Alfred Bielschowsky's 1940 legacy for neuro-ophthalmology.
OBJECTIVE
The author was stimulated to write this article by a 1996 visit to the University where Professor Alfred Bielschowsky was Chairman of Ophthalmology in the 1930s. Dr. Bielschowsky was one of the founders of neuro-ophthalmology. This review, with biographical notes, is presented in his honor. Dr. Bielschowsky and the author had similar disruptive experiences, of historic interest, during the Hitler regime in Nazi Germany.


METHODS
Professor Bielschowsky's legacy begins with his contributions to ocular physiology. For instance, his after-image test establishes the presence of retinal correspondence, important for stereoscopic vision. Alfred Bielschowsky taught how an ocular examination is critical for neuro-ophthalmologic diagnosis, localization, prognostication, and treatment. Much of our knowledge is linked with his name. Examples include "Bielschowsky's Phenomenon", explaining dissociated vertical movements, and "Bielschowsky's Doll's Head Phenomenon" (Doll's Eyes), describing proprioceptive reflexes important for localizing intracranial lesions. Dr. Bielschowsky emphasized many pitfalls in the differential diagnosis of oculomotor anomalies. For example, he cautioned against mistaking the compensatory head position in congenital fourth cranial nerve paresis for neck muscle disease.


CONCLUSIONS
Dr. Bielschowsky's emphasis on the clinical examination remains critical despite today's advanced diagnostic equipment. His legacy is the application of physiology to patient care.
Lippmann
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D005858:Germany; D049672:History, 19th Century; D049673:History, 20th Century; D009462:Neurology / Q000266:history*; D009513:New Hampshire; D009885:Ophthalmology / Q000266:history*