in the state in Mt. Vernon in 1920.³ Owing to a large patient burden, the Departments of Public Welfare and Public Health and the Illinois Society for the Prevention of Blindness  provided resources to establish five more centers for the treating “indigent victims of trachoma in Southern Illinois.”¹ Harry Gradle, the Director of the Infirmary, sent IEEI physicians to staff these clinics, held in libraries, Elks clubs, and courthouses.³ Over 3,500 cases of trachoma were diagnosed at the clinics, and thousands more evaluated.¹ The clinics closed in 1965 after the epidemic was eradicated, and represent a historic and successful partnership between the Eye and Ear Infirmary and state government.

The fields of ophthalmology and otolaryngology grew along with the Infirmary. The disciplines established individual research and educational programs in the 1930s, and started some of the first sub-specialty clinics in the country, including those dedicated to glaucoma, uveitis, beta irradiation, and ocular motility.  By 1940, the Infirmary was treating up to 100,000 patients a year, including five thousand inpatients.¹ Indeed, Ophthalmology dominated the College of Medicine after formally becoming part of the University of Illinois in 1943. The department recorded 70,000 yearly outpatient visits that year, and all other branches of medicine and surgery combined to total 133,000.¹

In addition to providing clinical care and medical education, the physicians at the Eye and Ear Infirmary have a long history as leaders in research. Frank Waxham introduced the concept of intubation in the 1880s as an alternative to tracheotomy.⁴  In the first half of the twentieth century, Peter Kronfeld carried out early work on aqueous fluid, and H. Saul Sugar published a seminal study on various types of glaucoma.¹ Henry Mundt Jr. and William Hughes published the first study describing the use of ultrasound to visualize posterior structures of the eye, and Joseph Brubaker and Paul Holinger created a revolutionary endoscopic camera.⁴  Francis Lederer, a chair in otolaryngology, served in the U.S. Navy during World War II, and the hearing loss suffered by many veterans inspired him to establish the Speech and Hearing center at the University of Illinois.⁴ He won a Navy Commendation for his audiologic rehabilitation efforts for these patients. Gholam Peyman, a visionary ophthalmologist with nearly 150 U.S. patents, made early contributions to LASIK, the vitrophage, and intraocular drug delivery.

Over 150 years after opening its doors, the Infirmary remains committed to superlative care and to training a future generation of eye and ear specialists.  During its history, it has made the transition from a small charitable project supported by local philanthropists to an international center of clinical and academic excellence that receives millions of dollars in research funding from the National Institutes of Health. And it continues to fulfill Edward Holmes’ mission to treat all in need, in their own community, and beyond.

References

1. Patricia Spain Ward, Ophthalmology at Illinois (Chicago: The University of Illinois at Chicago, 1985).
2. Stanley Burns, Ophthalmology: A Photographic History 1845-1945, Pioneers & Educators (Burns Archive Press, 2009).
3. Illinois Department of Welfare, Welfare Bulletin, 1920. 11-12: p. 43-5.
4. Illinois Eye and Ear Infirmary 1858-2008: A History of Dedication to the Future. (Chicago: The University of Illinois at Chicago, 2008).