Erica Crompton

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Pathos Ocularis-the Beautiful and the Curious, is a fascinating exhibition at the College of Optometrists in London which merges art with ophthalmology.

Almond shapes, long eyelashes and interesting irises-in particular those with several colours and patterns: these are what make beautiful eyes, according to artist and glassmaker IluÃ¡ Hauck da Silva. “However,” she says, “ultimately it is the intensity and sincerity of gaze which makes a pair of eyes beautiful: eyes that sparkle with enthusiasm and love, and that overflow with tears when emotion takes over. The ability to candidly and transparently express feelings is definitely the most fascinating and beautiful quality eyes have.”

The crux of Miss Hauck da Silva’s practice is to visually investigate the human condition, and she specialises in works of anatomical and pathological symbolism (see Figure 1). It is eyes, specifically, that she has dedicated her latest work to, following her artist-in-residence at the College of Optometrists in London, UK in 2019.

At the College’s museum-the British Optical Association Museum-she has created a fascinating modern-day cabinet of eye-related curiosities, complete with drawings, photographs, digital images and glass objects, all of which can be viewed by the public.

In producing Pathos Ocularis-the Beautiful and the Curious, the title of the exhibition, Miss Hauck da Silva took inspiration from the Museum’s collections, as well as from medical, scientific and historical research she conducted in the College library (which contains literature on the eye and optical science dating back to the 15th century). She combined her research findings and artistic expertise with facets of her own experience with eye disorders.

Glass eyeballs feature largely in the exhibition. In Eyeconography (Figure 2), an antique silver dish designed to look like a chalice holds a dozen or so exquisitely made but not so healthy-looking eyeballs-each a glossy white with irises in vivid blues, oranges and greens-and some with a double pupil or iris, to represent the double vision that the artist has herself experienced.

Describing her experience with diplopia, Miss Hauck da Silva told Ophthalmology Times Europe: “I suffered from diplopia as a result of sixth nerve palsy, which occurred due to the fact that I had an infection in my petrous bone [which I had] for at least 6 weeks before my sixth nerve was affected. In a way, I am glad I had diplopia because it was the symptom that urged me to seek help at Moorfields Eye Hospital [London]. Double vision was rather disorienting and deeply concerning-I remember feeling very fragile and vulnerable.”

Once hospitalised at Guy’s Hospital, London and medicated, Miss Hauck da Silva’s diplopic symptoms quickly subsided, but it took at least 3 months for the movement in her right eye to return to normal. Ever since the infection, she has suffered from dry eyes and photophobia, which worsen if she has to work on a computer for long periods of time, use her mobile phone a lot or travel on public transport. She finds these symptoms both “uncomfortable and frustrating”.

Miss Hauck da Silva is also an art historian and considered Saint Lucy, the patron saint of the blind in Roman Catholicism, when producing the show. “When I first saw the Museum’s cabinet drawers full of glass eye models representing ocular pathologies in advanced stages, I immediately made a connection with Saint Lucy’s eyes on a plate, her principle iconography, which suddenly resonated very differently with me,” she described.

“I was compelled to think of people from bygone eras who would leave votive offerings or ex-voto on altars dedicated to Saint Lucy either in hope to be cured or in gratitude for having been cured. Such people could have been suffering from those advanced ocular pathologies represented in the glass models-glaucoma, cataract or an eye infection-when there was no medical treatment for such conditions. It must have been truly awful!”

She added: “This called into question the role of the cult of saints before the advent of modern medicine, and how our attitudes towards illness and cure have changed since then. This is why, in my Self-portrait as Saint Lucy (Figure 3), instead of eyes I have placed images of the medication that cured me from acute diplopia on the plate, conflating the religious and the scientific.”

According to Miss Hauck da Silva, the most validating moment of her art residency was when she first told Neil Handley, curator at the Museum for the past 22 years, that whilst doing research in the Museum’s library, she had come across a chapter in a book that had been written by the very doctor who had treated her when she suffered from diplopia/sixth nerve palsy. This is when Mr Handley said she should make her work about the illness she had, since sharing her personal experience would potentially make it easier and more interesting for viewers to relate and engage with the show.

Mr Handley, who has a background as an historian of science and medicine, first encountered the artist as a visitor to the Museum. “Her obvious interest in our collections, coupled with fortuitous timing-it had been 7 years since our last artist-in-residence-meant she was an obvious person to approach,” he said.

“Her work is also very visual, but not abstract, which suits the general flavour of our displays, which our founder John Sutcliffe instigated as far back as 1901 (we are the oldest optical museum in the world). Sutcliffe commented that he wanted there to be eyes looking at you from every corner of the professional headquarters (then at a different location, but we’ve continued the theme in our present building) so that no one who crossed the threshold could be in any doubt as to the subject matter of the optometry profession,” he added.

“It’s appropriate, therefore, that IluÃ¡’s exhibition is in the reception area, making it the first thing that visitors to the College see.”

Mr Handley explained that all the College’s exhibitions are a challenge, because they have to operate on a very small scale due to their location in what were formerly domestic premises, albeit a pair of very nice Georgian town houses. He said: “Our first-ever artist-in-residence, Derek Ogbourne, produced a ‘micro’ exhibition within a single pull-out drawer, whereas our second, Patrice Moor, produced an exhibition comprising just three works, placed strategically at intervals within the permanent display.”

He added: “I decided to offer IluÃ¡ one entire display case, but she was governed by its dimensions and the fact that all the works would have to be displayable in the horizontal position. IluÃ¡ obtained great insight from holding discussions with our Clinical Adviser at the College, Mr Daniel Hardiman-McCartney. It was a learning journey for her as much as for us, in that she learned a lot more about her own eye condition and how others have coped with eye disease or visual impairment over the centuries.”

For Mr Handley, the lived experience that manifests in the exhibition is a highlight. He says: “I like the assemblage of pieces collectively entitled Dry Eyes [see Figure 4]. The aim was to represent, in artistic form, just what experiencing an eye condition feels like. That’s quite a challenge, but IluÃ¡ has succeeded; just looking at the pieces is painful.”

“Their rough, gritty surface texture took multiple firings to perfect and it was quite a lengthy process to achieve the end result, in the same way that treatment for a medical condition can often take a long time and bring its own pain in the process.” For this piece, the artist chose to move away from anatomically correct eyes to a two-dimensional form inspired by ancient Egyptian imagery.

Although her story is told ultimately as a positive one of recovery, Miss Hauck da Silva pointed out: “I wanted to include the word pathos in the exhibition title, as in many languages it evokes suffering and pain, and thus prompts empathy/compassion in the viewer for the sufferer.”

The Museum hopes that visitors to this show will respond to both the beauty and the curious nature of the exhibits. These concepts are not mutually exclusive. Some of the imagery may subvert commonly accepted notions of beauty, and some of the most curious things, including pathological conditions, can convey a strange beauty of own.

It is often suggested that the works of art in an exhibition will ‘speak for themselves’. For this show, Mr Handley said he wanted to allow the voice of the artist to be heard much more explicitly-and the College has certainly succeeded in this, for these exhibits ‘see for themselves’.

The exhibition will be available to visit by appointment at The College of Optometrists, London, once the lockdown restrictions currently in place due to the COVID-19 pandemic have been lifted. For more information, visit www.college-optometrists.org.


	MISS ILUÃ HAUCK DA SILVA
	E: ihauckdasilva@gmail.com
	Miss Hauck da Silva is an artist whose practice focuses on visually investigating the human condition. She specialises in works of anatomical and pathological symbolism.

MR NEIL HANDLEY
	E: museum@college-optometrists.org
	Mr Handley is the current curator of the British Optical Association Museum and the first full-time museum professional to hold the post.

Articles

The beautiful and the curious: Artwork of ocular pathologies

Charity Deafblind UK has worked with artists and The Stage to develop a multisensory mural that appeals to the deafblind community through playing with all the senses.

What would you miss if you lost your sight and hearing? Waves gently caressing a beach? The golden glow of a sunrise? Or the sound of leaves carunching underfoot as you walk through a forest on a dry autumn’s morning?

A mural entitled "What would you miss?" explores all these and has, very powerfully, been informed by people who are deafblind, by what they’ve have said they miss the most since developing their disability.

, an organisation specialising in their namesake, has created.

Each scene has been expertly represented using tactile materials to ensure it is accessible to a deafblind audience. The graphically enhanced street art depicts waves of string across the panel in a specific pattern that’s punctuated with starfish shells. The sunrise uses strings to showcase how lights go in every direction and the eerily-empty woodland walk includes strings to simulate trees and branches of a forest.

Of the startlingly colourful mural, Lee Bofkin, Co-founder of Global Street Art tells 

: “The whole mural was mocked up digitally first and we went through different options with Deafblind UK to make sure we were reflecting the things that had the most meaning to people with deafblindness. We made the images simple for those with visual impairments and the colours bold where possible (i.e., for the sunrise). We used spray paint and emulsion and we even mixed sand in some of the paint to increase its texture. There were a number of large wooden pieces also fixed to the wall at the same time. This was to give the mural more depth and allowed us to stick on even more textures to those boards. We experimented a lot with things like textured wallpaper for the tree bark, and then we added on fake ivy. There were even starfish on the beach! The artist, Perspicere, added all of the yarn elements - he’s incredible and added a completely different textural dimension to the wall too. The text on the mural was also printed in braille.”

The artist says Shoreditch was the desired location because as artists Global Street Art have such a great relationship with the landlords of the wall, and The Stage, whereby occasional commercial murals fully fund murals for charities.

“It happens to be an amazing site too seen by 30,000 cars per day. Essentially this wall is special and allows us to do something unique on it!”, said Lee, adding: “We’ve had great feedback-Deafblind UK’s Chairman, Bob Nolan, visited the mural last week. He is deafblind and seeing how he interacted with the wall meant a lot to us. Working with Deafblind UK has been a highlight of the project with staff and volunteers being hugely supportive and great to work with.”

Steve Conway is the CEO of Deafblind and says the spectrum of deafblindness is really wide and so it affects everyone differently: “Some people might just need to change the way they do things or make small adjustments, but for others it can make life very very difficult. The most basic of things, like going to the shops, catching up with friends or watching TV can be hard and a lot of the people we support tell us they often feel lonely and isolated. The world just isn’t made for people with sight and hearing loss, but we’re trying to change that.”

Deafblindness affects so many people but is often overlooked or under recognised, said the CEO, adding that this mural is rare in that those with sensory impairments can enjoy it as much as those with sight and hearing-something there is not enough of in today’s world.

 that all too often, people with deafblindness rely on their mind’s own interpretations of the world around them, based on their memories or what people tell them. "Our mural gives everyone the chance to experience art for themselves whether this is through sight or through touch."

It also gives a powerful message to those who don’t know about or haven’t considered the effects of sight and hearing loss.

Deafblind UK supports people with combined sight and hearing loss, enabling them to have the life they want. It is estimated that nearly 400,000 people in the UK are deafblind, and that figure is increasing as our population ages.

Global Street Art CEO and Co-founder Lee Bofkin says: “Working with Deafblind UK has been a brilliant experience for us and has really pushed our concept of what a mural is and who it is for. We’re really happy to have been able to include a much broader audience in who can appreciate this mural. We’re proud to support the great work Deafblind does.”

The mural was live for four weeks this summer at Great Eastern Street. Curated byinnovative Shoreditch-based organisation
	Global Street Art Agency in partnership with the developers The Stage, a mixed-use development on the site of Shakespeare’s Curtain Theatre, the mural is part of a programme on the Great Eastern Art Wall retained by The Stage as a space for local and international artists to collaborate with worthwhile charities.

The mural marks the start of Deafblind UK’s campaign ‘What would you miss?’ where they will be encouraging others to think about the implications of sight and hearing loss and how it would affect them. Post what you would miss on Facebook or Twitter using the hashtag #WhatWouldYouMiss and encourage others to do the same.

With the help of our friends at Global Street Art, we have brought this to life with a mural in London’s street art capital, Shoreditch. This mural is rare in that those with sensory impairments can enjoy it as much as those with sight and hearing–something there is not enough of in today’s world. It also gives a powerful message to those who don’t know about or haven’t considered the effects of sight and hearing loss. There was a lot of innovation in this mural - some things worked well and other things not so well. We tried a lot of techniques for texture before we felt we had the right toolkit!

Lee Bofkin concludes: “Working with Deafblind UK was our main route to involve the deafblind community. We’re hoping they can help get the message to people who are deafblind so people can come and visit the mural. The whole project was an inspiration and it made us think about who murals are for, and how they should be made, in a completely different way.”

Deafblind charity gets support from trendy Shoreditch, UK art collective

Popular or not, Brexit could offer benefits for eye surgeons born and trained in Commonwealth countries.

It’s not been widely reported in the United Kingdom (UK) media, more so in the Indian press, but some doctors coming from outside Europe, in particular India, are welcoming Brexit as it may create more jobs for their medical graduates.

 Britain has long depended on physicians from India to run the National Health Service (NHS). The reliance may increase after the UK leaves the European Union and EU-trained doctors no longer have the right to work here.

India is the largest-source country of doctors in the NHS after Britain-currently, 25,281 doctors gained their medical qualifications in India.


	
	While some younger surgeons and students born in India are welcoming Brexit to improve their chances of a Tier 2 Visa stay in the UK, not everyone agrees Brexit will benefit Commonwealth surgeons, such as Dinesh Verma, MD, a former Consultant Ophthalmologist in the NHS and independent sector for over 25 years, including Cambridge University Hospitals.

Like many ophthalmologists, Dr. Verma qualified in India (MBBS in 1978 at Maulana Azad Medical College) and was awarded his MD in ophthalmology in 1983, again in India, at the All India Institute of Medical sciences. He migrated to the UK in the same year, gaining a diploma in ophthalmology from the Royal College of Surgeons of England in 1984 and an FRCS at Royal College of Surgeons of Edinburgh in 1985. Later in 1988, he achieved a FRCO.

“Personally, I voted to remain but I can see why a small majority from England voted for Brexit,” Dr. Verma said. “I believe it was mainly due to fear of mass uncontrollable immigration from Europe (and beyond via Europe) that triggered it but Brexiteers did not foresee the likely negative economic consequences.”

Britain has long depended on doctors from India to run the NHS and Brexit will impact this.

“Britain has long tradition of welcoming doctors from the Asian subcontinent mainly for trainingpurposes but over last 25 to 30 years, the cream of those coming for training were absorbed into the NHS albeit either in middle grade jobs or GP/ Consultant only in areas of high demand, where white doctors didn’t want to practice,” Dr. Verma said. “There has recently been an increase in institutional rac- ism as BME doctors have been competing for and demanding more leadership positions.”

Dr. Verma’s views on Brexit and how it will impact on the NHS and ophthalmology in the UK are echoed by Gary McIndoe, the founder and managing director of specialist business immigration law firm, Latitude Law.

McIndoe helps businesses across the UK to retain and attract outstanding international talent and his companyboasts the largest dedicated business immigration team in the north of England.

Since the vote, McIndoe and his team have been providing strategic advice and support to businesses concerned about their ability to re- cruit and retain international employees, both now and in the post-EU commercial environment.

“Whilst in general, I believe Brexit to be a huge mistake, there can be no doubt that some people will benefit when the UK leaves the EU,” McIndoe said. “From a corporate immigration perspective, the UK relies heavily upon foreign talent to help support and grow our economy. We need external workers covering all skill levels and across a very wide variety of sectors and industries. One sector hit particularly hard by the Brexit process has been healthcare, with one in 11 NHS posts currently unfilled, rising to one in eight across available nursing positions.

“Employee shortfalls will continue, and indeed probably worsen once we leave the EU, and what is less clear is how employers will source staff once free movement ceases. For ophthalmolo- gists and other highly qualified medics from beyond the EU, Brexit may indeed level the playing field in terms of access to roles within the UK-once free movement of workers ends, all doctors and nurses wishing to work in the UK will have to apply for a Tier 2 visa, regardless of their country of origin.”

McIndoe also reckons that the passporting of European medical qualifications may also end after Brexit. EU-qualified individuals will also be stripped of that benefit and will have to prove their capability in the same way as any other non-EU applicants.

“These changes may encourage increased applications from Commonwealth countries such as Pakistan and India. The £30,000 minimum salary requirement remains in place for Tier 2 visa applications, ensuring Brexit will only really benefit more highly qualified and senior practitioners,” McIndoe said.

Commonwealth countries have always had a medical training program inspired and founded by Britain.

UK mainstream media haven’t widely reported any benefits to Brexit in terms of physicians, perhaps for unfounded fear of mass Asian immigrants if they hear that it will be easier after Brexit to get a UK visa as a professional.

“Personally, I don’t think that will happen due to deep-seated institutional racism in NHS which will only increase after Brexit,” Dr. Verma said.

 owes so much to Commonwealth-born eye surgeons who do so much for the NHS and other private practices. While it seems benefits to Brexit are slim-pickings it is refreshing to read in the Indian media, that Brexit is offering hope to a few, he noted. 


	1. https://www.hindustantimes.com/world-news/uk- reliance-on-indian-doctors-likely-to-rise-post-brexit/ story-ALvfLtrbKpX9KYae3r8gPI.html
	2. https://www.bmj.com/content/364/bmj.k5308

A small benefit from Brexit to Commonwealth ophthalmologists

With a PhD and fellowship in the therapeutic areas of retina and uveitis, and a current research area of ocular tuberculosis, Dr Luciana Finamor is not your typical internet sensation. However, she has taken Instagram by storm since her first post on the site on the 15

	Dr Finamor graduated in medicine at the age of 22 years-which one might consider the median age of the Instagram generation-from the Federal University of São Paulo (UNIFESP), Brazil. She concluded her residence and PhD studies at the same university.

	Currently, Dr Finamor is medical assistant at the eye care centre Clínica de Olhos Dr Moacir Cunha and researcher of the clinical research sector at UNIFESP’s ophthalmology department. She has published more than 20 papers in Brazilian and international reputed journals.

	However, her experience and expertise cannot easily be detected from her social media page, which currently boasts 18.1K dedicated followers comprising medical students, marketeers and established ophthalmologists. Her focus on social media has always been an appealing blend of real life; candidly photographed for the visual social media platform in an evocative way. This is why, she believes, people follow: because a quote can resonate more than, say, a clinical photo of an eye under surgery.

	“I try to inspire and make people feel better,” she said of her motivation to start her page. “I post good pictures, tips and motivational quotes” she added, when asked about the recipe for her popularity.

	Just scrolling through her page, you can see the appeal – a consistent blend of conference slides, quotes for your soul, family snapshots, food photos and selfies taken with her ophthalmology co-workers.

	“Fast and easy to operate” is how Dr Finamor describes Instagram, and on her page we are taken through her journey, not just as an ophthalmologist, but also as a mother, wife and avid traveller.

	Instagram has given Dr Finamor the tools and resources to combine this love of travel with meeting other ophthalmologists from all over the world, as well as studying their practises. According to webstat site Omnicore, Instagram has 500 million daily active users – that is a large audience to reach when you are sharing the right sort of content.

	As a doctor and travel enthusiast, Dr Finamor has a unique lens with which to see the world. So, how does she explain the differences between European ophthalmology and the practice in Brazil, her native country?

	She actually sees similarities in the two having spent so much time in both: “Fortunately Brazil has excellent ophthalmology, good teachers and universities! We need more support in our research. I can say that European ophthalmology is more similar to Brazilian than American.”

	She added: “We need to work hard to have vacations and travel around the world. And Brazil is a ‘hotter’ country, like the people. Maybe we have a closer approach to our patients than the European ophthalmologists. For example, in Brazil we still do not have optometrists and most of our patients come just to review the glasses.”

	So where will her success with Instagram take her next? “I really don't know what’s next for me but I may have an Instagram which focuses on published papers. I already established @Evidencebasedmedicine, but I still don’t have the time to dedicate to it. With a husband and three children, I’m very busy!” 

	Her advice to other ophthalmologists looking to enter the two-dimensional world of social media is to “keep it real”: “Try to make it not too professional and not too clinical, to gain followers. Your site should be like a dedication pleasure.” 

	Dr Finamor is a medical assistant at the Clínica de Olhos Dr. Moacir Cunha, Brazil, and researcher in the ophthalmology department of UNIFESP. At present, her main research area is ocular tuberculosis. Dr Finamor has no financial disclosures to declare. Visit her Instagram site at www.instagram.com/dralucianafinamor

Usually the reserve of millennials, one surgeon finds that Instagram can help make connections in clinical settings.

Author | Erica Crompton

Articles

The beautiful and the curious: Artwork of ocular pathologies

Deafblind charity gets support from trendy Shoreditch, UK art collective

A small benefit from Brexit to Commonwealth ophthalmologists

Could Instagram be the key to career success?