SPECIAL ARTICLE Gullstrand, Einstein, and the Nobel Prize James G. Ravin, MD nly one individual who practiced ophthalmology for a significant period has ever received a Nobel Prize. This was Allvar Gullstrand, MD (1862-1930) (Figure 1), a Swede who was awarded the Nobel Prize in physiology or medicine in 1911. Al- though Gullstrand is often said to be the only Nobel laureate who was an ophthal- mologist,O this is incorrect. Fritz Pregl, MD (1869-1930), an Austrian ophthalmologist who de- serted the eye for analytical chemistry, received the Nobel Prize in chemistry in 1923. Walter Hess, MD (1881-1973), a Swiss ophthalmologist and physiologist, was awarded the Nobel Prize in physi- ology or medicine in 1949 for his work on autonomic control by the hypothalamus. The king of Sweden, Gustav V, awarded vances, far more intense light and sharp Gullstrand the prize on behalf of the con- focus of the beam. ferring organization, the Royal Swedish Ophthalmologists who use this valu- Academy of Sciences “for his works con- able instrument so routinely today may be cerning the dioptrics of the eye.”1 Gull- surprised to learn that it was not imme- strand was recognized for making the most diately incorporated into clinical prac- significant contribution to our understand- tice. Earlier ophthalmologists, in gen- ing of the eye as a refractive organ follow- eral, believed that existing systems of ing the pioneering work of Hermann von illumination were sufficient. A long se- Helmholtz, MD, the German physician and ries of descriptions by many investiga- physiologist who invented the ophthal- tors, especially Alfred Vogt’s atlases, helped moscope in 1850. popularize use of this instrument. Today, Gullstrand is best known as Gullstrand was the Swedish repre- the inventor of the slitlamp. When his slit- sentative to the International Congress of lamp was combined with a microscope Ophthalmology held in Washington, DC, made by members of Zeiss Optical Works, in 1922. The president of the congress, Jena, Germany, it became the basis of the George de Schweinitz, MD, stated that the instrument that is still used in every oph- most important scientific contribution at thalmologist’s office today. Before the de- the meeting was Gullstrand’s demonstra- velopment of this exceptionally useful de- tion of an improved form of his inven- vice, examination of the anterior segment tion. De Schweinitz added jokingly, medi- of the eye could be done with a corneal cine now has a “gentleman with the lamp,” microscope. However, the lighting sys- a male counterpart to nursing’s Florence tems available were far inferior to Gull- Nightingale, the lady with the lamp.2(p330) strand’s slitlamp. At best, they used a dim Gullstrand made another important electric lamp that focused light poorly. contribution to ophthalmology, a reflex- Gullstrand first demonstrated his slit- less ophthalmoscope. Ophthalmoscopy lamp in 1911, the same year he received can be made difficult by the glare of re- the Nobel Prize for his contributions to op- flexes formed from the cornea and other tics. It incorporated 2 important ad- layers of the eye, which act like mirrors, reflecting light back at the examiner. Bright sources of illumination and small pupils From the Department of Surgery, Section of Ophthalmology, Medical College of Ohio, are contributory factors. The solution to Toledo. this problem is either to separate the sys- ARCH OPHTHALMOL / VOL 117, MAY 1999 670 ©1999 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/28/2021 tems of illumination and observa- tion or to use polarized light. Gull- strand used the first of these 2 options.3 Other ophthalmologists have been nominated, but not selected, for the Nobel Prize in physiology or medicine. Hjalmar Schio¨tz, MD, was considered for his tonometer, as was Karl Koller, MD, for his discovery of topical anesthesia in the eye. Jules Gonin, MD, nearly received the award for his innovations in retinal detachment surgery. He was recom- mended by the Nobel committee in 1934, but died before the Royal Swedish Academy of Sciences made 4 Figure 1. Allvar Gullstrand, MD (1862-1930). Figure 2. Albert Einstein, PhD (1879-1955). its decision. The Nobel Prize has Courtesy of Howe Library, Massachusetts Eye Courtesy of Corbis Images, New York, NY. been awarded to other scientists and Ear Infirmary, Boston. whose work concerns the function of the eye. In 1967, Ragnar Granit, their prize; Gullstrand declined the previous recipients of a prize and MD, Haldan Hartline, MD, and Nobel Prize in physics in favor of the members of the academy. The nomi- George Wald, MD, were the desig- Nobel Prize in physiology or medi- nations are reviewed by a commit- nees for their contributions to our cine.5(pp73-74) The Nobel statutes re- tee of 5 individuals, with a separate understanding of the chemistry and quire committee deliberations to be committee for each prize. Each com- physiology of vision. In 1981, David kept confidential. So what tran- mittee then submits its report to a Hubel, MD, and Torsten Weisel, spired during the committee meet- section within the academy for its MD, were the recipients for their ings in 1911 has never been made approval. The final decision is made work on information processing in public. We do not know if Gull- by a vote of the full academy. The the visual system. strand excused himself during the process in medicine or physiology The 5 original Nobel Prizes discussions. is similar, except that the Karolin- were first given in 1901 in the fields From 1911 to 1929, Gull- ska Institute, not the academy, is of physics, chemistry, physiology or strand was a member of the Nobel involved. medicine, peace, and literature. The Committee for Physics, and served From1910to1922,Einsteinwas Nobel Prize in economics was added as its chairman from 1923 to 1929. nominated every year except 2, 1911 in 1969. The prize has often been a During the academic year 1925- and 1915.5(p68) He had published sev- matter of national pride. The Swed- 1926, he was president of the Royal eral important papers in the first de- ish people were pleased when Gull- Swedish Academy of Sciences, the cade of the new century, and was strand was named a recipient, for body that awards the Nobel Prizes widely recognized for the importance until that time no citizen of the con- in chemistry and physics (as well as of his contributions. However, Ein- ferring country had ever won in 2 of economics since 1969). stein was a theoretical physicist, and the 5 categories: physics and physi- Albert Einstein, PhD (Figure by the terms of Alfred Nobel’s will, ology or medicine. 2), (1879-1955) was nominated for the prize was to go for works of Gullstrand is the only indi- the Nobel Prize in physics many times proved, not theoretic, value to hu- vidual who both received and also and was awarded this prize while manity. Nobel, who had died in 1896, declined a Nobel Prize. (Rarely has Gullstrand was a member of the No- left a will that stated the proceeds a Nobel Prize been declined. Rus- belCommitteeforPhysics.Gullstrand “shall be annually distributed in the sian author Boris L. Pasternak de- was a strong personality and a pow- form of prizes to those who, during clined the Nobel Prize for litera- erful force on the committee. He the preceding year, shall have con- ture in 1958, French writer Jean- wrote 2 harsh opinions against giv- ferred the greatest benefit on man- Paul Sartre declined the Nobel Prize ing the prize to Einstein, in 1921 and kind.”6 The nominations for Einstein for literature in 1964, and Le Duc 1922. Einstein did receive the Nobel were strong. Max Karl Ernst Ludwig Tho, of North Vietnam, declined the Prize in physics in 1921, which was Planck, PhD, the 1918 recipient in Nobel Prize for peace in 1973.) In not awarded until 1922. physics, said Einstein had taken the 1910 and in 1911, Gullstrand was To understand what took place first step beyond Isaac Newton. Niels nominated for the Nobel Prize in requires an understanding of how Henrik David Bohr, PhD, the eventual physics. In 1911, the Nobel Com- the selection process works. The 1922 winner, described Einstein’s mittee for Physics, of which he was Royal Swedish Academy of Sci- work as “advances of decisive signifi- a member, suggested that he re- ences selects the awardees in phys- cance for the development of research ceive the prize. At the same time, the ics, chemistry, and economics. in physics.”5(pp72-73) Nobel Committee for Physiology or Nominations are made only by A major part of the problem Medicine was considering him for invitation. The invitees include all was that Einstein’s ideas were not ARCH OPHTHALMOL / VOL 117, MAY 1999 671 ©1999 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/28/2021 easy to understand. Relativity theory, able by physical means are, how- proven to be of lasting importance, his most important contribution, re- ever, so small that, in general they but has been eclipsed by his better mains a difficult concept. Accord- lie below the limits of experimental known relativity theory. Gull- ing to Einstein’s general theory of error.”5(p74) He also misinterpreted strand’s contributions to ophthalmol- relativity, gravity is not a force as critical experiments by others. Ar- ogy have also stood the test of time. Newton had described, but is a rhenius’ report on the photoelec- curved field in the continuum of tric effect was also negative. In the Accepted for publication December 4, space and time, created by the pres- aftermath of these 2 reports, the de- 1998.