I took over as Head from Dr. RMH Pinkerton in 1991, and was appointed Professor in January 1992.
I returned from Wills Eye Hospital’s retina fellowship in 1983 to my alma mater (Queen’s Meds ’75) to establish a modern sub-specialty retina unit, having been inspired to do so by both Drs. Pinkerton and Rosen, who were my teachers. Drs. Wendell Willis and Jack Morgan were also enthusiastic clinical teachers and supporters of my training. Clinical research was my interest as an Ontario Career Scientist, and I was very fortunate to have the help of Drs. Joe Pater (epidemiology) and Andy Willan (biostatistics), who put Queen’s on the map, so to speak, in the world of clinical trials. Canadian retina specialists in academic centres across the country were generous supporters of the work, and formed the Canadian Ophthalmology Study Group or COSG, the basis of what was to become many years later the Canadian Retina Society.
We had a strong postgraduate residency program, as RMH Pinkerton mentioned, which made for a rigorous immersion course for our residents, especially since we had no regular fellows through the early years. Early recruits to the geographic full time (GFT) department included Dr. Martin ten Hove in neuro-ophthalmology from Bascom Palmer Eye Institute, and Dr. Donna Bautista in pediatric ophthalmology to replace Dr. Brian Arthur, who had left for the U.S. Our community ophthalmologists, including Drs. Allan Kerr, R. David Macklin, and Ray Gauthier were outstanding and generous surgical teachers; we could not have thrived without them. Allan Kerr, a gifted surgeon, was the first to transition to phacoemulsification cataract surgery. The community group was joined as RMHP mentioned by Dr. Vlad Kratky who brought subspecialty orbit/oculoplastics surgery to enrich the postgraduate teaching and clinical service in our department.
One important postgraduate educational development occurred during Dr. Robin Walker’s internship, now called PGY1, when ophthalmology gained control over the curriculum of the PGY1 year, allowing us to design our own pre-residency year for the first time. This occurred as the residency became 4 years in length. We relied on our understanding and accommodating partners in the Departments of Medicine and Surgery to provide appropriate sub-specialty rotations for our upcoming residents. Dr. Jim Wilson, then Associate Dean of Undergraduate Affairs, is to be commended for effectively allowing us to grow our number of residency positions to maintain two residents per year, an essential quality preserving strategy for the postgraduate education program.
1994 saw the establishment of Queen’s School of Medicine’s Alternate Funding plan (AFP) and a governing organization known as SEAMO (Southeastern Ontario Academic Medical Organization) to fund academic medicine at Queen’s. We in ophthalmology struggled within this organization for several years to make our case amongst the competing priorities of the School of Medicine, but the academic future of the department to support sub-specialty care, teaching and research was then made secure.
1997 saw a major turning point for the department’s clinical teaching and research facilities when we were embraced by the Sisters of St. Joseph, and the Board of the Hotel Dieu Hospital to incorporate our clinical, teaching, and research facilities from KGH and Etherington Hall. A beautiful new eye clinic was opened on Johnson 6 of the HDH, which has been recently renovated and expanded. Challenges included starting sub-specialty retina surgery at the Dieu, as this was the last surgery to move over from KGH, but the staff and officers of the HDH at the time, including especially CEO Hugh Graham, are to be commended. The unflagging support of the Jeanne Mance Foundation, under the leadership of Geraldine Tepper, also deserves special mention; we were never once refused our requests for critical pieces of high tech diagnostic and therapeutic equipment for our work.
The recruitment of Dr. Sanjay Sharma (medical retina) to our faculty was a proud achievement, which allowed us to build a centre for clinical research on Johnson 2. His work on cost-effectiveness and utilities of novel therapies in ophthalmology was immediately recognized internationally and has been adopted by newer additions to the faculty.
The department had a strong tradition of outreach clinical service and teaching to Rideau Regional Hospital in Smiths Falls dating from the 1970’s first with Dr. David Rosen and later Dr. Ray Bell (neuro-ophthalmology), and continued by AFC after 1983. Outreach expanded to include screening the indigenous Cree communities of western James Bay for diabetic retinopathy, and receiving tertiary surgical referrals from Moose Factory Hospital, work which helped to propel telemedicine and tele-ophthalmology in Canada.
2001 saw a major milestone achieved in philanthropy towards the department when Dr. Ernie Johnson endowed a Chair in Ophthalmology at Queen’s with a $1,000,000 gift. Dr. Johnson was a proud graduate of Queen’s Medicine, beloved in Calgary, where the Alumni Association named their Chapter after him. He had a distinguished career in ophthalmology being awarded the Order of Canada in 1992 for his missionary efforts, and for the founding of Operation Eyesight Universal. He endowed the Ernie and Edna Johnson Chair in Ophthalmology. Additionally, Dr. David Barsky, also honoured his medical alma mater with a 1 million dollar gift to our department. A former AFIP fellow in ophthalmic pathology, Dr. Barsky had a distinguished career in private practice in Detroit, and contributed to the Kresge residency program by teaching pathology to its residents.
By 2001-2002, the department saw 5 of its members incorporated as geographic full time (GFT) members of SEAMO: Dr. Alan Cruess (retina), Dr. Martin ten Hove (neuro-ophthalmology), Dr. Donna Bautista (pediatrics), Dr. Sanjay Sharma (retina) and Dr. Wendell Willis (cornea and external disease).
Other members of the department included: Dr. Allan Kerr, Dr. Vlad Kratky (oculoplastics/orbit) Dr. David Macklin, Dr. Frank Stockl (retina), Dr. Elaine Woo (glaucoma), Dr. John Cheung (uveitis), Dr. Garth Taylor (cornea) and Dr. David Edmison (refractive). The full-time university portion of the department was, by and large, a “one string basketball team” with limited bench strength in the sub-specialties. It would take the next generation of leadership to add the depth needed to build on the excellent core of ophthalmologists listed above to develop the superb department it is today.
It was my honour and privilege to serve Queen’s as Head of Ophthalmology until 2003, when I was appointed as Head of the Department of Ophthalmology and Visual Sciences at Dalhousie in Halifax.
Alan Cruess