https://doi.org/10.1177/1179172117721902 Ophthalmology and Eye Diseases Volume 9: 1–51 © The Author(s) 2017 DOI: 10.1177/1179172117721902 Creative Commons CC BY: This article is distributed under the terms of the Creative Commons Attribution 4.0 License (http://www.creativecommons. org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). Introduction The establishment of European colonies in the New World after 1492 brought about the proximity of indigenous, European, and African cultures, each with distinct approaches to medical care. Diseases such as smallpox, measles, scarlet fever, typhoid, cholera, diphtheria, and malaria were intro- duced to the Americas, 1 where the native populations who lacked immunity suffered very high mortality rates. The Old World skills and techniques in every medical area, including ophthalmology, were gradually transferred to the Americas. In Europe, spectacles were used to correct refractive error and cataract couching was performed. European oculists and other surgeons traveled to the colonies, and early American settlers returned to Europe for training. We present a review of some aspects of early North American ophthalmology not highlighted previously in the ophthalmology literature. 2–4 This review discusses the follow- ing: (1) Native American cultures, (2) particular eye ailments and treatments, and (3) surgeon biographies and early American universities. We define North America to include the areas of present-day Canada, the United States, Mexico, the Caribbean, and Greenland. A complete list of native American and European ophthal- mic remedies during this period is beyond the scope of this work. 5 The cases presented are merely illustrative examples of early American treatments. We searched for terms such as eye, oculist, cataract, glau- coma, and retina in numerous databases: American newspa- pers, 6 the Human Relations Area Files, 7 the Colonial North American Project, 8 American National Biography Online, 9 the Dictionary of Canadian Biography, 10 Hemeroteca Nacional Digital de México, 11 Caribbean Newspapers (1718-1876), 12 Early American Imprints (1639-1819), 13,14 American Periodicals Series Online, 15 Founders Online, 16 Early English Books Online, 17 and Gale Eighteenth Century Collections. 18 Native American Ophthalmology Overview Some information about Native American understanding of the eye comes from the reports of European settlers. Of course, these observers wrote from their own perspectives and may not have always understood what they were seeing. The Native Americans may have been influenced by earlier European set- tlers. Moreover, some eye diseases treated by the Natives, such as smallpox and trachoma, were not even thought to have existed in pre-Columbian America. These limitations notwith- standing, the reports provide some idea of the types of Ophthalmology in North America: Early Stories (1491-1801) Christopher T Lefler 1 , Stephen G Schwartz 2 , Ricardo D Wainsztein 3 , Adam Plugrath 1 and Eric Peterson 1 1 Department of Ophthalmology, Virginia Commonwealth University, Richmond, VA, USA. 2 Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Naples, FL, USA. 3 Instituto de la Visión, Buenos Aires, Argentina. ABSTRACT: New World plants, such as tobacco, tomato, and chili, were held to have beneficial effects on the eyes. Indigenous healers rubbed or scraped the eyes or eyelids to treat inflammation, corneal opacities, and even eye irritation from smoke. European settlers used harsh treatments, such as bleeding and blistering, when the eyes were inflamed or had loss of vision with a normal appearance (gutta serena). In New Spain, surgery for corneal opacity was performed in 1601 and cataract couching in 1611. North American physicians knew of contralateral loss of vision after trauma or surgery (sympathetic ophthalmia), which they called “sympathy.” To date, the earliest identified cataract couching by a surgeon trained in the New World was performed in 1769 by John Bartlett of Rhode Island. The American Revolution negatively affected ophthalmology, as loyalist surgeons were expelled and others were consumed with wartime activities. After the war, cataract extraction was imported to America in earnest and academic development resumed. Charles F Bartlett, the son of John, performed cataract extraction but was also a “rapacious privateer.” In 1801, a doctor in the frontier territory of Kentucky observed anticholinergic poisoning by Datura stramonium (Jimsonweed) and suggested that this agent be applied topically to dilate the pupil before cataract extraction. John Warren at Harvard preferred couching in the 1790s, but, after his son returned from European training, recommended treating angle closure glaucoma by lens extraction. Other eye procedures described or advertised in America before the 19th century included enucleation, resection of conjunctival lesions or periocular tumors, treatment of lacrimal fistula, and fitting of prosthetic eyes. KEYWORDS: Ophthalmology history, cataract surgery RECEIVED: March 9, 2017. ACCEPTED: June 26, 2017. PEER REVIEW: Five peer reviewers contributed to the peer review report. Reviewers’ reports totaled 974 words, excluding any conidential comments to the academic editor. TYPE: Review FUNDING: The author(s) disclosed receipt of the following inancial support for the research, authorship, and/or publication of this article: Partially supported by NIH Center Core Grant P30EY014801 and by an Unrestricted Grant from Research to Prevent Blindness to the University of Miami and within the past 3 years, SGS has received funding from Alimera, Bausch + Lomb, and Welch Allyn. DECLARATION OF CONFLICTING INTERESTS: The author(s) declared no potential conlicts of interest with respect to the research, authorship, and/or publication of this article. CORRESPONDING AUTHOR: Christopher T Lefler, Department of Ophthalmology, Virginia Commonwealth University, Richmond, VA 23298-0438, USA. Email: chrisleflermd@gmail.com 721902OED 0 0 10.1177/1179172117721902Ophthalmology and Eye DiseasesLeler et al research-article 2017