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Baby Blindness Pioneer Dr Arnall Patz, ex-WA3EVC (SK)

03/17/2010

Dr Arnall Patz, ex-WA3EVC -- an ophthalmologist who discovered and eliminated a major cause of blindness in premature infants -- passed away from heart disease on March 11. He was 89. In 1954, Patz proved that treating premature babies with pure oxygen could destroy their eyesight. At the time, this was the most common cause of blindness in premature infants.

As was a young physician at Washington DC's Gallinger Municipal Hospital (now known as DC General Hospital), Patz observed that a new incubator, sealed all around to contain an inner climate, was enabling doctors to save premature babies. "But something was wrong," he told the Baltimore Sun in 2004 profile. Patz noticed that the advance coincided with an epidemic of infant blindness, and that most of the victims were "preemies" who lay for weeks in an atmosphere of near-total oxygen. "In a question that outraged physicians at the time, but later won their admiration, Dr Patz wondered whether there might be a connection: Was it possible that oxygen was robbing babies of their sight?" the profile read. "It had become standard practice to put babies in incubators and crank up the oxygen," Patz told the Sun. "[I] could hardly blame the doctors who did this because it turned struggling babies from blue to pink."

Unable to secure grant money to prove their hypothesis, Patz and his colleague Leroy Hoeck funded their early tests with money borrowed from Patz's brother Louis, later receiving a small grant after promising to turn on the oxygen at the first sign of troubled breathing (Louis Patz and his wife were killed in a 1962 airplane crash; their three children were raised by Patz and his wife Ellen). Their hunch was correct: Almost immediately, doctors stopped automatically giving oxygen to premature infants, ending the epidemic of blindness because of retrolental fibroplasias, now known as retinopathy of prematurity (ROP). By the time the practice of providing pure oxygen to premature infants was stopped, more than 10,000 of these babies had had their eyesight destroyed.

To prove their theory, the pair of doctors conducted what is widely believed to be the first randomized controlled trial in ophthalmology. In the early 1950s, they divided 120 premature babies at Gallinger into two groups. In the first group, which received concentrated oxygen constantly, 12 infants went blind. In the second group, babies received oxygen only if they were in respiratory distress, and only one became blind. Elevated oxygen levels, it turned out, destroyed the arteries of the eye. That in turn caused abnormally wild growth of blood vessels, irreversibly damaging the retina. It was discovered that oxygen caused blood vessels in the back of the eye to constrict. In a doomed attempt to compensate, the eye sprouted twisted vessels that would eventually bleed and destroy the retina. "Never in the history of ophthalmology has a blinding condition become so quickly widespread and equally rapidly been abolished," wrote Scottish ophthalmologist Sir Stewart Duke-Elder in the 1970s.

The results of a subsequent larger trial led by biochemist Everett Kinsey and involving patients at 18 hospitals substantiated the earlier findings at Gallinger. Although the new understanding came too late for thousands of people who were made blind by oxygen -- including the singer Stevie Wonder, ARRL Connecticut Section Manager Betsey Doane, K1EIC, and her twin sister Barbara Lombardi, K1EIR -- it undoubtedly saved many more from a similar fate. "Barb and I are thrilled to learn that the doctor who discovered the effect of too much oxygen at birth was a ham. We only wish we had met him or worked him on the air. How exciting that would have been!" Doane told the ARRL.

Patz operated a ham radio from his home on behalf of the Maryland Eye Bank. According to The Wall Street Journal, Patz erected an 80 foot tower at his home and became known to amateurs across the country for putting out the word on the airwaves whenever corneas were needed for transplant.

Patz became interested in Amateur Radio thanks to his nephew Sam, ex-WA3EAV, son of his deceased brother Louis. "Arnall knew of my interest in electronics and science, and when I came to Baltimore, he encouraged me to get my ham license," Sam Patz told the ARRL. "I started with a Novice license and the moved to a General perhaps a year or two later. Arnall then got more and more interested and then he obtained his license. It is true that he purchased an 80 foot tower. We assembled a two element cubical quad antenna on top of it. Arnall also received a complete set of Swan gear as a gift from one of his patients that we immediately installed, switching from an old Galaxy V unit. I believe the gift came from the owner of Swan, who had come to see Arnall for a problem with his eyes."” Patz also introduced his nephew to the Maryland Eye Bank: "One of us would sign in daily to report either the need for or the availability of corneas for human transplant. Other ham operators associated with different cities would do the same. Whoever had a need or availability would then report back to their Center which cities had an availability or need. The Centers would then contact each other by phone to arrange emergency transport of the corneas."

Both uncle and nephew became involved in public service over the airwaves. "Arnall and I got interested in doing phone patches for military personnel overseas," Sam Patz told the ARRL. "Arnall used the Eye Bank and the phone patch experiences to teach me about public service!" Sam Patz is now an associate professor of Radiology at Harvard Medical School and is also the Scientific Director for the Center for Pulmonary Functional Imaging at Brigham and Women's Hospital in Boston, Massachusetts. "Arnall was truly an incredibly special man. For me, he became a second father, looking after me and nurturing me during a very critical time in my life. Everyone in the family will miss him sorely."

In 1955, Patz became a part-time member of the Johns Hopkins faculty, maintaining a private ophthalmology practice for 15 years until becoming a full-time research professor in 1970. In 1979, he became the director of the Wilmer Eye Institute at Hopkins, a position he held for 10 years. Patz collaborated with colleagues at the Johns Hopkins Applied Physics Laboratory to develop one of the first argon lasers used to treat diabetes-related eye disease and other retinal problems. He and Kinsey received the Albert Lasker Clinical Medical Research Award for his groundbreaking research. Helen Keller presented them with the honor in 1956. In 2004, President George W. Bush presented Patz with the Presidential Medal of Freedom, the nation's highest civilian award, calling him "the man who has given to uncounted men, women and children the gift of sight."  -- Thanks to The Wall Street Journal, The New York Times, The Washington Post and The Baltimore Sun for some information



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