Eponyms in : What’s in a Name? What’s in a Name?

 How do ophthalmic diagnostic findings get their names?

Timothy J. Bennett, CRA, OCT-C, FOPS Penn State Hershey Eye Center Hershey, PA SA-5-C

What’s in a Name? What’s in a Name?

 Linnaean Taxonomy: system of  Linnaean Taxonomy

classification  Binomial nomenclature

Carl Linnaeus, 1707-1778

What About Human Anatomy? Anatomic Terminology

 In the late nineteenth century some  Nomina Anatomica was the international 50,000 terms for various body parts standard on human anatomic terminology were in use. from 1956 until it was replaced by Terminologia Anatomica in 1998.  The same structures were described by different names, depending on the anatomist’s background: school, language, culture, traditions, etc.

1 How About Ophthalmology? Diagnostic Naming Conventions

 Etymology: origins of words often from Greek or Latin roots

 Named for anatomic location

 Descriptive of process or result

 Descriptive of appearance

 Acronyms or initials

 Eponyms: named for first person to identify or describe

Etymology Etymology

from the Greek “Pathos”: suffering, disease, feeling, passion.

Descriptive of Process or Result Descriptive of Process or Result

 Vitreo-macular traction

 Plaquenil toxicity  Macular hole

2 Descriptive of Appearance Descriptive of Appearance

 Literal  Synonymous (looks like something else)

 Pink eye  Cherry red spot

 Floppy lid syndrome  Bear tracks

Cataract? Ichthyosis

 Genetic skin disorder characterized by dry, scaly, or flaky skin that resembles the scales of a fish.

Acronyms: the other “nym” Acronyms: CHRPE

 NPDR  Congenital Hypertrophy of the Retinal

 ARMD Pigment Epithelium

 DUSN

 APMPPE

 MEWDS

 AZOOR

3 Acronyms: the other “nym” ICE Syndrome

 ICE Syndrome  Iridocorneal Endothelial Syndrome

 HELLP Syndrome

 FEVR

 PORN

 SCUBA

 ELVIS

FEVR Eponyms: Named for Me!

 Familial Exudative VitreoRetinopathy  Named for first person to identify or describe: Best’s Disease (Franz Best)

According to Wikipedia According to Wikipedia

 Eponyms are a longstanding tradition in  Being awarded an eponym is regarded Western science and medicine. as an honour:

 At a time when medicine lacked tools to “Eponymity, not anonymity, is the investigate underlying causes of many standard." syndromes, the eponym was a (Merton R K, 1973) convenient way to label a disease.

 To discuss something, it must have a name.

4 Eponyms: Named for Me! Eponyms: Named for Me!

 Anatomy

 Bowman’s Membrane

 Descemet’s Membrane

 Canal of Schlemm

 Annulus of Zinn

 Schwalbe’s Line

 Tenon’s capsule

 Bruch’s Membrane

Eponyms: Named for Me! Eponyms: Named for Me!

 Diagnosis/clinical findings

 Sjögren’s Syndrome

 Eales Disease

 Oguchi’s Disease

 Behcet’s Disease

 Marfan Syndrome

 Mittendorf Dot Bergmeister Papilla Thygeson’s superficial punctate

Other Eponyms Atypical Eponyms

 Proper names of places:  Legionaire’s Disease

 Lyme Disease  Acquired its name in July 1976, when an outbreak of pneumonia occurred among  North Carolina Macular Dystrophy people attending a convention of the American  Famous patients: Legion at a hotel in Philadelphia.

 Lou Gehrig's Disease (amyotrophic lateral  The causative agent was identified as a sclerosis) previously unknown strain of bacteria, subsequently named Legionella, and the  Tommy John surgery (named for first person to undergo the procedure). species that caused the outbreak was named Legionella pneumophila

5 Atypical Eponyms Eponyms: Named for Me!

 Zamboni Disease  Fuch’s Spot

 Tachycardia, tachypnea, frothy sputum and bilateral perihilar infiltrate seen on chest radiograph.

 Occurs in ice skaters exposed to nitrogen oxides in fumes of ice-resurfacing machines.

 Condition spontaneously resolves in 2–3 days. Ernst Fuchs

1-3 Eponyms: Named for Me! Common method of measuring aqueous tear production.  Vogt Koyanagi Harada

What is Fuch’s ?

Eponyms: Named for Me! Are Eponyms Bad?

 Wyburn-Mason Syndome  There has been sparring in the

 aka Bonnet-Dechaume-Blanc Syndrome literature for years over the use of eponyms and the worthiness of some of the individuals that have conditions named for them.

6 Are Eponyms Bad? Are Eponyms Bad?

 Eponyms are often controversial,  In a 2010 editorial in , Pulido and especially when questions arise about Matteson ask the question: the moral and ethical character of “Is it worth having eponyms at all?” “Although they can function as a memory aid, they eponymous honorees. do not enhance understanding of disease….”  Egos are involved! “It is best henceforth to not name new diseases with eponyms and to start moving away from their use completely.”

Arguments FOR Eponyms Arguments AGAINST Eponyms

 The name may be shorter and more  Several eponyms may refer to the same memorable than the medical one. disease.  Sometimes the medical name proves to be  The same eponym may apply to incorrect. different diseases, which creates  The syndrome may have more than one confusion. cause, yet it remains useful to consider it as a whole.  A number of authors turned out to be

 It continues to respect a person who may Nazis (Wegener's Granulomatosis) or otherwise be forgotten. conducted unethical medical research. wikipedia wikipedia

Arguments AGAINST Eponyms Are Eponyms Bad?

 The name confers no information other “For example, the dystrophy named than historical. Waardenburg and Jonkes was not a

 There can be a Western bias to the unique entity and was actually identical to choices. the previously described Thiel-Benke dystrophy.”  Different countries may have different Weiss JS, et al. The IC3D classification of the corneal dystrophies. . 2008 Dec;27 Suppl 2:S1-83. eponyms for the same disease.

 History sometimes shows credit should have gone to a different person. wikipedia

7 Are Eponyms Bad? Genetic Names

“Furthermore, central cloudy dystrophy of  Move to name diseases by the gene François appears clinically mutation that cause them: indistinguishable from the degenerative  ABCA4 mutation results in Stargardt condition, posterior crocodile shagreen.” disease.

 RPE65 Mutation results in Leber’s Weiss JS, et al. The IC3D classification of the corneal dystrophies. Cornea. 2008 Dec;27 Suppl 2:S1-83. congenital amaurosis.

Are Eponyms Bad? Are Eponyms Bad?

 Stigler's Law of Eponymy states, "No scientific  Malcolm Gladwell stated, discovery is named for the original "We think we're pinning medals on heroes. discoverer." In fact, we're pinning tails on donkeys.”  As proof, Stigler freely admits that others postulated the idea before he named it for himself.

According to Wikipedia Not So Fast Wikipedia!

 “The current trend is away from the use of eponymous disease names, towards a medical name that describes either the cause or primary signs.”

8 I Discovered it. Name it for Me! According to Wikipedia

 “The scientific and medical communities regard it as bad form to attempt to eponymise oneself.”

 I guess Dr. Dua didn’t get the memo!

Eponyms in Ophthalmology: Eponyms are Here to Stay! What’s in a Name?

 Despite the egos and controversies involved, eponyms seem like they are here to stay.

 So let’s take a look at some of the more interesting eponyms in ophthalmology. Timothy J. Bennett, CRA, OCT-C, FOPS Penn State Hershey Eye Center Hershey, PA SA-5-C

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