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There have been greater advances in our knowledge of the visual
function and its disabilities in the past 50 years than had
accumulated in all of the previous years. This applies not only to
the basic science of biochemistry, physiology, physiopathology, and
cytopathology but also to the diagnosis and treatment of visual
dysfunction and ocular disease. These advances have been aided by a
proliferation of ingenious instruments. When I began my residency
in ophthalmology at The Wilmer Institute in 1938, one was supposed
to learn not only the physiology of vision but also how to diagnose
and treat all phases of ophthalmology including disabilities of the
orbit, sclera, retina, lens, and cornea. In addition he or she was
supposed to understand neuro-ophthalmology, ophthalmic genetics,
and so-called uveitis. It soon became evident that no one could
adequately comprehend all of these areas and, therefore, most young
trainees today take a year or two of fel lowship in a specialized
area following their three-to five-year residency train ing.
Following this they join a group of other ophthalmologists and
specialize. Thus, they become more expert in the diagnosis and
treatment in a limited area in ophthalmology. When I returned to
The Wilmer Institute in 1955 as Head of the Department I was the
only full-time member of the staff. To date we have some 28
full-time ophthalmologists working in highly specialized areas of
our institution.
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