Austrian first to describe iris nodules of neurofibromatosis

After extensive ophthalmological training in Vienna and Innsbruck, Carl Lisch (1907-1999), an Austrian ophthalmologist, became the chief of ophthalmology in W?rgl, a small town in the North Tyrolean region of Austria. He practiced in W?rgl from 1947 to 1980. During his lifetime he wrote approximately 120 papers focusing primarily on the phakomatoses and in particular neurofibromatosis.

Editor's Note: A number of physicians have described the various cysts, tumors, lumps, bumps, nodules, and growths that affect the iris. Some of them carry the names of these famous medical men. We will review a few in this month's column.

In 1937, he described the nodules of neurofibromatosis type I that are found on the iris. He acknowledged in his original paper that others before him, including Waardenburg, Fuchs, and Treacher-Collins, among others, had previously described these. Lisch wrote many articles about neurofibromatosis, indicating that the mere presence of these pigmented nodules on the iris can indicate the diagnosis of neurofibromatosis type I. In 1981, Lewis and Riccardi found an incidence of these nodules in 92% of neurofibromatosis type I patients.

Brazilian ophthalmologist Archimede Busacca (1893-1971) was an expert on the use of the slit lamp, and in 1957, he wrote an extensive report to the French Ophthalmological Society on biomicroscopy of the vitreous and fundus oculi. His coauthors were Hans Goldman (1899-1991) and Suzanne Schiff-Wertheimer (1895-1958). In 1971, Busacca wrote an article in the American Journal of Ophthalmology describing nodules that he found on the mesodermic surface of the iris in uveitis. Today those nodules are referred to as Busacca nodules.

Down's syndrome

John Langdon Down (1828-1896), a British physician, was the first to describe a group of patients who had similar clinical features in a paper entitled "Ethnic Classification of Idiots." Early in his career he worked at the Earlswood Asylum for Idiots and noted the following details in these patients' appearance.