Sir Harold Ridley
Sir Harold Ridley was a modest giant of science who, despite fierce professional opposition, established one of the greatest milestones in medical history. – Pearce Wright, The Guardian newspaper, 2001.
The life and work of David Apple is intertwined with the life of Harold Ridley, the English inventor of the intraocular lens (IOL).
Sir Nicholas Harold Lloyd Ridley (10 July 1906, Kibworth, Leicestershire – 25 May 2001, Salisbury, Wiltshire) was the son of Nicholas Charles Ridley and his wife Margaret, née Parker. He was educated at Charterhouse School. He studied at Pembroke College, Cambridge from 1924–1927, and completed his medical training in 1930 at St Thomas’s Hospital in London. Subsequently he worked as a surgeon at both St Thomas’s Hospital and Moorfields Eye Hospital, specialising in ophthalmology. In 1938 he was appointed full surgeon and consultant at Moorfields Hospital. In 1946 he was appointed Consultant Surgeon.
In World War II, Ridley treated Royal Air Force casualties with eye injuries. He noticed that when plastic splinters from the cockpit canopies of Hurricane and Spitfire aircraft became lodged in the eyes of pilots this did not trigger rejection while glass splinters did, leading him to propose the use of plastic implant lenses to correct cataract.
In the late 1940s he had a lens manufactured using Perspex material (made by Imperial Chemical Industries) at Rayner’s lens-manufacturing site in Brighton, East Sussex. On 29 November 1949 at St Thomas’ Hospital, Harold Ridley achieved the first implant of an intraocular lens.
The first IOL implant performed in the USA was in 1952, a Ridley-Rayner lens implanted at the Wills Eye Hospital in Philadelphia.
Ridley pioneered this treatment in the face of prolonged and strong opposition from the ophthalmic community. It took many years for IOLs and the associated surgical techniques to be accepted. It was not until the 1970s that a new generation of eye surgeons re-discovered the intraocular lens. The first IOl to be approved as “safe and effective” and approved for use in the USA by the Food and Drug Administration in 1981 was an anterior chamber lens manufactured by Rayner and designed by Ridley’s disciple Peter Choyce.
Ridley retired from NHS hospital service in 1971. His contribution to modern ophthalmic surgery was not fully recognised by his peers and the general public until the late 1980s, when David Apple began to campaign for recognition of his achievement as inventor of the IOL.
In the 1990s Ridley had a further remarkable achievement – and this time a personal one – when he had successful bilateral IOL implantation at St Thomas’s Hospital by the surgeon Michael Falcon: thus Harold Ridley benefitted from his own invention and the surgical procedure that he had pioneered. What was most pleasing to him was that he had the operation done at the same hospital where he performed the first IOL operation.
On 29th November 1999 a Gala Banquet was held in the Science Museum in London to commemorate the fiftieth anniversary of Ridley’s 1949 IOL operation. This event reunited the early pioneers of IOL surgery (Ridley with Peter Choyce, Edward Epstein and Svyatoslav ‘Slava’ Fyodorov) with later generations of ophthalmologists including Eric Arnott and many distinguished guests from the UK and overseas. David Apple was unable to attend because of illness but his wife Ann and daughter Jacqueline were there. The Parliamentary Under-Secretary of State in the Department of Health, Lord Hunt of King’s Heath represented Her Majesty’s Government. Ridley was photographed in front of World War II fighter planes, holding a pair of cataract-spectacles. His IOL invention had rendered these spectacles obsolete.
He was knighted by HR Queen Elizabeth II in 2000 at a ceremony in Buckingham Palace. Sir Harold Ridley resided in Stapleford near Salisbury, Wiltshire until his death on 25 May 2001. In the 1990s he had appointed Apple as his biographer. The book, Sir Harold Ridley and his Fight for Sight: He changed the world so that we may better see it, came out in 2006, the centenary of Ridley’s birth. This was a time when David Apple was very ill and at the beginning of 2006 there was some doubt that he might complete it within the year but he persevered: published it and launched the book in London in September 2006.
Apple, David J (2006). Sir Harold Ridley and his fight for sight. Thorofare, NJ. SLACK Incorporated. ISBN 1-55642-786-7
David J Apple entry in Wikipedia.com
Harold Ridley (ophthalmologist) entry in Wikipedia.com
Onchocerciasis (River Blindness)
Harold Ridley also led important research into onchocerciasis when he was stationed in the Gold Coast, now Ghana, for part of his war service in World War II.
In 1941 while Ridley acted as part-time sanitation officer at the capital city of Accra, he met Brigadier G. M. Findlay, AMS, who stimulated Ridley’s interest to study River Blindness, an endemic disease in parts of the country. To find onchocerciasis patients, Ridley left the coastal city and travelled overland with Captain John Holden to north west Ghana. He worked in Funsi in the Wa East District of the Upper West Region for two weeks, examining patients with a slit-lamp, which ran off a 12-volt battery. Most (90%) had onchocerciasis; ten percent of these were blind. Conditions were primitive and Ridley recorded his observations of the Fundus by water-colour painting and photography. His painting of the fundus (sometimes termed the “Ridley fundus” of onchocerciasis) was completed in Accra upon his return from Funsi. “The attention he called to this disease constitutes one of Mr. Ridley’s major contributions. His monograph “Ocular Onchocerciasis,” published in 1945 in a supplement of the British Journal of Ophthalmology was a landmark.”
The Implant Club
The International Intra-Ocular Implant Club (IIIC)
The Club was founded in 1966 by Ridley and Choyce to promote research in the field of IOL implantation. At that time there was widespread opposition in the profession to the use of IOLs. The founders saw the club as a forum to allow free and unhindered exchange of ideas about IOLs and implantation surgical techniques. From the outset it was international in its membership and set itself a parental and advisory role for the then nascent national societies to develop in each country for intraocular implant surgeons. However, this global role was only acknowledged in the name change in July 1975, when the Intra-Ocular Implant Club became The International Intra-Ocular Implant Club (IIIC)