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Guest Editorial

Incoming Academy President Message: Knowledge is the Enemy of Disease

Eger, Mark

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doi: 10.1097/OPX.0b013e31818fbab6

I can't say I have ever been much of a history buff, but I have learned in my senior years now that history is much more interesting when it deals with a subject one is interested in and have been a part of. In my case it would be our Academy. In preparation for my 2-years as president I have re-read the history of the first 65 years of the Academy. Like the framers of our country's constitution, I marvel at the foresight the founders of our Academy had at the time they wrote the initial constitution and by-laws of this organization. I felt it would be worth the time to take a look back before setting my sights on the future. It is also appropriate that we do this in a year when the annual meeting of the Academy was held in Anaheim, as the book I reference, ‘History of the American Academy of Optometry (AAO), 1922–1986'1 was published in 1987, and unveiled in Anaheim by its author, Jim Gregg.

So where to begin? How did the Academy come into being? Many of you know that the Academy was founded in 1922, but it took nearly 20 years for the vision of the Academy to come to fruition. The Academy was born out of a section of the American Optometric Association (AOA) and controversy over its formation was fomented by concerns by the founders that the issues of certification and competency needed to be addressed. This is an issue we are still actively debating today, and isn't it interesting that our profession can't get comfortable with this issue even now, a century later. But I digress, back to the formation of the Academy. There were no laws regulating optometry until 1901, and at that time there were approximately 60 schools teaching optometry with some courses only 2 weeks in duration. In addition, no optometrist had to prove ability to practice, and there were no opportunities for additional education. Many optometrists were conscientious and competent given the education and tools available at the time, while others were disparagingly labeled as “spectacle peddlers.” At the AOA Congress held in Chicago in 1901, the establishment of the American Optical College was proposed to provide a form of certification so that passing its examination would be an indication of proficiency. Like today, however, both groups at that time, professionals and commercialists, objected to meeting rigorous standards, and as I have already mentioned, here we are over 100 years later and certification of clinical competencies is still contentious to many. The college never materialized, and in 1905, E. LeRoy Ryer, president of the Optical Society of the City of New York proposed the establishment of an American Academy of Optometry, and once again the fundamental idea was certification. Once more the idea failed! There would be another proposal in 1912. Its object would be to advance optometric science and extend optometric education, but it wouldn't be until 1922, that the proposal to form a national Academy would be adopted. It was agreed that there was a need for a learned body to develop the science of optometry and to upgrade education. However, the greater motivating factor on the part of the men who founded our Academy was still the dissatisfaction with the commercial state of the profession. The vision of the Academy forefathers was to transform the entire body optometric to a profession with a scientific base. Adoption of a constitution and a code of ethics was a top priority by our founders, and this would be an early order of business.

The Academy came in to being at the Planters Hotel in St. Louis on January 11, 1922. It would endeavor to establish standards of examination and practice among its members, and adopt the aforementioned code of professional ethics. Optometrists of high character and high standing throughout the country would be invited to join, and upon passing certain rigid qualification tests would be admitted to fellowship. There would be a meeting in December of that same year. The meeting was the first at which papers were presented; and thus it was the first Annual Meeting of the AAO. Ten people attended the meeting at the Chase Hotel, and the final evening was to be called the Academy Round Table Banquet. A tradition that we celebrated this year for the 86th time.

Adoption of the Constitution was accomplished at that first December meeting, and adoption of By-Laws of the Academy would occur at the third annual meeting in 1925, which included standards of practice required for membership. In 1929, the first chapter of AAO would be formed in Maryland. That same year, membership passed 100. In 1934, The American Journal of Optometry became the official news organ of the organization. Our journal has been a rich and integral part of our Academy. Tony Adams is but the sixth editor over these 86 years, and I would recommend that you revisit the wonderful series of four papers written by Mert Flom in the 2005–2006 issues of Optometry and Vision Science2–5 for further insight into the evolution of the Academy and the Academy's journal.

From its very early days, research and its support would occupy high priority on the part of the Academy leaders. In 1930, the Academy granted its first research fellowship at Columbia University to William Feinbloom. In 1938, it established an editorial committee to review and select papers to be presented at the annual meeting. Examinations for membership started in 1940, and were given to more than 60 applicants. An instructional manual had been prepared for guidance for applicants. Many of you may find it interesting that the suggestion was made that in addition to submitting cases and passing an examination for initial membership, a re-certification examination ought to be required periodically for all members. Again, this is another topic that prompts discussion today.

Year 1941, saw the beginning publication of the American Journal of Optometry and Archives of the American Academy of Optometry. In 1942, the Academy published its first book, Hering's Special Sense and Movement of the Eye. The formation of sections was highly significant and by 1944, saw the adoption of a plan to establish special sections on contact lenses and orthoptics. It marked the beginning of an interest in and a concern about proof of competence in specialty areas, and it would lead to the development of “diplomate” status. Membership stood at 350 in 1945, and the Academy was recovering from reduced activities during the war years.

By 1950, membership exceeded 500. Meredith W. Morgan became president of the Academy in 1952. He was primarily an educator, and this marked the beginning of a balance of educators and practitioners on the then Executive Council. It also established the Academy as no longer primarily an organization of optometrists seeking more education, but as a forum for communication between vision scientists as well. In fact, by this time the large majority of individuals presenting papers were educators and/or scientists. Fewer optometrists solely in private practice presented papers as compared to earlier years. There even became a concern that the Academy was becoming an organization only for scientists and PhD's. This remains a misperception that still impacts membership today. In 1959, The American Academy of Optometry Series was published. It was a home study course on various topics, and Vol. 1 was Synopsis of Glaucoma, by Arthur Shlaifer.

Membership in the Academy would double through the 1950s and exceed 1000 by the early 1960s. The first Prentice Medal was presented in 1963, to William A. H. Rushton. Other diplomate programs would be developed in the 1960s in orthoptics and visual training, and there would be seven sections established by 1971 and 1979 was a challenging year for the Academy. The Federal Trade Commission (FTC) had made a determination that mode of practice could not be used to exclude an individual from becoming a Fellow. The FTC ruling had significant impact on the Academy resulting in a departure from and a change to the original Code of Ethics of the Academy which had been its reason for existence for almost 5 decades. Guided by the leadership of Mel Wolfberg, President during that time, the Executive Council of the Academy was forced to make that significant transition in a short period of time, but it should be noted that with the changes implemented, the Academy was destined to become stronger.

So, given the changes mandated by the FDA, is the purpose of the Academy different today from what our founders perceived it should be? I think not! As Mert Flom points out,4,5 the vision of the Academy from inception up to the FTC ruling was “to transform the body optometric to a profession with a scientific base.” It accomplished that, and the FTC ruling simply presented a reason for altering the Academy's vision going forward. What has evolved is the new vision for the Academy: “Today's Research—Tomorrow's Practice.” But, what is the purpose of the Academy today? I think the purpose of the Academy today is: “To unite optometrists of recognized professional ability and ethical standing for the purpose of affording them opportunities of educational advancement; to establish a standard of optometric practice; to encourage and assist optometric research; and to work along all lines to raise the standards of optometric practice, education, and ethics.” All things the Academy does quite well. But, lest you think I penned those words, let me set the record straight. These words describing the new Academy appeared in The Optical Journal and Review of Optometry in February 1923.1 I know I mentioned that the insight of our founders amazes me. I think you would agree that those words are as accurate a description of what the Academy represents today, and going forward, as they were 85 years ago.

The take-away message for me, having reviewed the history of this organization, is that the Academy has been fortunate to be filled with talented individuals who have all been committed to the betterment of our profession and whose efforts have resulted in preservation of sight and protection of the visual welfare of the public. We are truly the only organization in optometry that has the unique ability to bring together the scientist and educators in our field to present their outstanding discoveries so they can be blended into the clinical care we provide our patients. It has been said by others that “knowledge is the enemy of disease,” and I am proud to be part of an organization that has provided the ammunition of knowledge in such abundant quantities to our profession. Yes, the things the Academy has done have been good, but good is not enough, we need to strive to be better. We can't be content with what the Academy has done in the past. We need to push harder to make sure we continue to raise the bar. Fortunately we have many wonderful individuals who share this vision as well.

Finally, it has been stated that organizations like the Academy are generally easier to create than they are to sustain. That we have sustained didn't happen by happen stance, it happened because of the skill and dedicated leadership of those volunteers, Executive Councils, and Presidents that have created the history briefly reviewed here. I am humbled by the realization that the future of the Academy will be influenced by the decisions that my colleagues and I make going forward, and that it won't be long before our actions become a part of the Academy's history as well. My personal challenge is to try to make the right decisions as we continue the Academy's journey toward our new history. My promise to you is that I will do everything within my power to sustain the great tradition of this organization. I am surrounded by an extremely talented Board, passionate volunteers, and dedicated Academy staff. I thank them and you for the support and confidence I have received.

Mark Eger

President, American Academy of Optometry

REFERENCES

1. Gregg JR. History of the American Academy of Optometry, 1922–1986. Washington, DC: American Academy of Optometry; 1987.
2. Flom MC. How did our academy journal start and become preeminent? Optom Vis Sci 2005;82:1011–13.
3. Flom MC. Carel Koch—the person. Optom Vis Sci 2006;83:11–14.
4. Flom MC. U.S. Federal Trade Commission threatens our academy. Optom Vis Sci 2006;83:70–2.
5. Flom MC. Our academy's purpose and vision—then and now. Optom Vis Sci 2006;83:130–2.
© 2008 American Academy of Optometry