Doctor Pinpointed Oxygen as Cause of Preemies' Blindness
Arnall Patz helped solve the riddle of how 10,000 babies went blind.
Dr. Patz, who died Thursday at age 89, was the Johns Hopkins ophthalmologist who in 1954 showed that treating premature babies with pure oxygen had the unexpected result of destroying eyesight in some. By the simple expedient of regulating oxygen levels inside incubators, the epidemic was quelled.
"Never in the history of ophthalmology has a blinding condition become so quickly widespread and equally rapidly been abolished," wrote Sir Stewart Duke-Elder, a Scottish ophthalmologist, in the 1970s.
[REMEMBRANCE] The Wilmer Eye Institute at Johns Hopkins
Helen Keller, left, presents the 1956 Lasker award to Arnall Patz.
A epidemic of retrolental fibroplasia (RLF) seemed to have grown up just as treatments for preemies had improved. By the time of Dr. Patz's investigations in the early 1950s, an estimated 10,000 children had been blinded in the U.S. and abroad, according to a history of the disease by William Silverman. Ophthalmologists were searching for a cause in the way preemies were treated—possible culprits included vitamins and hormones.
Dr. Patz, a resident at Washington's Gallinger Municipal Hospital, nearly didn't manage to bring his study off, because it involved experimenting on babies, and because the idea that oxygen could cause harm was so counterintuitive. The gas provided obvious benefits for preemies, often turning them to a healthy pink from blue in the incubator.
"It had become standard practice to put babies in incubators and crank up the oxygen," he said in a 2004 interview with the Baltimore Sun.
Having failed to obtain a grant, Dr. Patz borrowed funds from his family and demonstrated that oxygen could cause blindness in opossums, rats and kittens. The gas did this by causing blood vessels in the eye to became overdeveloped, damaging the retina.
The scientific community was skeptical. "These guys are going to kill a lot of babies by anoxia to test a wild idea," warned grant referees for the National Institutes of Health. Hospital ward nurses occasionally turned the oxygen back up on infants in the study.
By turning down the oxygen on half the infants in his study, Dr. Patz was able to demonstrate that oxygen therapy had caused the epidemic. A wider study confirmed his results and was announced in 1954. Textbooks and practices quickly changed. Oxygen-caused RLF—today called retinopathy of prematurity—seemed conquered, though it continues to strike preemies at a much-reduced rate.
A native of rural Georgia, Dr. Patz attended the Emory School of Medicine. In addition to his clinical experiments, he had a private practice in Baltimore and worked at the Maryland Eye Bank.
After erecting an 80-foot tower at his home, he became known to ham-radio operators across the country for putting out word on the airwaves whenever corneas were needed for transplant.
In 1970, he joined Johns Hopkins as full-time faculty, and helped develop the argon laser as a tool for eye surgery.
Just two years after the RLF results were announced, in 1956, Dr. Patz and another researcher, Everett Kinsey, who performed the wider study, were given the Lasker Award for clinical research. Also honored was Jonas Salk, who developed the first polio vaccine.
Helen Keller presented Dr. Patz's award in a ceremony in Atlantic City, N.J. Ms. Keller seemed nervous, Dr. Patz later told his son, Jonathan Patz. She kept feeling the inscribed nameplate on the statuette. After she handed it to Dr. Patz, he realized why: Someone had given her Dr. Salk's statuette instead of Dr. Patz's.
Dr. Patz, who died Thursday at age 89, was the Johns Hopkins ophthalmologist who in 1954 showed that treating premature babies with pure oxygen had the unexpected result of destroying eyesight in some. By the simple expedient of regulating oxygen levels inside incubators, the epidemic was quelled.
"Never in the history of ophthalmology has a blinding condition become so quickly widespread and equally rapidly been abolished," wrote Sir Stewart Duke-Elder, a Scottish ophthalmologist, in the 1970s.
[REMEMBRANCE] The Wilmer Eye Institute at Johns Hopkins
Helen Keller, left, presents the 1956 Lasker award to Arnall Patz.
A epidemic of retrolental fibroplasia (RLF) seemed to have grown up just as treatments for preemies had improved. By the time of Dr. Patz's investigations in the early 1950s, an estimated 10,000 children had been blinded in the U.S. and abroad, according to a history of the disease by William Silverman. Ophthalmologists were searching for a cause in the way preemies were treated—possible culprits included vitamins and hormones.
Dr. Patz, a resident at Washington's Gallinger Municipal Hospital, nearly didn't manage to bring his study off, because it involved experimenting on babies, and because the idea that oxygen could cause harm was so counterintuitive. The gas provided obvious benefits for preemies, often turning them to a healthy pink from blue in the incubator.
"It had become standard practice to put babies in incubators and crank up the oxygen," he said in a 2004 interview with the Baltimore Sun.
Having failed to obtain a grant, Dr. Patz borrowed funds from his family and demonstrated that oxygen could cause blindness in opossums, rats and kittens. The gas did this by causing blood vessels in the eye to became overdeveloped, damaging the retina.
The scientific community was skeptical. "These guys are going to kill a lot of babies by anoxia to test a wild idea," warned grant referees for the National Institutes of Health. Hospital ward nurses occasionally turned the oxygen back up on infants in the study.
By turning down the oxygen on half the infants in his study, Dr. Patz was able to demonstrate that oxygen therapy had caused the epidemic. A wider study confirmed his results and was announced in 1954. Textbooks and practices quickly changed. Oxygen-caused RLF—today called retinopathy of prematurity—seemed conquered, though it continues to strike preemies at a much-reduced rate.
A native of rural Georgia, Dr. Patz attended the Emory School of Medicine. In addition to his clinical experiments, he had a private practice in Baltimore and worked at the Maryland Eye Bank.
After erecting an 80-foot tower at his home, he became known to ham-radio operators across the country for putting out word on the airwaves whenever corneas were needed for transplant.
In 1970, he joined Johns Hopkins as full-time faculty, and helped develop the argon laser as a tool for eye surgery.
Just two years after the RLF results were announced, in 1956, Dr. Patz and another researcher, Everett Kinsey, who performed the wider study, were given the Lasker Award for clinical research. Also honored was Jonas Salk, who developed the first polio vaccine.
Helen Keller presented Dr. Patz's award in a ceremony in Atlantic City, N.J. Ms. Keller seemed nervous, Dr. Patz later told his son, Jonathan Patz. She kept feeling the inscribed nameplate on the statuette. After she handed it to Dr. Patz, he realized why: Someone had given her Dr. Salk's statuette instead of Dr. Patz's.