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We humans share a lot of odd habits. One of the most ubiquitous is the celebration of the annual appearance of certain special dates in our lives or in the lives of those close to us. Early in childhood we learn that birthdays are a big deal. We get to be messy with cake frosting, learn how to blow out candles and open brightly colored packages. But most children don’t devote a lot of time reflecting on any particular special meaning a birthday has. Adults spend a lot of energy telling their kids to think about the true meaning of religious holidays like Easter or Passover, or commemorative holidays like Martin Luther King or Presidents’ Day, but it sinks in only gradually for most. I’m convinced that gradual process extends well into adulthood. In fact, the older I get, the more conscious time I spend appreciating the meaning behind my anniversaries, my grandkids’ birthdays and my college reunions.
The National Eye Institute is 40 years old this year. So why is that a special event for private practice ophthalmologists and other readers of EyeNet to commemorate, let alone reflect upon? Perhaps you have heard the phrase “value-based purchasing” that’s all the rage as Congress wrestles with health care reform. It just means that the government (and, yes, the private insurers are in lockstep) will pay for services only if there is evidence that those services are helpful. What kind of evidence? Only high-quality evidence will suffice. All agree that the best evidence is derived from randomized clinical trials (RCTs), epidemiologic studies and basic research. Were it not for the NEI, we’d be in a lot worse shape than we find ourselves today. The NEI has funded more than 60 RCTs to date, in addition to countless population-based studies and breakthrough science, that provide the evidence for rational treatment of diabetic retinopathy, glaucoma, macular degeneration and a host of other conditions.
It’s useful to reflect on how the NEI came into being. Back in 1960, ophthalmologist and music impresario Jules Stein, MD, formed Research to Prevent Blindness (RPB), with the goal of creating a new institute for vision research within the National Institutes of Health. RPB commissioned a Gallup poll to demonstrate that blindness was second only to cancer as the ailment people feared most. Prominent chairs in ophthalmology banded together to form the Association of University Professors in Ophthalmology (AUPO), resolving to support the establishment of a national eye institute. On the eve of congressional debate, 100,000 Lions Club members nationwide sent letters and telegrams in support. President Lyndon Johnson signed the enabling legislation for NEI on Aug. 16, 1968. To this day, RPB, the AUPO and the subsequently formed National Alliance for Eye and Vision Research have been strong advocates for adequate NEI funding in each annual budget cycle.
If eye and vision research had remained within the National Institute for Neurological Diseases and Blindness, it’s likely that public interest in Alzheimer’s and Parkinson’s disease would have left vision research a forgotten stepsister. Now that we have the NEI as a separate institute within NIH, it is important not to take it for granted because, without continued passion and advocacy, there is no guarantee it will exist forever. So let us all take a moment to reflect on the meaning of NEI’s 40th anniversary, and on the vision of our forefathers whose persistent passion paid off.