Department History (1858 - 2003)

1858-1912 1913-1930 1931-1942  1943-1958 1959-1968 1969-1970 1971-1985 1986-2006

1971-1985 Morton Goldberg Pursues Visions and Captures Excellence

Like Edward L. Holmes, who founded the Infirmary when he was only thirty, Morton Goldberg, at thirty-two, was at the beginning of his career when he undertook the awesome responsibility of directing Ophthalmology at Illinois. Also like Holmes, Goldberg had a superb background, having sought out the best training available at the leading centers of his day - including Harvard College and Harvard Medical School, where he came under the influence and worked in the laboratory of the brilliant scholar, David Cogan. Furthermore, what Vienna and Paris and Berlin were to Holmes in the 1850s (in the days of Helrnholtz and Von Graefe) the Wilmer Eye Institute of The Johns Hopkins University (with A. Edward Maumenee and Frank Walsh) was to Goldberg in the 1960s.

Morton F. Goldberg, Professor and Head of Ophthalmology, University of Illinois College of Medicine, 1970

Goldberg's strong background in genetics, including work with Victor McKusick at The Hopkins, added a dimension to his mastery of ophthalmology which was to prove central to the development of his own clinical and research interests—and to the extraordinary growth of the Department at Illinois under his leadership. Goldberg was to gain international recognition for his researches into retinal vascular diseases, notably diabetes and sickle cell eye disease, with a consultation practice emphasizing laser therapy and vitreoretinal surgery in the treatment of retinal, vitreous, congenital, diabetic and genetic disorders. In all of these areas—indeed in all aspects of ophthalmology—he was to lead the Department to its present high standing in the field, with, for example, a Sickle Cell Eye Center which is the only unit of its kind in the world.

Gholam Peyman uses the indirect ophthalmoscope during a retinal examination

Goldberg brought to Illinois a comprehensive familiarity with ongoing investigative ophthalmology and a commitment to increase the Department's research involvement. Although he is now especially noted for his own research contributions and for those of the Department he has built, no account of his tenure would be complete if it fails to record that he is primarily a clinician. One of his co-workers has observed that—whatever the other demands on his attention—everything else goes "on hold" when he is with a patient; he cares for each one as if he were attending one of his own parents. Far from sacrificing patient care in the interests of research, he deliberately set out to integrate the two so that they would become mutually reinforcing—always a desideratum in medicine, but one attainable only with strong leadership and adequate physical and human resources. That he succeeded in the face of many obstacles is a tribute to his organizational ability.

One of the goals Goldberg stated in his Annual Report for 1969-1970 was "more comprehensive, complete, and rapid service." As he reorganized the Department—which was, for the first time in its history, synonymous with the Infirmary—one of his initial acts was to equip the General Eye Clinic (formerly a mere triage and screening station) so that residents could do a complete eye examination rather than just a screening inspection, for each patient visiting the Infirmary. This reduced the need for later visits, except where examination indicated a need for attention in one of the Specialty Clinics.

As Goldberg brought in one highly qualified faculty member after another, each with special skill in one of the ophthalmic subspecialties, the number of these clinics gradually grew to constitute a truly comprehensive eye center: Contact Lens Service; Cornea Service; Electrophysiology Service; Glaucoma Service; Low Vision Aid Service; Macular Disease Service; NeuroOphthalmology Service; Pathology Laboratory; Pediatric Ophthalmology Service; Ocular Plastic Surgery Service; Retina Service; Ultrasound Laboratory; Uveitis Service; Veterinary Ophthalmology Service; Vitreous Service, and most recently Ocular Melanoma Service. In addition, Goldberg has also created a series of Research Treatment Centers which provide excellent care, while supplying an organizational structure that fosters the initiation and evaluation of new forms of therapy. Clinical trials are ongoing in the Angle-Closure Glaucoma Study, the Retinal Branch Vein Occlusion Study, the Diabetic Retinopathy Study, the Glaucoma Laser Trabeculoplasty Study, the Radial Keratotomy Study, and the Sickle Cell Eye Center.

Goldberg's dedication to patient care is apparent also in the fact that the Infirmary offers complete emergency eye care at all times, on a round the-clock basis. So far as the Infirmary's limited space has permitted, Goldberg has attended to patient amenities, most recently by providing comfortable and attractive furnishings in the main admissions area and in the faculty's examining suites.

One palpable result of these various efforts is the success of the Infirmary in attracting tertiary and private care referrals, an area in which Ophthalmology leads the campus. This success in turn, has generated patient care revenues which, together with extramural grants and State funds, have brought the Department's budget from about $350,000 in 1970 to a current total in excess of five million dollars.

The Department has excelled in both clinical and investigative pursuits, due to the diverse accomplishments of the large full-time and part-time faculty and the dedication of its house staff. The Eye Clinic, for example, is the single largest in the entire University Hospital. Moreover, the array and sophistication of clinical services gives Ophthalmology the highest rate of profitability of any service in the Hospital, according to a recent study by Peat, Marwick and Mitchell. The Department has also competed successfully for over 40 research grants, making it one of the largest ophthalmic grant recipients in the nation.

In terms of scholarly achievement as well, the Ophthalmology faculty is among the most productive in the University of Illinois at Chicago, publishing over 100 research papers and chapters yearly, and approximately one book every twelve to eighteen months. Out of the comprehensive and well balanced program which Goldberg has created in investigative ophthalmology have come several major discoveries from highly talented faculty members, ranging from the biochemical ophthalmic defect in Tay-Sachs disease to a new tool for removing blood clots from the vitreous.

To bring about change of such magnitude has required enormous tenacity and powers of persuasion, as the documents of Goldberg's administration attest. Even at a distance of fifteen years, his first Annual Report (written after he had been at Illinois for only six months) crackles with energy and determination to eliminate or circumvent existing administrative and academic bottlenecks.

He quickly discovered that Illinois then had an unduly restrictive policy requiring special permission for donation of postmortem eye tissue— unlike other medical centers, where ocular tissues could be obtained routinely at any complete autopsy. This restriction obstructed functioning of the Cornea Clinic and the Medical Eye Bank, hampering both patient care (cornea! grafts needed to restore vision in otherwise blind patients) and teaching and research in ocular pathology and experimental ophthalmology. "This must be changed," Goldberg wrote. He did not add any qualifying adjectives or adverbs.

And so it was with faculty; with physical facilities at the Infirmary; with the residency program: ''This must be changed." At the close of this first Annual Report Goldberg stated his conviction that "the Department of Ophthalmology has as much potential for teaching, research and patient care as any other ophthalmic department in the country today." At that time the only full-time faculty member, Goldberg knew precisely what Ophthalmology at Illinois needed to do to realize this potential. With the support of intelligent and informed administrators in the offices of the Hospital Director, Dean, Vice Chancellor, Chancellor, and President, he set about getting it done. The Department's present standing nationwide is witness to his effectiveness. In May 1984 he received recognition from his colleagues as well, when a special faculty committee, nominated by and reporting to the Dean, awarded him the College of Medicine Faculty Award, for "distinguished contributions in teaching, and administration.'' In July 1984 he was named Editor of the venerable and prestigious Archives of Ophthalmology.

In addition to building a full-thee faculty which now numbers twenty-three and a part-time staff of fourteen engaged in basic or clinical research, Goldberg has encouraged the active involvement of practitioners (now 58 in number), placing high value on their contributions to the teaching of a clinical specialty. Besides basic lectures for undergraduate students, the faculty offer elective clinical rotations for senior medical students from Illinois and other medical schools and elective research rotations for those interested in ophthalmology as a specialty.

At the graduate level, the department trains eight residents each year, in a three-year program, for a total of 24 at all times. In July 1975 Goldberg created a chief residency, for which he has selected candidates in the fifth or sixth year of training after medical school. Successive chief residents, after functioning as chief of the General Eye Clinic and as major supervisor of the house staff at Illinois, have distinguished themselves as particularly talented and well-trained and have gone on to highly responsible positions in other departments of ophthalmology. A regular schedule of lectures and conferences and grand rounds within the Infirmary and the West Side VA have replaced the former custom of sending residents outside the city of Chicago for summer courses. As an introduction to techniques necessary to stay abreast of future developments in the field, each resident now conducts a personal research project during the course of training.

In the last six years, Goldberg has found a way to integrate Illinois residency training with a longstanding concern, first apparent in an exchange program he devised while in the Public Health Service in the late sixties; namely, obtaining United States personnel to help India deal with her multiple causes of blindness. Since 1979 Illinois residents have had the option of a rotation at the Aravind Eye Hospital in Madurai, South India.

During the early 1980s the Department established a postresidency fellowship program, offering one to two years of training in such specialty disciplines as vitrectomy (pioneered at Illinois by Gholam Peyman), medical diseases of the retina, motility, pathology, and glaucoma The fellowship training in pathology, supervised by Mark Tso, has perennially attracted the most promising young ophthalmologists from numerous other countries, including Japan, China, Israel, Germany, and the United Kingdom.

As befits its place in a state land-grant university, Ophthalmology under Goldberg has introduced a series of courses for practicing physicians, offering also an annual full-day Clinical Challenges conference at which complex clinical management problems are discussed with a large attendance of clinicians. A yearly fall meeting takes place in conjunction with the Peter C. Kronfeld Lectureship (established in 1982). There is also a spring Residents Day, at which a Distinguished Alumnus Award is given. Far and away the best known of Goldberg's offerings to those outside the campus is his weekly clinical conference. Consistently large numbers of practicing Chicago ophthalmologists and residents-in-training flock to hear--and take part in—these Wednesday afternoon discussions of unusual and difficult cases. Week in and week out, these conferences sparkle with intellectual give-and-take.

To develop the many aspects of modern medical care and investigation that constitute the standard in his field, Goldberg enlarged his staff at the very beginning to include an ophthalmic biochemist, an ophthalmic surgeon, an ophthalmic pathologist, and a librarian. Subsequently, other ophthalmic specialists have been added to the faculty. Over the years he found it necessary also to add a faculty epidemiologist, computer analyst and programmer, two ophthalmic artists, scientific photographers, an editor, a departmental business manager and staff, a fund-raiser (the first in an Illinois department), and a number of specialized laboratory and clinical technicians. These individuals, chosen with the same care Goldberg has brought to his faculty appointments, have proven to be extraordinarily loyal, furnishing much of what he calls ''the glue that holds the department together."

The 1964 Infirmary building—inadequate even to the relatively modest research needs of the Kronfeld years--has presented a major challenge to every innovation requiring space during the Goldberg administration. Considering the almost total transformation in the Department's size and activity since 1970, it is astonishing that a facility designed primarily for patient care and teaching has been so successfully adapted in its internal capabilities. Goldberg has had to 'make space" for an electron microscopy laboratory; for fluorescein angiography, and ultrasound equipment; for the first argon laser to be used in the Midwest and the original long line fiberoptic cable for laser endophotocoagulation; for such major investigative and clinical tools as the krypton laser (added in 1981), the YAG laser (1983) and the Fluorotron Master (a commercially available vitreous fluorophotometer invented by the Department's Jose Cunha-Vaz and Ran Zeimer in 1980); for computerized perimeters, phacoemulsifiers, cryotherapy, and microsurgical instruments; and for several devices for noninvasive eye research developed in the Department during his tenure; and most recently for a radiologic CT scanner. It soon became apparent that no amount of renovation— however ingenious the dividing and subdividing and juggling—could transform a building designed for one full-time investigator into a facility adequate to the needs of Goldberg's comprehensive, multi-disciplinary research faculty and staff.

In 1980 Joseph Sheridan Begando, then Chancellor of the University of Illinois at the Medical Center, responding to recommendations by Goldberg and by Norman Dahl of the Lions of Illinois Foundation, attempted to convey to the public the need for a new eye building. Begando explained that staggering service loads (60,000 outpatient visits annually, with 2000 inpatients and 1600 major eye surgeries) were forcing Ophthalmology's mushrooming research activities into converted linen closets and basement storerooms, restrooms and even hallways. Laboratories and equipment— even then—were shared and crowded. The Lions of Illinois, collaborators with the Department in many past endeavors (including the Glaucoma Screening Project which had started in the early sixties), agreed to undertake the construction of a research building for the State to operate and maintain as a part of the University.

Jacob T. Wilensky observes the patients eye position at the Octopus Perimeter, while the technician centers the data on the computer console.

With its dedication in June 1985 the Lions of Illinois Eye Research Institute will provide 30,000 square feet of research space, the culmination of eight years of work by Morton Goldberg, his staff, and countless generous contributors. Initially completed to two stories in height, the Institute can have two floors added when needed. The six research teams who will work here, each engaged in three or four active lines of inquiry, will lay primary emphasis on common or serious diseases of the eye: diabetic blindness, viral eye infections, retinitis pigmentosa, macular degeneration, retinal vascular diseases, and the surgical therapy of lacerations, cataract, retinovitreous diseases, glaucoma and cancer.

In his first Annual Report of the Chicago Charitable Eye and Ear Infirmary in 1859, Edward L. Holmes reflected on the good which his little, private, one-room institution had accomplished in just one year. But it would be better far, Holmes wrote, "to provide the necessary means, comparatively so small, for institutions devoted to the prevention of blindness and deafness--and thus in the most effective manner avert the misery which must attend them, as well as the burden, private or public, they must entail."

Just over a century and a quarter later, the Lions of Illinois have joined forces with the University of Illinois to advance the research necessary to preventive ophthalmology under Holmes' worthy successors.

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