Sir Harold Ridley and His Fight for Sight

Imagine this plot for a novel:

A brilliant eye surgeon performs a revolutionary operation in secret, implanting a new device, the intraocular lens, which replaces the cloudy cataract.

Word leaks out two years later, and the world’s most prominent ophthalmologist vilifies and ostracizes him. He suffers from depression, an outcast in his profession.

He and a handful of other doctors around the world toil in obscurity for three decades, performing a few hundred, and later, a few thousand surgeries a year, advancing the science.

Ralph Nader and Sydney Wolfe petition the FDA to outlaw the lens. Robert Young (who played Marcus Welby, M.D. on television), testifies in Washington D.C. that the lens “saved my career and should be available to all Americans.”

The lens gains acceptance. 100 million patients around the globe regain their vision from the lens. The surgeon, at 93 years of age, is knighted by Queen Elizabeth.

Sir Harold Ridley and His Fight for Sight by David J. Apple

This plot is not a novel, but the biography Sir Harold Ridley and His Fight For Sight by David Apple, M.D. (Slack Books, 2006). Dr. Apple, a prominent ocular pathologist, met Ridley in 1985 and became close friends until Ridley’s death in 2001.

He also became his official biographer. The story of his pioneering surgery, the politics and jealousy which impeded its acceptance, and his final vindication, form the basis of this book.

The story begins in World War II, when Ridley examined a fighter pilot injured by the shattered plastic of his cockpit window. He noted that the plastic deeply embedded within his eyes caused no inflammation, unlike most foreign bodies which are rejected by the body.

That gave him the idea of replacing the cataract (the eye’s natural lens which has become too cloudy for useful vision) with a plastic lens. He performed the first implant surgery on November 29, 1949.  

Ridley knew the operation might not be accepted, so he kept the surgery secret, planning for considerable follow-up before publishing  his results. In 1951 word leaked out, and a storm of controversy followed.  

Dr. Apple contends that a primary reason for this hostility was jealousy. Sir Stewart Duke-Elder was the most prominent ophthalmologist in the world during the middle of the 20th century. His multi-volume textbook remains on the bookshelves of ophthalmologists today.

Duke-Elder actually examined the fighter pilot with plastic embedded in his eye, but the idea for the lens implant did not occur to him.

Duke-Elder ostracized and vilified Ridley for decades, and caused an entire generation to miss the benefits of the intraocular lens implant.

Only a handful of doctors around the world were willing to risk their reputations by implanting lenses during the next thirty years.

Ralph Nader and Dr. Sydney Wolfe (of the group Public Citizen) joined the fray in 1980. They petitioned the FDA with the hope of banning the intraocular lens (IOL).

The future of the implant looked grim until television star Robert Young (who played Father Know Best, and Marcus Welby, M.D.) testified. He stated “IOLs saved my career and should be available to all Americans.”

His words paved the way for acceptance of the IOL, and since that time over 100 million IOLs have been implanted around the world.

Dr. Apple played no small role in the story. His laboratories at the University of Utah, and later at the Medical University of South Carolina were the first to study the pathology of the intraocular lens.

He was instrumental in improving their safety. He guided surgeons to improve their technique and guided industry to improve their products. He remains today the most respected researcher in this field.

In 1985, after learning of Dr. Apple’s work, Ridley invited him to his home in England. This began a long friendship. Apple visited Ridley at least three times a year until Ridley’s death in 2001.

Apple was named Ridley’s official biographer.Apple’s meticulousness as a pathologist is reflected in the fascinating detail he provides in the book. It is copiously illustrated with relevant historical documents.

He provides background on the history of ophthalmology, on World War II, and shows how Ridley’s work paved the way for the future of not only cataract surgery, but refractive surgery and the entire field of bioengineering.

He documents Ridley’s other notable achievements in the field of tropical medicine (he was a pioneer in describing and treating onchocerciasis [River Blindness]).

Because of the hostility that Ridley’s innovations met with, he suffered depression through much of his life. Dr. Apple’s professional and personal work helped lift Ridley out of his depression.

Indeed, Ridley became Sir Harold Ridley in 2000, receiving knighthood from Queen Elizabeth.  

As readers, we also are indebted to Dr. Apple for bringing the life and achievements of this pioneer to light. Perhaps Sir Harold will someday win the Nobel Prize which he so richly deserves.

Dr. Apple appropriately begins his book with a quotation:

“Throughout the centuries there were men who took first steps down new roads armed with nothing but their own vision. Their goals differed, but they all had this in common: that the step was first, the road new, the vision unborrowed and the response they received — hatred.

“The great creators — the thinkers, the artists, the scientists, the inventors — stood alone against the men of their time. Every great new thought was opposed. Every great new invention was denounced.

“The first motor was considered foolish. The airplane was considered impossible. The power loom was considered vicious. Anesthesia was considered sinful. But the men of unborrowed vision went ahead. They fought, they suffered and they paid. But they won.”

— The Fountainhead, Ayn Rand, 1944

Blake Shaw, M.D. is an ophthalmologist with a private practice in Chula Vista, California. He writes one of the few ophthalmology blogs, www.EyeDidntKnow.com, and his award-winning photography can be seen at www.BlakeShawPhotography.com.