Mr Roper-Hall narrates the story of BMEC

The namesake of the prestigious Roper-Hall prize, Mr Michael Roper-Hall, shares his story of the development of academic and research departments at the now Birmingham and Midland Eye Centre.

1934: Dorothy Campbell was a consultant in Coventry and accepted an invitation to establish our Research Department in 1934.  As director (1934-1940) she researched Miner’s nystagmus and organised several courses in industrial ophthalmology. The Research Department existed under the direction of Dorothy Campbell several years before the appointment of a professor.

Many of us did some work in the department, but two in particular were Michael Hay and James Crews. Dr Michael Hay studied Migraine and ran a Migraine clinic and James Crews did a great deal of research into ‘Retinitis Pigmentosa’.

1945: At Birmingham & Midland Eye Hospital, I was House Surgeon in 1945 and Resident Surgical Officer in 1946. Around this time I was permitted to spend six weeks in Zurich to see the research and clinical progress that had been made in Switzerland during the years when the rest of Europe was at war and such progress was impossible.  I was asked by Prof Amsler to write a report on ‘Research in Zurich’ and this was my first publication (BJO 1947; 31; 223-228).

1958: Between 1958 and 1975 I was appointed as a clinical lecturer of the University of Birmingham at Birmingham and Midland Eye Hospital. I was then followed by Philip Jameson-Evans as Senior Clinical Lecturer and Tutor until the present Chair was establishes in 1988.

1960: In the 1960s a number of research associations and societies were formed. The Association for Eye Research (AER), one of the first in the UK was founded by Terry Perkins and soon went Europe wide. Several consultants from the Birmingham and Midland Eye Hospital joined this research association and I was elected Chairman from 1969-1972. Towards the end of my time as Chairman the association merged with another research society and became the European Society for Vision and Eye Research (EVER).

1964: I recall in August 1964 Pseudomonas infections occurred on the main operating lists on the Thursday, Friday and Monday. My list was on the Tuesday and should have been cancelled but there was a lack of communication between the two firms and no information had been passed on.

1968: The Eye Foundation was set up in 1968 as a charitable body in order to obtain much needed equipment. Although this was its main objective there was always the aim of promoting research in conjunction with the University of Birmingham. The University was willing to establish a chair in ophthalmology if £55,000 was provided annually.  The Foundation was soon successful in raising that sum.

1969: On the 17th July 1969 I attended the official opening of the academic unit. Alistair Fielder, who had been appointed as Professor, welcomed the guests before I gave a presentation giving insight into the background of the development. Following my presentation Gerard Coghlan gave the West Birmingham Health Authority view of future development and the value of the links between the NHS and the university. Before the formal opening Alistair thanked the Birmingham Eye Foundation, Hale-Rudd Trust, West Birmingham Health Authority and the University for their Support. The formal opening and the unveiling of the plaque then took place, performed by Sir Adrian Cadbury.

1971: By 1971 the foundation had enough funds and the university was ready to establish a chair for a Professor to hold half of his appointment in clinical work, unfortunately the NHS were unable to fund new sessions which halted progression for several years.

1972: With James Crews and the Architect John Humby, I visited newly built Eye Hospitals in Europe and wrote an article ‘Planning of a 100 bed Eye Hospital’ published in 1972.

1973: I served on the Council of the Royal College of Surgeons from 1973-78 and on its Academic Board from 1973-75.

1979-1985: James Crews, who I had previously visited Europe with, held complementary sessions with me during this time. He specialised in Retina and established the retinal clinic.  He researched retinitis pigmentosa and other familial retinal conditions. He was appointed as Professor at Aston University.

1985: In February 1985 I resigned from the NHS. There were several reasons for my resignation at that time but one was that it would help the progression of the academic unit by giving enough sessions to cover the clinical work of a Professor or Senior Lecturer. It took four years to finalise the job description, send out the advertisements and make the first academic appointments. I worked doing my own locum during this time until 1990 when the Chair was established.

1988: In 1988 Alistair Fielder was the first to be appointed to the new chair of ophthalmology in the University of Birmingham. He remained chair until 1995. Phillip Murray took over from Alistair gaining promotion to Professor after five years as a senior lecturer.

My highlights of research at Birmingham & Midland Eye Hospital:

Joseph Hodgson (1823-1835) was a general Surgeon at General Hospital Birmingham, but had a strong interest in Ophthalmic Surgery. Thus he founded and then worked as a consultant at The Infirmary for the Cure of Diseases of the Eye.

He appointed Bowman as a young man to prepare specimens, examine them with a compound microscope and make drawings. It is relevant that he studied specimens from eye and kidney while at the Birmingham & Midland Eye Hospital.

William Bowman was the first, or among the very first, to apply the compound microscope to biological problems.  When he had completed the work given, Hodgson presented him with this microscope.  He took off to London to qualify in medicine.  He then used the microscope to publish much on histology between 1838 and 1849.

D Priestley Smith (1913-1916), contributed to the development of the perimeter and published his work on investigations on Glaucoma in 1978. He was awarded the Jacksonian Prize (in Medicine) for his essay on Glaucoma in 1879. He delivered the Bowman lecture in 1898 on Convergent Strabismus. He later became Professor of Ophthalmology and held a personal chair in Ophthalmology at University of Birmingham.

T Harrison Butler (1913-1930) introduced the slit-lamp to this country, he had many talents; wrote extensively; was a great teacher and designed many ophthalmic instruments often described as ‘Birmingham Pattern’.

Dorothy Campbell (1934-1940), a consultant ophthalmologist at the Coventry and Warwickshire Hospital, opened the Research Department at BMEH and studied Miner’s nystagmus and other occupational eye conditions.  She organised a series of courses on Industrial Ophthalmology.

James Crews (1959-85) specialised in Retina and established the retinal clinic.  He researched retinitis pigmentosa and other familial retinal conditions. He was appointed as Professor at Aston University.

Research milestone highlights:

Birmingham and Midland Eye Hospital was one of the first eye hospitals in the country to:

  • Import and use the integrated Haag-Streit slit-lamp microscope
  • Introduce microsurgery. In 1957, microsurgery started with the use of the coaxial Zeiss microscope (OpMi 1) with which the field of view was directly illuminated
  • Introduce cryosurgery
  • Introduce trabeculectomy operation for glaucoma
  • Pioneered enzymatic surgery, advances in cataract surgery and the use of intraocular lenses
  • Introduce photocoagulation for the treatment of diabetic retinopathy and other retinal conditions (first with the Xenon Arc, then with Ruby, Argon and Indo-cyanine green)
  • Start an Ultrasound clinic
  • Pioneered the use of static and automated perimetry