Charles L. Schepens, long considered one of the giants of 20th Century ophthalmology and the unquestioned leader in retinal detachment surgery, died March 28th, 2006 at the age of 94 in Boston, MA.
Born March 13, 1912, just before World War I, to a much-admired general practitioner and the daughter of a burgemeister, the medical profession and war would impact Charles throughout his life. Mouscron, Belgium, his birthplace, was just 30 kilometers behind the German front. Charles was the youngest of six children. His three brothers all became physicians and his sisters, nurses. Though the family suffered during the war, their mother managed to care for them and Charles enjoyed accompanying his father on Sunday house calls in a horse-drawn carriage.
By the time Charles was thirteen both his parents had died and he was sent off to the Jesuit boarding school in the city of Namur, a most happy time according to his later recollections. He was drawn to sports and the outdoors, and daily exercise remained part of his life to the end. At fifteen he met Oleg Pomerantzeff, a classmate who became his closest friend. This enduring friendship grew into a collegial association when, four decades later, Oleg joined Charles’s medical research team in Boston.
Charles Schepens first obtained a certificate in mathematics at the University of Ghent. He would have used this to enter the engineering school, his preference, but bowing to peer pressure and family tradition, he entered the medical school. He earned his medical degree in 1936 and received surgery training at the City Hospital of Ghent. During this time he met Marie-Germaine Van der Eecken. An established artist, “Cette” as she was known, fascinated Charles with her creativity. They married in 1937 and throughout their nearly 70 years of marriage she served as a complement to her husband’s independent and innovative spirit.
Charles, a bright graduate, took a student fellowship in the world-renowned Institute of Pharmacodynamics headed by 1938 Nobel Prize winner C. Heymans. Coincidentally, Heymans’ wife Bertha May was an ophthalmologist. Schepens’ dissertation at the Institute reflected a deep interest in physiology and biochemistry, and won a first prize.
After obtaining the MD degree in 1936, Charles chose to specialize in ophthalmology in the service of Professor Hambresin of Brussels, and with an opportunity first to work at Moorfields Eye Hospital in London for two years. Before that could transpire and while he was working at the prestigious Eye Institute of Professor H. Weve in Utrecht, the Netherlands, his life took another turn due to war.
Germany invaded Belgium and Charles joined his country’s Air Corps as a medical officer. When the Air Corps was disbanded he joined the Resistance, fighting the Nazi occupation. For two years his medical office in Brussels functioned as a mail drop for the transfer of secret documents. After two arrests by the Gestapo and alerted to another, he escaped to France with his family. In the Basque border town of Mendive he adopted the alias Jacques Perot and directed a highly secret information and evacuation operation in coordination with the Belgian underground.
From June l942 to July 1943 Jacques Perot ran a large lumber mill and logging enterprise to camouflage his clandestine work that facilitated the escape of more than 100 people over the Pyrenees Mountains. His family kept a low profile so that their Belgian French would not give away their secret. His resistance work ended with his own dramatic escape to Spain and ultimately to England. Here, a fortuitous appointment found him, finally, at Moorfields Hospital for the second time in his life.
While at Moorfields, working with Professor Ida Mann, Charles developed a prototype of the binocular indirect ophthalmoscope, which for the first time, allowed stereoscopic viewing of the eye fundus out to the peripheral retina. The Belgian Ophthalmological Society reported upon the instrument in December of 1945 and published an article in their bulletin shortly thereafter. The instrument revolutionized fundus examination and retina specialists worldwide adopted it. An early version sits on permanent display at the Smithsonian Institute.
On the strength of this success, Charles Schepens immigrated to the United States in 1947 to continue his interest in research and conduct a clinical practice. He accepted a post as research fellow at Massachusetts Eye and Ear Infirmary (MEEI). To augment his research salary he assisted the senior clinicians in surgery and conducted a special “Retina Clinic” for the treatment of detached retinas. Residents rotated through this clinic and post residency fellows also came for short stays. The training grew very popular and the surgical techniques were considered most promising. A formal fellowship program followed in the 1950’s and early fellows were the first to use the new techniques when they returned to their home practice. In the 1960’s the fellowship was extended to two years. In a measured way and with the help of fellows and associates, Schepens pioneered surgical techniques for retinal reattachment, with subsequent development of the scleral buckling procedure. This retina fellowship, the first of its kind, trained nearly the entire future leadership in retina. Past trainees often express their loyalty and gratitude to Charles Schepens’ friendly mentoring and continuing support.
The impact of Charles Schepens’ contributions is immense. Before him no effective way to see the retinal periphery with an ophthalmoscope existed. The invention of the binocular indirect ophthalmoscope revolutionized ophthalmology. The development of the indirect ophthalmoscope and the scleral buckling procedure brought the success rate for retinal reattachment surgery from 30% to 90%. Finally, his insistence on assigning an equal value to education, research, and clinical practice pioneered an approach now so widespread that it is taken for granted. His strategy broadened and deepened the knowledge of retina to a point that it became a subspecialty of its own. Because of his remarkable leadership he is revered as “The Father of Modern Retina Surgery.”
A fierce sense of independence characterized Charles’ life and work. In spite of his later success, Schepens was never an “insider” at the MEEI or Harvard – by his own choosing. Reflecting back on his 1947 arrival in Boston, he was initially accommodated by Dr. David G. Cogan at the Howe Laboratory. However, after a few months he left and was installed in a small room on the clinical side headed by the Chief of Ophthalmology at MEEI, Dr. E. B. Dunphy. Here he rapidly built his extraordinary Retina Service. Dr. Dunphy supported a policy that no one interfered with Charles’ clinical initiatives.
Later, when Charles Schepens started the Retina Foundation (later called The Schepens Eye Research Institute), it remained outside the Infirmary and unaffiliated with Harvard Medical School (HMS). The Harvard department of Ophthalmology did not confer academic titles on its investigators. Schepens’ HMS title of Clinical Associate was outside the professorial ladder. Finally, in 1978, however, the political climate had changed and Charles received the title of Clinical Professor of Ophthalmology. The formal affiliation between HMS and the Schepens Eye Research Institute did not occur until 1995.
In 2001 Harvard Medical School established the Charles L. Schepens Professorship. In retrospect, building the retina practice and the research institute might not have been possible without Charles’ near total independence in fundraising, recruitment, and expansion.
Charles Schepens is survived by his wife Cette and his four children: Claire (Brussels, Belgium, Luc (Southborough, MA), Bernadette (Nahant, MA) and Catherine (Petaluma, CA), as well as eight grandchildren and five great grandchildren.
Alice R. McPherson
Frans J. Van de Velde
Claes H. Dohlman, Chairperson