In Memoriam: James Finbarr (Barry) Cullen

In Memoriam In Memoriam: James Finbarr (Barry) Cullen FIG. 1. Barry Cullen 1928–2020. J ames Finbarr Cullen died on September 23 2020, in Edinburgh, Scotland, at the age 92 years. Barry, as he was affectionally known, was born July 13, 1928, in Cavan, Ireland (Fig. 1). He trained in Ophthalmology in Newcastle, England, and then did a neuro-ophthalmology fellowship at the Wilmer Eye Institute in Baltimore, Maryland, with Frank Walsh, the father of American neuroophthalmology. In 1965, he joined the Eye Department at the Royal Infirmary of Edinburgh where he remained until he left for private practice in 1994. During his time, he was a founding member of The British Isles NeuroOphthalmology Club, which still meets annually (Fig. 2). In 1998, at the age of 70 years—an age when many physicians have long-since retired or at least are about to retire —Barry moved to Singapore to set up a neuroophthalmology service at the Singapore National Eye Centre (SNEC). Tow et al: J Neuro-Ophthalmol 2021; 41: e251-e253 Actually, Barry’s first foray into Singapore began 12 years prior in 1986, at the invitation of Professor Arthur Lim who was the head of the newly formed department of Ophthalmology in the 1-year-old National University Hospital (NUH), to approve the department for training. Discussion to create a Master of Medicine in Ophthalmology (MMedOphth), conjoined with the Fellowship of the Royal College of Surgeons of Edinburgh, also began at that time. Barry arranged for his senior registrars to go to NUH to work for 6 months at a time for the purpose of supervising and training the residents. Tutorials, given 3 times a week were open to all trainees in Singapore, as instructed by Barry. He was so successful that in 1998, Dr. Vivian Balakrishnan, Medical Director of SNEC at the time, invited Barry to Singapore to set up a neuro-ophthalmology service at SNEC. What was meant to be a 2-year assignment developed into a 17-year calling (Fig. 3). Barry was deeply committed to teaching. Ophthalmology residents, including those from other hospitals, came under his wing at combined teaching rounds. He endeared himself to the residents by reaching out to every single one to learn their name and to get to know them. He also generously volunteered his time to give preexam tutorials. At a party organized by the residents to celebrate Barry’s 80th birthday in 2008, he revealed the reason behind his passion and dedication in mentoring them, stating that “The future of ophthalmology lies with its residents.” Barry was a keen researcher in clinical neuroophthalmology, publishing about 100 journal articles before he joined SNEC, including pioneering work on occult giant cell arteritis. He encouraged residents and fellows to do research, and during his time in SNEC, he published together with them about 20 articles. In 2012, at the age of 84 years, Barry was awarded the prize for the Best Oral Presentation for his talk on ‟Ischaemic Optic Neuropathy in South East Asia” at the 19th (and last) meeting of the International Neuro-Ophthalmology Society that was held in Singapore. Even after he returned to Edinburgh from Singapore in 2015, Barry continued to publish articles in journals. Indeed, in his 91st year, he described the 60-year follow-up of a 10-year-old girl who, in 1927 (a year before Barry was born), had undergone a successful transsphenoidal hypophysectomy for a pituitary adenoma, following which she had radium needles inserted. This treatment was performed 18 years after Marie and Pierre Curie had discovered the element and while Marie was still a healthy 60 years old. At the age of 71 years, this remarkable patient had been evaluated over at least 3 professional lifetimes and caused Barry to opine e251 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited. In Memoriam FIG. 2. British Isles Neuro-Ophthalmology Club (BINOC): Dan Milea, Neil Miller and Barry Cullen. that “we only dabble in the care of our patients” (https:// www.eyenews.uk.com/media/15385/eyeam19-cullen.pdf “A Pituitary Tumor from 1927”). Barry had a strong influence in the Royal College of Surgeons of Edinburgh, being the chief overseas advisor to the Edinburgh College, and he used that influence for the good of ophthalmology all over the world. The first FIG. 3. At the Singapore Neuro-Ophthalmology Group (SNOG) 2003: left to right: Alvin Seah, Kong Yong Goh, Sharon Tow, Neil Miller, Barry Cullen, Su Ann Lim, Clement Tan. e252 FRCSEd exam to be organized outside Edinburgh was held in Singapore in 1989, conjoined with the newly established MMedOphth examination. Barry would travel to Singapore every year, take down the names of all the trainees and speak with each one personally to find out how they were doing and when they were due to take the exams. In Edinburgh, he mentored Singaporean candidates and helped them with the exam preparations—such was his concern for their training. Barry subsequently made it possible to run RCSEd preparatory courses and exams in India (Chennai), Hong Kong, Malaysia, and Dubai, and he encouraged some ophthalmologists from Singapore to contribute to these exams as instructors in the courses or as external examiners. As a result of local training and examinations, many more candidates were able to take and pass the exams, thus becoming Fellows of the RCSEd. It is no wonder that Barry was held in high esteem by numerous ophthalmologists whom he helped train in these countries. Barry’s affable personality led to the formation of numerous friendships between him and his colleagues around the world (Fig. 4). Following Barry’s retirement from SNEC, he received a regular stream of visitors at his home in Edinburgh, with reunions often celebrated on the golf course! Inspired by Barry’s many years of selfless contributions to ophthalmology, the concept of a Barry Cullen International Fellowship in Ophthalmology and Visual Sciences was proposed to Barry by SNEC in late 2019, to which he responded with enthusiasm. This award will be conferred on a local or international fellow for subspecialty training at SNEC, preferably in neuro-ophthalmology. The official introduction of the Barry Cullen Fellowship Fund was meant to take place at the 30th Anniversary Meeting of SNEC in July 2020 with Dr. Neil Miller giving a citation in honor of Barry; however, due to the COVID-19 pandemic, the meeting was postponed. When Barry passed away peacefully in his sleep on September 23, 2020, all who knew him felt a deep and FIG. 4. Friends 2003: left to right: Kong Yong Goh, Barry Cullen, Neil Miller, Clement Tan, Alvin Seah, Sharon Tow. Tow et al: J Neuro-Ophthalmol 2021; 41: e251-e253 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited. In Memoriam tremendous loss. As Dr. Vivian Balakrishnan said, “He gave us more than ophthalmology. He was a mentor, an inspiring role model, a fine gentleman, a paragon of good old fashioned virtue and source of quiet wisdom and support. It is not an exaggeration to say that everyone who worked with him loved him.” He leaves Ann, his wife of 66 years, 5 children–Paul, Stephen, David, Peter, and Sally–and 11 grandchildren. Sharon L. C. Tow, MBBS, FRCS(Ed), FAMS Neuro-ophthalmology Service, Singapore National Eye Centre, Singapore Eye Research Institute, Duke-NUS Graduate Medical School, Singapore Gawn G. McIlwaine, FRCOphth Ophthalmology Department, Mater Hospital, Belfast Health and Social Care Trust, Belfast, Northern Ireland, United Kingdom Tow et al: J Neuro-Ophthalmol 2021; 41: e251-e253 Neil R. Miller, MD, FACS Neuro-Ophthalmology Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland E-mail: [e-mail] ACKNOWLEDGMENTS The authors thank Drs. Vivian Balakrishnan, Caroline Chee, Jod Mehta, K Ravishankar, Khor Wei Boon, Melissa Wong, Muthusamy Palanisamy. Mr. Ian Leo. Click on this link if you would like to support the Barry Cullen International fellowship: https://www.giving.sg/ snec-health-research-endowment-fund/barry_cullen. You may also contact Ian Leo at [e-mail] if you have any questions. e253 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited.