Kerr, James Douglas

2018-01-31T11:46:26Z

2018-01-31T11:46:26Z

1953

T.L. Terry (1942), in the United States of America, first described an alarming condition of blindness affecting babies of low birth weight. He called the condition RETROLENTAL FIBROPLASIA. At that time the condition was relatively uncommon and, generally speaking, the average medical man was not altogether surprised to read of a new hazard affecting the prematurely -born infant. However, from that date cases appeared with Quite frightening regularity in the United States of America. It was realised that this condition of blindness had a tragic implication on the family unit, and if it was not checked it might well become a social problem for which a satisfactory solution would be difficult. The after-care and education of blind children was already a large enough burden.

Naturally, with the advent of a new condition, search began to be made of earlier records. As this proceeded new cases came to light and it was found that in 1938, the incidence of what was now recognised as retrolental fibroplasia occurring among babies in the Boston Lying-In Hospital with a birth weight of 4 lbs. and under, was 18% (Zacharias 1952). Although the condition was not known by the name of retrolental fibroplasia, cases resembling it were described in the earlier literature, e.a. Travers (1820) and Treacher Collins (1892).

It seemed in Britain that we were to escape this tragic occurrence. However, it was not to be, for in 1948 the first case under the title of retrolental fibroplasia was shown at the Royal Society of Medicine by Galloway. It is interesting to note that Franklin (1949) described retrolental fibroplasia as "a rare disease in and around London ". Moffat (1950) found, out of 119 cases of blindness in Sunshine Homes in England, twelve were definite cases of retrolental fibroplasia and two were doubtful cases. It appears that the years 1946- 1947 marked the initial record of cases in this country (Crosse and Evans 1952). From that date onwards the incidence has gradually increased. As interest throughout the world increased reports began to come in from other countries. As in the United States of America, once the condition had been defined reviews of the national literature and of existing cases of blindness were undertaken to determine the earliest true appearance of retrolental fibroplasia.

Reports of investigations and opinions as to the possible aetiology became increasingly numerous. Although opinions differed widely, all groups had two common objectives, namely the understanding and prevention of retrolental fibroplasia.

The first recorded case of the condition in Edinburgh was in 1948. At the beginning of 1952, it was decided to survey all babies who were born and resident in the city during the previous four years, provided that their birth weight was 4 lbs. or under. All babies of a similar weight group born during 1952 were to be examined at frequent intervals up till the age of six months. It was hoped that a clearer understanding of the disease might be achieved by the adoption of such measures.

http://hdl.handle.net/1842/28351

The University of Edinburgh

Annexe Thesis Digitisation Project 2017 Block 16

Retrolental fibroplasia: a clinical and experimental survey during the five years (1948-1952) in the City of Edinburgh

Thesis or Dissertation

MD Doctor of Medicine