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Up Front | Nov 2008

5 Questions with G.O.H. Naumann, MD, ML, FRCOphth(Hon)

Dr. Naumann is Immediate Past-President of the International Council of Ophthalmology and the International Federation of Ophthalmological Societies, and he is a Professor Emeritus at the University Erlangen-Nuremberg in Erlangen, Germany.

1. How has your work for blindness prevention in developing nations influenced how you educate your students in Germany?
The striking disparity in the standards of eye care in developing countries compared with industrialized countries has influenced my teaching profoundly. I strive to make my medical students aware of the global differences in health care. I stress that every physician must understand the common causes of blindness today, including cataract, glaucoma, trachoma, diabetic retinopathy, and macular degeneration. I emphasize and illustrate that ophthalmology is not a small field; it should belong to the core curriculum for all medical students, and it never should be considered as elective coursework. For my residents, I demonstrate the spectra of ocular diseases in countries around the world and impress upon them that blindness prevention in developing countries must have priority over lifestyle intervention. Additionally, I try to raise awareness in the public media about the magnitude and severe consequences of blindness, not only in terms of individual suffering but also in terms of the serious economic impact that it creates.

2. Describe the foundation that you and your wife created to support the study of ophthalmic pathology.
Ophthalmic pathology is often underestimated and neglected as a clinical subspecialty today. Because of our extensive clinical research in anterior segment microsurgery and ophthalmic pathology, my wife, Lieselotte Naumann, MD, and I are aware that many of the spectacular advances in ophthalmic microsurgery are based on the knowledge of the underlying pathological structures of the eye. Therefore, we established a foundation to highlight the significance of ophthalmic pathology. Our foundation funds the International Council of Ophthalmology (ICO) Ophthalmic Pathology award, a $50,000 prize that the ICO presents every 4 years to an outstanding researcher in ophthalmic pathology. The first award was presented to Thaddeus Dryja, MD, at the 2006 International Ophthalmological World Congress in Sao Paulo, Brazil. The next award will be given at the ICO/World Ophthalmology Congress in 2010 in Berlin.

3. You have served as a leader of many ophthalmic associations throughout your career. What do you find most challenging about balancing your leadership and professorial responsibilities?
The greatest challenges are time limitations and the constant pressure of keeping up with a busy schedule. I minimize the time I spend on administrative tasks. It is my pleasure and privilege to enjoy the harmony and stimulating cooperation of the members of our entire department. No matter how busy I was as the Professor and Chairman of the Department of Ophthalmology, my absolute priority was daily contact with the residents and—most important—with patients.

4. What is your advice to the next generation of ophthalmologists?
My foremost advice is to enjoy the unique features of ophthalmology. This field offers striking opportunities for effective therapy for our patients as well as challenging clinical research. Also, subspecialization offers immense advantages. To this end, the next generation should not forget that the eye is round; they should avoid narrow attitudes toward exploring subspecialties.

Up-and-coming ophthalmologists must build relationships with their peers. As much as our therapy can be done on an outpatient basis, we are in danger of losing daily contact with our medical colleagues. New physicians must make efforts to build relationships with other members of their universities. Additionally, the next generation of ophthalmologists must emphasize their leadership role in Vision 2020, the World Heath Organization initiative. They must not forget the countries with minimal ophthalmic presence. There are only 100 countries represented by ophthalmic societies; more than twice as many countries were represented at the 2008 Olympics. Thus, there are great gaps that must be filled.

5. What is your most memorable international experience?
There are several international experiences that I would like to highlight. They all have influenced my work. The vivid international spirit of the Ventnor Foundation brought me to the Americas in 1959. A 5-month study trip through Middle and South America educated me about diseases unknown in Europe, such as onchocerciasis in Guatemala, smallpox and diphtheria in Ecuador, and vitamin A deficiency in Bolivia. This experience raised my curiosity about medicine in other countries.

In 1965, I traveled to Washington, DC, with my mentor, Lorenz E. Zimmerman, MD, on a fellowship from the Armed Forces Institute of Pathology. It was during this time that I built lifelong friendships with my co-fellows.

In the 1980s, it was rewarding to be an ophthalmologist in Europe and serve as president of the European Ophthalmic Pathology Society, founding member of the European Board, and be a part of the co-initiative for the foundation of the Association of European University Professors of Ophthalmology. One of the most stimulating aspects of my daily work while I was Professor and Chairman of the Department of Ophthalmology at the University Erlangen-Nuremberg (1980-2003) was the opportunity to host 63 fellows from 27 countries.

Not until the 1990s did I begin to ascertain knowledge about the global aspects of our field through the International Federation of Ophthalmological Societies (IFOS) and the ICO. This brought me in contact with Serge Resnikoff, MD, of the World Health Organization, and nongovernmental organizations, such as Christoffel Blindenmission. During my ICO presidency (1998-2006), I cherished daily contact with other officers, particularly Bruce Spivey, MD; Mark Tso, MD; and Balder Gloor, MD, as well as interaction with physicians from 100 ophthalmic societies. Networking with these colleagues inspired groundbreaking projects such as assessment tests; the fellowship program; a curriculum for medical students, allied health personnel, medical specialists, and continuous medical education; visual standards for driving; and clinical guidelines.

Teaching as a visiting professor in institutions throughout Europe and worldwide reinforced my conviction that ophthalmology is a uniquely privileged medical specialty. It deserves our devotion to its progress in teaching, research, and patient care, both now and in the future.