History of Optometry

The early history of optometry was linked to the work of opticians as the correction of refractive errors depended on experiments with lenses. The oldest lens that is known is a plano-convex piece of polished rock crystal, 3.8 cm in diameter with a focal length of 11.5 cm found in the ruins of Nineveh, and others date back to 1200 B.C. It is uncertain whether or not they were used to aid vision. It is more likely they were used as burning glasses. Pliny, the philosopher, recorded them as being used by physicians for cauterising wounds. However, it is known that the Romans used glass bowls of water as magnifiers.

The Greeks worked out the laws of reflection in mirrors but did not fully understand the principles of refraction. They also knew of the crystalline lens in the eye but had no knowledge of the retina and thought that rays of light came from the eyes, a myth that existed until Leonardo da Vinci’s investigation into the physics of light rays led to establishing the role of the retina.
Another major step in the development of knowledge about optics came in 1268 when Roger Bacon, an English Franciscan monk wrote his works in which he devoted considerable space to optics. The significance for refraction is that he demonstrated that ‘by placing a segment of a sphere on a book with its plane side down, one can make small letters appear large’. It was the first time that it was suggested that plano-convex lenses could be used to improve the poor vision of older men. However, he did not pursue this theory and it was left to an unknown glass worker, probably from Murano in Italy, to manufacture the first spectacles around 1280.

No historians have been able to trace the inventor of spectacles although there is a legend that they were invented by an Italian named Armato degli Armati supported by an inscription on his tombstone:

"Here lies Salvino d’Armato degli Armati, of Florence, the inventor of spectacles.
May God forgive his sins. He died Anno Domino 1317."

A quotation from Fra Giordano Di Rivalto confirms that spectacles were indeed invented in the late 13th century when he wrote in 1305, ‘it is not yet twenty years since the art of making spectacles, one of the most useful arts on earth, was discovered’. By 1300, laws were enacted in Venice to control the quality of lenses. The spectacles of this time and up to the beginning of the 16th century were primitive being made of horn, bone, leather or metal in two pieces and held together by a rivet, these were eventually replaced by one-piece mounts but the problem remained as to how to keep the spectacles on the nose. Towards the end of the 16th century the Spanish fastened these spectacles by means of threads passed behind the ears but it was not until the early 18th century that spectacles with sides appeared.
By the end of the 16th century guilds of spectacle makers were established in Italy, France and Germany. While these spectacle makers controlled apprenticeships, discipline and quality, they gradually declined. One still exists today however and that is the Worshipful Company of Spectacle Makers in the United Kingdom, chartered by King Charles I in 1629. Its history embodies that of the development of optometry from the manufacture of spectacles, the skill of opticians in the design and production of optical instruments and the move from customers buying spectacles on a trial and error basis to custom made.
In the 1780’s, Franklin improvised what later became known as bifocals but it was not until the beginning of the 19th century that astigmatism was understood and in 1827 the first spectacles were made to correct it by an optician named Fuller in Ipswich in the UK. The terms bifocal and trifocal were introduced by John Isaac Hawkins in London who also patented a trifocal.
The development of spectacles and optical lenses is only one part of optometry. The 19th century saw significant discoveries which led to the rapid development of the science of ophthalmic optics and these would be reflected in the establishment of optometry as a profession in the late 19th century and onwards. It was Donders, a Dutch ophthalmologist and medical scientist who, in 1864, published ‘Anomalies of refraction and Accommodation of the Eye’, which for the first time explained the nature of hypermetropia and presbyopia. It also showed how spectacles could be used for the correction of a squint. Around the same time Helmholtz, a German physician and physicist made significant contributions to the mathematics of the eye and theories of vision, visual perception and colour vision.

In the United States, the first college of optometry in the world was established in Illinois in 1872 followed by the New England College of Optometry in 1894. The American Optometric Association was formed in 1922. In 1891, a London School of Optics and Sight Testing was established by the optical industry in the UK but it was not until some years later, under the direction of the newly established British Optical Association, that the Worshipful Company of Spectacle Makers introduced national examinations for ophthalmic opticians. The British Optical Association was formed by a dissident group of opticians in 1895 and they held the first examinations in 1896, thus setting a national standard for ophthalmic opticians (known today as optometrists) in the UK.
It was almost simultaneous that the professions of optometry and ophthalmic optics came into being, blending together the developments in spectacles and the optics of lenses with visual optics and the physiology of the eye. In the UK legal action brought against a sight-testing optician established that the recognition of abnormalities of the eye and referral to a medical practitioner should be considered the responsibility of an ophthalmic optician.
Throughout the 20th century the scope of practice of optometry has developed with an increasing emphasis on health care. Optometrists around the world are aiming to obtain the right to use diagnostic and therapeutic drugs. In the UK diagnostic drugs have been used since the very early days of the profession in the 20th century simply because there was no legal barrier to their use. The US followed a long time afterwards and achieved the right to use therapeutic drugs in 1976.
In 2008 Dr Simon Barnard, a UK optometrist, made the following statement about the development of Optometry:
“Optometry has developed, and continues to develop differently and at different rates throughout the world. However, in these developments there are some basic principles that can be recognised and are shared by the optometry profession in most countries. What usually occurs, but not necessarily in this order, is:
·    a recognition (usually by the profession’s leaders) of the need to advance and expand the education of the profession;
·    implementation of that education by the training institutions and/or professional body a change in state legislation
·    implementation and integration of these developments into optometric practice.
·   In some cases a change in the law and even state wide education has not been, or indeed may not be necessary.
If the law does not specifically forbid a technique or a use of a drug and optometrists have been carrying out certain procedures for a while, then, in some countries precedent creates a ‘fait accompli’ that may be difficult for legislators to reverse.”

(Sources and references contributing to this article has been made sourced from the internet. Used for not-for-profit and educational purposes only.)