The History of Neuro-Ophthalmology in Chile

WorldWide Neuro-Opthalmology Section Editor: Kathleen B. Digre, MD The History of Neuro-Ophthalmology in Chile D r. Albert Schweitzer was a pioneer in neuroophthalmology in Chile (Fig. 1) Born in 1901 and graduating from medical school in 1922, he became chief of the Ophthalmology Department at the Hospital Salvador, Santiago, Chile, the first ophthalmology service in the country. In 1939, Dr. Alfonso Asenjo, Professor of Neurosurgery, invited Dr. Schweitzer to help create a neurosurgical institute called Instituto de Neurocirugia (INCA). This established the first neuro-ophthalmology service in Chile and Latin America (Fig. 2). During his professional life, Dr. Schweitzer taught medical students, residents, and fellows in neurology, ophthalmology, and neurosurgery, and in 1993, he was named "Master of Neuro-Ophthalmology in Chile." He died in 1998. Neuro-ophthalmology was continued at the INCA by Ximena Vicuña and then Mariana Schweitzer, daughter of Albert Schweitzer. She worked at the INCA for 40 years serving as chief of the neuro-ophthalmology department for 23 years. Generations of ophthalmology and neurology residents were taught by her, with most coming from different areas of Chile, but others from other Latin American countries as well (Fig. 3). In 1988, Mariana Schweitzer with Cristian Luco (Chile) and Lidia Lopez (Argentina) created the Latin American Club of Neuro-ophthalmology (CLAN). The first meeting was held in Reñaca, Chile. Since then, the meeting has been held in various sites in North, South, and Central America including Argentina, Venezuela, Brazil, Cuba, Ecuador, Mexico, Paraguay, United States, and Uruguay. One of the most memorable meetings was held in Buenos Aires in 1990, where William Hoyt was one of the honored guests. Dr. Hoyt also attended a 1996 meeting in Santiago, Chile (Fig. 4). Major American supporters of annual CLAN Meetings include Tom Hedges and Peter Quiros. Over the years, attendance at CLAN meetings led to the creation of the "Ami-CLAN," friends of CLAN family members actively participate in social activities during the meetings, leading to wonderful friendships among the members. Education Currently, in Chile there are 4 university hospitals that have neuro-ophthalmology clinics, mostly based in ophthalmology departments. In all of them, neuro-ophthalmology is a mandatory part of residency training in (Universidad de Chile, Salgado: J Neuro-Ophthalmol 2016; 36: e13-e15 FIG. 1. Albert Schweitzer, a pioneer in neuro-ophthalmology in Chile. Pontificia Universidad Catolica de Chile, Universidad de Los Andes, and Universidad de Concepcion). Today, there are 2 training tracts for fellows in neuroophthalmology in Chile. One is for 6 months and the other lasts 1 year, and both are held at the INCA. While the fellows are primarily from Chile, ophthalmology and neurology residents from different hospital clinics from Santiago rotate as part of their training under supervision of Veronica Fernandez and Cristian Luco. In addition, 2 ophthalmologists from Colombia and one from Argentina have received training at the INCA. In the near future, an additional 1-year fellowship will be created at the Pontificia Universidad Católica de Chile, open to national and international physicians. A few ophthalmologists have been received neuroophthalmology training outside of Chile. Nicolàs Seleme did an observership for 4 months under supervision of Peter Savino at the Wills Eye Institute (Philadelphia) in 2007, Olga Acuña trained for 6 months at the Wilmer Eye Institute from December 2007 to July 2008, and Cristian Salgado was trained for one year clinical/research fellowship under the supervision of Neil Miller and Prem e13 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited. WorldWide Neuro-Opthalmology FIG. 2. The first neuro-ophthalmology department in Chile created in 1977. Albert Schweitzer is seated in the middle, with his daughter, Mariana, to his left and Christian Luco to her left. FIG. 3. Mariana Schweitzer (left) teaching residents. FIG. 4. William Hoyt (middle) at the CLAN meeting held in 1996 in Santiago, Chile. To his right is Mariana Schweitzer and to his left, Christian Luco. e14 Salgado: J Neuro-Ophthalmol 2016; 36: e13-e15 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited. WorldWide Neuro-Opthalmology Subramanian at the Wilmer Eye Institute from August 2008 to July 2009. In all, there are approximately 20 active neuroophthalmologists in Chile, most of them practicing in academic settings in Santiago. There are only 2 active members of NANOS from Chile, Cristian Luco and Cristian Salgado. With increased awareness and interest in neuro-ophthalmology, it is likely that more clinicians will become international members. The development of neuro-ophthalmology in Chile will continue to grow in the years to come, and the future appears very promising. ACKNOWLEDGMENTS Thanks to Mariana Schweitzer and Veronica Fernandez for pictures and relevant information that they generously shared with me. Cristian M. Salgado, MD Chief, Department of Ophthalmology, Pontificia Universidad Catolica de Chile, Santiago, Chile Difficulties in Daily Life Reported by Patients with Homonymous Visual Field Defects: Erratum In the article that appeared on page 259 of the September 2015 issue of the Journal of Neuro-Ophthalmology, a sentence within the Results section listed the wrong reference. The corrected sentence and reference are below. Linking the reported difficulties to the ICF: Classifying the reported difficulties according to the ICF linking rules (21) resulted in 268 concepts for the open-ended question and 248 concepts for the standardized questionnaires. Additionally, the following sentence within the Results section had a link to the incorrect Supplemental Digital Content table. The corrected link is below. During the process of linking these concepts, in 4 of 516 concepts, no unanimous decision was reached, and the fourth evaluator was involved in the decision process, resulting in agreement (see Supplemental Digital Content, Table E4, http://links.lww.com/WNO/A211). REFERENCE 1. de Haan GA, Heutink J, Melis-Dankers BJM, Brouwer WH, Tucha O. Difficulties in daily life reported by patients with homonymous visual field defects. J Neuroophthalmol 2015;35:259-264. Salgado: J Neuro-Ophthalmol 2016; 36: e13-e15 e15 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited.