On the 200th Anniversary of the Madras Eye Infirmary, the First Ophthalmic Hospital in Asia

Ramya Raman and Anantanarayanan Raman

The Madras Eye Infirmary (MEI) was the first eye hospital, not only in India but in the whole of Asia as well, and the second oldest in the world. It was a public facility that was established in Madras city (now Chennai) in 1819 to address the ophthalmic problems of the residents of the city and the neighbourhood. Robert Richardson was its first superintendent. Whereas the Madras General Hospital, in the early days of its establishment, serviced only the British army personnel and civilians, the MEI, right from inception, serviced Indians for reasons unknown.

This facility moved around the town during its early days but settled in its current location in Marshalls Road (now Rukmini Lakshmipathi Salai), Egmore (Ézhumbûr), in 1886. The MEI changed names over time: ‘Government Ophthalmic Hospital’ (GOH) in 1886, and presently the ‘Regional Institute of Ophthalmology and Government Ophthalmic Hospital’. Local people fondly refer to it as the Ézhumbûr Kanaaspatiri.

Robert Elliot (1904–1913), Henry Kirkpatrick (1914–1920), Robert Wright (1920–1938), K. Koman Nayar (1940–1945) and R.E.S. Muthayya (1947–1956) are significant names in the annals of GOH. Elliott is remembered by ophthalmic surgeons throughout the world for his pioneering surgical-management technique of glaucoma, which involved a novel improvement over the one proposed by Pierre Félix Lagrange of Bordeaux in 1907. This note recounts the key milestones in the history of this public facility while referring to the science promoted by the medical men who led this hospital at various times until 1956 and placed it on the world map of medicine.

About The Madras Eye Infirmary (1819), a.k.a the Government Ophthalmic Hospital (1886)

While writing on the hope of establishing a new eye hospital in Calcutta in the 1910s, Frederick Pinsent Maynard (1864–1921), Ophthalmic Surgeon attached to the Bengal Medical Service, Calcutta, lamented, “The new eye hospital for Calcutta is still only in the state of being proposed. The Madras Ophthalmic Hospital had made considerable progress towards its present condition…”. Such was the heartburn that The Madras Eye Infirmary (MEI) gave to medical professionals and administrators in other Indian Presidencies and Principalities in the early decades of the 20th Century. The MEI, renamed as the Government Ophthalmic Hospital (GOH), Madras in 1886, has withstood the test of time and grown by building a reputation for reliability and tradition. With a humble start in 1819, today it stands tall as the ‘Regional Institute of Ophthalmology and Government Ophthalmic Hospital’. It is the oldest exclusive eye hospital in Asia and the second oldest dedicated ophthalmic facility in the whole world, next only to the Moorfields Eye Hospital in London, established in 1805.

1819–1901: The Madras Eye Infirmary is established

With rising eye problems among the soldiers of the Madras army, the Board of Directors at Fort St. George decided to establish an eye hospital in Madras, naming it the MEI, somewhere at the rear of the Madras Club (suspected to be the Compton’s Gardens) in Royapéttah, Madras, in July 1819 (Fig. 1). Robert Richardson was appointed as the superintendent of MEI in July 1819. Available information pertaining to the appointment of Richardson is conflicting. One is that he was a student of the then well-known British ophthalmic surgeon Benjamin Travers, who was also the health adviser to English East India Company; Travers recommended Richardson and sent him to Madras to establish the MEI. According to Treacher-Collins:

Fig. 1, Map of the city of Madras, 1914. The star at the bottom shows the approximate location of the first established eye infirmary in Royapettah in 1819. The star at the top shows the approximate second location of the infirmary in Vepery (1820–1885) and the star in the middle shows the final destination of the Government Ophthalmic Hospital in Marshalls Road. (Source: Baedeker, K., Indien– Handbuchfür Reisende, Verlag Karl Bädeker, Leipzig, Germany, 1914.)

“Travers held the appointment of surgeon in London to the East India Company. In 1819, its Honourable Directors became impressed by the great prevalence of eye disease in the large and populous districts over which they ruled, and applied to Travers in the matter. He pointed out to them the excellent results which had followed the establishment of the Eye Infirmary in London and that similar Institutions might be started in India. This advice was accepted and Mr. R. Richardson, one of the Company’s surgeons who had studied ophthalmology under Travers, was sent to Madras, where he founded the Madras Eye Infirmary.”

The other is that Richardson was serving with the Madras Medical Service as an Assistant Surgeon from 1905 and was recruited as the foundation-stone Superintendent of MEI at the rank of full surgeon in 1819. Diron Grey Crawford indicates:

“523. Richardson, Robert. M.R.C.S. (1802). Surg. Mate. Ceres, 1802–03 (1802-built ship). Surg. Canton, 1804–05 (1790-built ship). A.S. (Assistant Surgeon) 15 July 1805, Surg.18 February 1819. D. at Madras, 31 May 1824. S.A.L.L.M. (Service Army Lists Medical, Madras) gives the first date of commission as 15 July 1807.”

1842: The Madras Eye Infirmary shifts to Vepery

Alexander Lorimer, Garrison Assistant Surgeon, Fort St. George, prepared the Report on the Medical Topography and Statistics of the Presidency Division of the Madras Army, based on the instructions from the Directors of the Court at Fort St. George and authorized by George Pearse, Secretary, Medical Board, Fort St. George. Since this report includes excellent comments on MEI in the years 1830–1836, we reproduce below two of Lorimer’s remarks, that are self-explanatory:

“The eye infirmary was established in 1819, and is open for the reception of European and native soldiers, as well as for Europeans and natives not belonging to the service. The medical charge is vested in the Company’s oculist; the duties being conducted under the general supervision of the Superintending surgeon, and of the Medical Board. Assistant surgeons recently arrived from Europe are enjoined to pay every possible attention to the practice in this institution; and they are ordered to attend there frequently, and especially on the day set a part for operations.”

“The eye infirmary is situated at the S.W. extremity of Vepery, in a large enclosure adjoining the Poonamallee road. The edifice which has a southern aspect is built of brick and terraced, and consists of a centre and two wings. The centre portion which is two stories high, is the residence of the superintendent; the wing on either side, of one story, forming the wards for the patients; one wing consists of a ward 133 feet (40.5 m) long, and 20 (6.1 m) broad, capable of containing 103 patients, and the other is divided, into four separate apartments, viz. one for sepoys, a second and a third for natives, and the fourth for all serious cases, particularly those who have undergone any operation. This wing can accommodate 105 patients, so that the whole house is calculated for 208 patients. It is well ventilated by doors, and Venetian windows; and there is an ample supply of good water on the premises. A commodious surgery and rooms for the medical subordinates are attached, also a room for natives to take food, with cooking-rooms, and other conveniences.”

The MEI was shifted to a building (which does not exist anymore) on the road referred today as the E.V.K Sampath Salai (until recently, the Randalls Road), closer to Poonamallee (High) Road in Vepery in 1820. Thomas Moore-Lane was appointed as a deputy to Richardson in October 1823. He succeeded Richardson in May 1824 as superintendent and held the position until 1844. Moore-Lane had earlier trained at Moorfields as an oculist (ophthalmologist). He earned his Fellowship of the London Royal College of Surgeons in 1844, the year he died because of cholera. During his tenure in Madras, he was also the consulting physician to the 12th Nawab of Arcot, Ghulam Mohammed Ghouse Khan.

Lorimer furnishes details of treatments provided for amaurosis, incipient and morgagnian (read ‘morgãnian’) cataracts, acute, chronic and suppurative ophthalmias, ulcerated corneas, nebula, albugo and night blindness to both inpatients and outpatients at the MEI, supplemented by relevant statistics.

1844–1901: The Madras Eye Infirmary becomes the Government Ophthalmic Hospital

Table 1 lists the names and service periods of successive presiding officers, from 1844 to 1901. In 1886, during Drake-Brockman’s third-phase superintendence (1884–1892), the MEI shifted to its present location on Marshalls Road (now Rukmini Lakshmipati Salai) enabled with new buildings and renamed as the Government Ophthalmic Hospital, fully supported by the Government of Madras. Joseph Fayrer, professor of surgery, Calcutta Medical College, Calcutta (1859-1872) remarks: “The practice of the hospital (GOH, Madras) is open to all members of the medical profession, both European and Native, and affords an extensive field for acquiring knowledge in the diseases of the eye.”

Fig. 2, Government Ophthalmic Hospital in Marshalls Road (1886).

The new Marshalls Road precinct

The buildings in the new precinct were designed by the consulting architect of the Government of Madras, Robert Fellowes Chisholm (1840–1915), who championed the Indo-Saracenic style of construction in Madras (for example, the Madras Central Station, the Presidency College and the Senate House of the University of Madras) and elsewhere in India (such as Laxmi Vilas Palace, Vadodara; Napier Museum, Thiruvananthapuram and All Saints’ Church, Bengaluru).

The principal hospital complex at GOH consisted of three two-storied blocks that ran north-southerly in a row (Fig.2), with a large water tank opposite to the main entrance. An ornamental railing enhanced the beauty of the constructed buildings. The middle block was meant for administration, which included a surgical theatre, offices, an examination room, and more than one medical store. The southern block, intended for female patients, could accommodate nine European and 20 Indian women. The northern block was identical to the southern block but was for male patients. Both female and male blocks included separate resting rooms with two beds each, for house surgeons and junior duty medical personnel. In 1889 and 1891, two separate inpatient wards with six beds each were added for Indian army personnel and privileged Indian civilians. Separate outpatient clinics functioned for Europeans and Indians. A residential accommodation adjoining the hospital was available for the residing duty medical officer. The outpatient clinic opened at 7 a.m. every day and patients were seen by the Superintendent until 9 a.m.

(To be continued next fortnight)

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