After the Revolutionary War, there is evidence that Americans turned their zeal for change and invention to tasks outside of the political arena. In particular eyesight and eyeglasses were of interest to these early Americans as is evident by Benjamin Franklin’s own invention of bi-focal lenses in 1784. Americans were also interested in creating new commerce. In 1800 John McAllister (1753-1830) began to carry spectacles in his cane and whip shop. The War of 1812 forced him to begin manufacturing eyeglasses as importation became harder. These early steps were the beginning of the American ophthalmic industry.

It was not until the 19th Century, however, that ophthalmology both in America and abroad really began to evolve into a modern medical specialty. The evolution began in Europe when, in 1812, the University of Vienna championed the specialty by appointing George Joseph Beer (1763-1821) to professor of the new department of ophthalmology. His appointment and subsequent publications surely influenced Americans to take steps in the direction of establishing their own medical institutions including the New York Eye and Ear Infirmary and the Massachusetts Charitable Eye and Ear Infirmary.

George Frick (1793-1870) was a pioneer in the establishment of American ophthalmology. In 1822, Dr. Frick created the first American ophthalmology ward in the new Baltimore General Dispensary. One year later, Frick became the first American to publish a book on ophthalmology, entitled, Treatise on the Diseases of the Eye. Having places to teach and learn ophthalmology, with textbooks written in English, greatly increased the number of medical students interested in eye disease. Henry Willard Williams (1831-1895) of Boston followed in this same path, and became the first to conduct a clinical course in ophthalmology at Harvard Medical School in 1850, and the first professor of the school’s ophthalmology department in 1871.

One noteworthy result of this early period was the career of John Homer Dix (1811-1884). In 1834, Dr. Dix was the first resident to be trained in ophthalmology and otology at the Massachusetts Eye and Ear Infirmary. Dr. Dix went on to establish a full-time eye, ear, nose and throat practice; a move that most American physicians considered financially risky. Most notably in the development of ophthalmology, Dr. Dix was the first American to perform an eye operation using ether anesthesia in 1846.

The establishment of institutions and the introduction of anesthesia were major developments for American ophthalmology, however the one invention that fundamentally changed the profession was introduced in 1850. In that year, Herman von Helmholtz demonstrated the ophthalmoscope and for the first time revealed the inner workings of the living eye. The invention quickly crossed the Atlantic. In 1854, John Homer Dix wrote the first paper by an American to describe the ophthalmoscope and how it worked. With the help of the ophthalmoscope, great strides were made in diagnosis and description of eye disease. Between 1850 and 1900 the amount of work in the area of ophthalmology more than doubled and it was truly established as a modern medical specialty.