history and development of ophthalmology in taiwan

Journal of the Formosan Medical Association (2016) 115, 1025e1031 Available online at www.sciencedirect.com ScienceDirect journal homepage: www.jfma-online.com REVIEW ARTICLE History and development of ophthalmology in Taiwan Yu-Chih Hou a, Gale A Oren b, Muh-Shy Chen a,c, Fung-Rong Hu a,* a Department of Ophthalmology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan b Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA c Department of Ophthalmology, Cardinal Tien Hospital, College of Medicine, Fu Jen University, New Taipei City, Taiwan Received 21 March 2016; received in revised form 17 September 2016; accepted 24 September 2016 KEYWORDS evolution; history; ophthalmology; Taiwan Western medicine was first introduced to Taiwan by medical missionaries in the mid-19th century Modernization of medicine was systematically transplanted to Taiwan in the Japanese colonial period, and ophthalmology was established third among hospital departments, following internal medicine and surgery Dr Hidetaka Yamaguchi, an ophthalmologist, was the first head of the Taihoku Hospital, later known as National Taiwan University Hospital (NTUH; Taipei, Taiwan) Ophthalmologists during the colonial period conducted studies on tropical and infectious eye diseases After World War II, ophthalmologists at NTUH played an important role in medical education, residency training, studies, and teaching Dr Yan-Fei Yang established the Taiwan Ophthalmological Society in 1960 and instituted its official journal in 1962 Dr Ho-Ming Lin established the Department of Ophthalmology at the Tri-Service General Hospital in the 1950s and the Veterans General Hospital in the 1960s Taiwan ophthalmologists eradicated trachoma by 1971 Cataract surgery and penetrating keratoplasty were initially performed in the 1960s Currently, there are about 1600 ophthalmologists in Taiwan conducting an estimated 120,000 cataract surgeries and 600 corneal transplantations annually Many subspecialty societies have been established recently that serve to educate Taiwanese ophthalmologists and to connect with international ophthalmic societies Taiwan ophthalmologists continue to contribute to the advancement of ophthalmic knowledge globally Copyright ª 2016, Formosan Medical Association Published by Elsevier Taiwan LLC This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/) Conflicts of interest: The authors have no conflicts of interest relevant to this article * Corresponding author Department of Ophthalmology, National Taiwan University Hospital, 7, Chung-Shan South Road, Taipei 10002, Taiwan E-mail address: fungronghu@ntu.edu.tw (F.-R Hu) http://dx.doi.org/10.1016/j.jfma.2016.09.011 0929-6646/Copyright ª 2016, Formosan Medical Association Published by Elsevier Taiwan LLC This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) 1026 Introduction Taiwan is also known as Formosa, meaning “beautiful island,” as named by the Portuguese cartographer, Lopo Homem, as he first laid eyes on this previously uncharted green island in 1544 Later, the island was invaded and ruled by several foreign powers over the next 400 years.1,2 The course of medicine in Taiwan was profoundly influenced by its destiny of frequent changes in sovereignty over the years and can be roughly classified into three periods: precolonial period, Japanese colonial period, and postcolonial period Internal medicine and surgery initially were the two major disciplines of established medical practice in Taiwan, but ophthalmology as a specialty received substantial attention later on because of its unique characteristics Taiwanese ophthalmology was significantly influenced by Japan and the United States, and subsequently, ophthalmology played an important role in Taiwanese medical history Precolonial period Early history Early accounts of the Formosan aborigines by outsiders mentioned bathing in streams as the main treatment for sickness3; however, witchcraft and herbs were recorded as the prevalent treatments for an extensive period The early Chinese immigrants also brought with them their own practice of traditional Chinese medicine In 1624, the Dutch landed at Anping Harbor, Tainan in Southern Taiwan The doctors from the Dutch East India Company may have been the first Western doctors in Taiwan, but, unfortunately, no record of their medical practices remained Missionaries Missionaries, combining medicine with religion, contributed a great deal to the furthering of medical services in Taiwan In 1865, the first Presbyterian medical missionary, Dr James L Maxwell (1836e1921), arrived from England and began preaching and practicing medicine in Tainan Dr Maxwell introduced Western medicine to the island and established the first ward-based hospital in southern Taiwan.4,5 Reverend George Leslie Mackay (1844e1901) arrived from Canada in 1872 and, with the help of several doctors, established medical and dental services in Northern Taiwan He continued his work in Taiwan until his death in 1901 The Mackay Memorial Hospital, established in 1912, was named in his honor.6,7 Dr David Landsborough III (1870e1957) from Scotland, who arrived in Taiwan in 1895, established a hospital in Changhua where he devoted 40 years to his mission Dr David Lansborough IV (1914e2010), born in Taiwan, continued his father’s work for another 28 years.8 Dr Gushue-Taylor (1883e1954) arrived in 1912 from England and spent more than 30 years caring for patients at both British and Canadian medical missions in Taiwan He and his wife established the Happy Mount leprosy colony in northern Taiwan in 1934.9 Y.-C Hou et al These and many other medical missionaries played an important role in the provision of healthcare William Campbell, a Scottish Presbyterian missionary, founded the island’s first school for the blind at Tainan during that era.2 Their associated hospitals have evolved into the three large Christian hospital chains in Taiwan While they may have been the first to introduce Western medical practice to Taiwan, the systematic modernization of medicine came later Japanese colonial period Westernization of healthcare in Taiwan A half century of Japanese colonial rule began in 1895 when Taiwan was ceded to Japan by the Ch’ing Dynasty, China Japan strove to turn Taiwan, its first colony, into a showcase to demonstrate parity with the Western imperial powers1; subsequently, the Japanese medical education and healthcare system were transplanted to Taiwan during this period In effect, the entire style of care was systematically transformed from Chinese medicine to Western medicine In 1897, there were 1046 traditional Chinese medicine practitioners; by 1945, only 97 remained.10 Infectious diseases were rampant at that time, including dysentery, malaria, typhus, cholera, small pox, measles, and trachoma.2 Great strides were made in improving public health for the island, including building water and sanitation systems, mandating compulsory immunizations, and dealing with epidemics and contagious diseases, etc.11 First hospital in Taiwan during Japanese period After Japanese troops entered Taipei (Taihoku in Japanese), the “Japanese Taiwan Hospital” was first established in the Dadaocheng district of Taipei City on June 20, 1885 Initially, there were only two departments (internal medicine and surgery), serviced by 10 medical doctors, nine pharmacists, and 20 nurses, all of whom came from Japan.12 In 1896, a total of seven hospitals were set up among the initial four districts of Taiwan Dr Shinpei Goto, a politician with a medical background who served as Civil Governor between 1898 and 1906, is considered to be the father of the Taiwan modernization As the head of the Home Ministry’s Medical Bureau and the Taiwan Government General (TGG) medical advisor in 1896, he invited Dr Hidetaka Yamaguchi, an ophthalmologist, to be the first head of the “Taipei Hospital” and the first president of the TGG Medical School The wooden “Japanese Taiwan Hospital” was renamed “Taihoku Hospital,” and in 1923 it was rebuilt in attractive red brick It’s now known as National Taiwan University Hospital (NTUH; Figure 1) First medical education in Taiwan during Japanese period The only institution of medical education during the colonial period was the TGG Medical School, which was established in Taipei in 1899 Thirty-seven years later, it was renamed Taihoku Imperial University Medical School, and is History of ophthalmology in Taiwan 1027 ophthalmological paper published in a Taiwan medical journal.15 Among the succeeding chairs, Dr Toru Motegi played a significant role in the modernization of ophthalmology and the organization of ophthalmological academic meetings in Taiwan Because Taiwan is in a subtropical region, he conducted several studies in tropical eye diseases, including uv-related conjunctivitis (4.38% in young males)16 and pterygium (6.5% in males and 7.1% in females).17 He made a significant contribution to the medical literature by publishing 76 papers and also presented 125 lectures from 1930 to 1938 In 1937, he presented a paper “Trachoma research in Taiwan” at the International Ophthalmology Society in Cairo, Egypt He organized an academic meeting series, “Taiwan Ophthalmological Focus Talks,” starting in 1933, which were held in a different prefecture each time; there was 16 meetings and 273 lectures in all through 1943 When he became chairman in 1938, he launched another academic meeting series, “Taihoku Imperial University Ophthalmological Focus Talks,” which were held two or three times annually These meetings helped raise the academic standards of ophthalmology at the university hospital and other hospitals in Taiwan Postcolonial period National Taiwan University Hospital Figure National Taiwan University Hospital The red brick hospital was rebuilt from the original wooden architecture in 1923 (A) and became the Outpatient Department of National Taiwan University Hospital (B) now known as National Taiwan University College of Medicine (NTUCM) Prior to 1945, the majority of local ophthalmologists either came from Japan or were educated at the Taihoku Imperial University.13 At the end of World War II in 1945, Taiwan was returned to Chinese rule The “Taihoku Imperial University” was renamed “National Taiwan University” (NTU) Dr Lin-Yuan Chiou became the first chairman of the Department of Ophthalmology at the NTU Hospital (NTUH), but he left for China following the 228 Massacre of 1947 He was succeeded as chair by Dr Shin-Lin Hu, who was arrested at a hospital faculty meeting in 1950 and was imprisoned for 10 years during the White Terror period of the Chinese Nationalist Party, also known as Kuomintang (KMT) Ophthalmology during the Japanese period Dr Yamaguchi established the Department of Ophthalmology as separate from internal medicine in March 1897 The Department of Ophthalmology became the third clinical department at Taipei Hospital and the first ophthalmology department in Taiwan.2,14 Because of this unique consideration, ophthalmology received a great deal of attention at that time This event served as a model in other newly established hospitals in other districts, as departments of ophthalmology were set up earlier than other specialties Dr Yamaguchi recruited Dr Shosaku Seo as the first chairman of the Department of Ophthalmology Initially, there were five doctors in the department Owing to the lack of textbooks at that time, Dr Seo translated Handbuch der Augenheilkunde, which was edited by Edouard Meyer, for teaching medical students Later, several German books were used as textbooks including Lehrbuch und Atlas der Augenheilkunde by P Axenfeld, Lehrbuch der Augenheilkunde by E Fuchs, and Augenarztuche Eingriffe by J Meller Drs Yamaguchi and Seo authored the first 1910e1997 Dr Yan-Fei Yang, the third chairman of NTUH’s Department of Ophthalmology, held the chair position for 20 years, and under his leadership a solid foundation for the future development of the department was established He completely changed the medical educational system from the original Japanese lecture structure to the American medical education system The original system of charting medical records in German was also converted to an English system Subspecialty clinics were set up in 1954, which included trachoma, refraction, glaucoma, strabismus, and amblyopia Dr Yang authored the Manual of Ophthalmology for interns, and edited the Lectures of NTUH Ophthalmology for residents Medical clerks had lectures in general ophthalmology and underwent training and practice to improve their skills in giving ophthalmologic examinations In a 4week-long course, interns attended a 12-lecture series on topics in ophthalmology, and also trained under residents and attending physicians while caring for admitted patients These improvements in ophthalmological education 1028 significantly impacted the training outcomes of medical students and residents in Taiwan To further raise the levels of academic professionalism, Dr Yang established the Ophthalmological Society of the Republic of China in 1960 (later renamed as the Ophthalmological Society of Taiwan) He became the first president of the society and continued in that capacity from 1960 to 1978 (His successor, Dr Chen-Wu Chen, succeeded in 1978, and Dr Liang-Shi Ko followed in 1986.) Dr Yang also instituted the official journal of the society, Transactions of the Ophthalmological Society of the Republic of China, in 1962, which was renamed Acta Societatis Ophthalmologicae Sinicae in 1992 In the inaugural issue of the transactions, Dr Yang reported a 68% success rate using electrocoagulation for treating retinal detachment.18 When Dr Yang passed away in 1997, he donated his body to the NTUCM for anatomical education Ophthalmologists from NTUH 1918e1997 Dr Wu-Fu Chen was born to a family of devout members of the Presbyterian Church in Yilan County in Northeast Taiwan Dr Chen graduated from Taihoku Imperial University Medical School in 1943 After a 3-year training program in ophthalmology at Taihoku Hospital, he returned to his hometown and founded a hospital to serve the people of Yilan County, at that time a poor area lacking doctors and medical care Because of his religious beliefs and humanitarian way of life, he often went to the mountain areas to take care of indigenous patients free of charge Although many people were helped because of his skillful care and charity, some patients unavoidably still lost their sight In 1959, Dr Chen established the “Mu-Kuang Rehabilitation Center for the Blind” and also developed devices to help rehabilitate blind patients in Luodong in Yilan County When he learned about Dr Albert Schweitzer’s work at Lambare ´ne ´, Gabon, he was inspired to write to Dr Schweitzer, who replied with an encouraging letter to him in 1959 Dr Chen became known as the “Taiwanese Dr Schweitzer,” and is remembered for his devotion to the poor and blind 1926e2009 Dr Pei-Fei Lee (also known as Pei-Fei Li), a founding member of the Asia-Pacific Academy of Ophthalmology, received advanced training at NTUH He reported a 2.25% prevalence of primary glaucoma among the Chinese in 1960 and used the Scheie procedure to treat primary glaucoma with an 86.4% success rate.19 In 1969, he first introduced the application of microsurgery to treat a variety of ocular diseases in Taiwan.20 Later, Dr Lee moved to United States and became an internationally respected glaucoma specialist Military hospitals in Taiwan When the KMT troops retreated from China to Taiwan in 1949, the original Japanese military hospitals were also taken over by the KMT troops These Chinese military medical doctors played another important role in the Y.-C Hou et al development of healthcare in Taiwan, especially with soldiers and veterans Among them, Dr Ho-Ming Lin was assigned to establish the Department of Ophthalmology at the Tri-Service General Hospital and became the first departmental chairman in 1949 He discovered vitamin A deficiency in soldiers with night blindness who were subsequently treated successfully with fish oil and carrots He also treated soldiers with vitamin B deficiency and optic neuropathy who improved after adding brown rice and fruits to their diets As an associate professor at the Institute of the National Defense Medical Center in 1950, Dr Lin wrote educational materials on the prevention and treatment of trachoma, and trained military doctors to help control trachoma among soldiers and veterans.21 The Veterans General Hospital was established in Taipei in 1954, and Dr Lin became the founding chairman of Department of Ophthalmology there in 1959, and retained this position (chairman) for 23 years Most ophthalmologists trained in military and veterans hospitals in Taiwan were students of Dr Lin Trends of epidemic diseases Trachoma Trachoma was highly prevalent in the colonial period and was considered to be the major cause of preventable blindness The prevalence rate was 44.9% in 1913, 38.7% in the period from 1915 to 1917, 35.3% from 1922 to 1925, and then 22.95% in 1929.15 A mass survey by NTUH showed a high prevalence rate of trachoma among students, 73.35% in 1950.15 In 1952, the Expert Committee on Trachoma of the World Health Organization (WHO) proposed treating trachoma with aureomycin and terramycin.22 A mass campaign against trachoma in Taiwan allocated by the United Nations Children’s Fund started in 1954, initiated by Dr Fakhry A de Assaad in cooperation with the ophthalmologists of NTUH Prior to treatment, the prevalence rate of primary school children was 46.9% in Taipei City and 75.1% in the Taipei suburbs After months of treatment with topical 1% terramycin twice a day or terramycin in combination with oral tresamide, the cure rate was 77.1%.15 Because of the good response in this initial trial, a nationwide survey and treatment program began in 1960, and the prevalence of active trachoma decreased to 21.8% in 1961, and then to 4.7% in 1968.23 By 1971, the WHO announced that Taiwan was no longer a trachoma-endemic area Myopia Over the past 50 years in Taiwan, it has been found that as the level of education and quality of life increase, the prevalence of myopia also increases In 1959, Dr Liang-Shi Ko found that the rate of myopia in primary school children in Taipei was 5.31%.24 From 1983 to 2000, a nationwide study of refraction in > 10,000 schoolchildren was conducted by Drs Luke Long-Kung Lin and Yung-Feng Shih at NTUH.25 It was found that the prevalence of myopia and History of ophthalmology in Taiwan high myopia (> À6 diopters) was substantially increased in all age groups over this period It is thought that long periods of near work may be contributing to the growing prevalence and severity of myopia in Taiwan Development of cataract, vitroretinal surgery, and corneal transplantation The practice of cataract surgery in Taiwan began with lens aspiration in soft cataract performed by Dr Yan-Fei Yang in 1956.26 In 1961, a-chymotrypsin was used in intracapsular cataract extraction, and anterior camber intraocular lens implantation was first done in 1972.27,28 Phacoemulsification procedures were also first performed in 1972.29 Extracapsular cataract extraction and posterior chamber intraocular lens implantation were started in the late 1980s.28 Surgery for repair of retinal detachment evolved from initial diathermy18 in the 1960s to scleral buckle in the 1980s and pars plana vitrectomy in the 1990s Penetrating keratoplasty was first done with the use of mm trephine and conjunctival flap fixation by Dr Yu Na in 1954 Later, Dr Na used 5.5 mm trephine with overlay corneal suture During the period from 1954 to 1960, he performed penetrating keratoplasty on 23 eyes in 21 cases and reported a success rate of 91.3% (21/23 eyes).30 Although the first eye bank had been established previously by Dr Chen-Wu Chen, the National Taiwan Eye Bank was launched at NTUH and the National Cheng Kung University Hospital in 2014, and began harvesting donor corneas nationwide Over the past 10 years, an average of 121,500 cataract surgeries, 1600 retinal detachment surgeries, and 600 corneal transplantations were performed annually.31 As for corneal transplantation, half of all donor corneas were imported from foreign countries prior to the establishment of National Taiwan Eye Bank in 2014 However, the number of domestic donor cornea has exceeded the number of imported donor corneas in 2015 Development of private hospitals Since the beginning of the Japanese colonial period, healthcare was provided mainly by government-owned hospitals and local private clinics In addition, after World War II, most of the large medical hospitals (including NTUH), military hospitals, veterans’ hospitals, and county hospitals were established by the government At that time, most private hospitals were too small to provide highquality medical service 1922e2016 Dr Chen-Wu Chen graduated from NTUCM in 1947 and continued practicing in the Department of Ophthalmology of this institution Dr Chen was devoted to treating and preventing the spread of trachoma and became a government consultant on the disease He not only trained doctors, nurses, and technicians, but also gave many lectures and services in the aboriginal communities and in the countryside When Kaohsiung Medical College, the third 1029 medical school in Taiwan, was founded in Kaohsiung in 1957, Dr Chen established the Department of Ophthalmology and became its first chairman, and continued to serve for 22 years Dr Chen was also the founder of Kaohsiung Eye Bank of the Red Cross Society (Taiwan’s first eye bank) in 1965.32 Dr Chen first reported using a local application of mitomycin C in trabeculectomy to enhance control of intraocular pressure in 1983, which became a popular method of treating glaucoma worldwide.33 In 1976, Chang Gung Memorial Hospital was established by the Formosa Plastic Group and later became one of the largest medical centers in Taiwan This private medical group eventually built and set up seven medical centers located around Taiwan As the east coast of Taiwan is relatively poor and underdeveloped compared with west coast, it also has lacked adequate large hospitals The Tzu Chi Foundation established Buddhist Tzu Chi General Hospital in Hualien in 1986 on the east coast, and later set up another six large hospitals around Taiwan These two biggest private medical groups also established their own medical schools As time went on, additional private large medical centers were also established and have played an important role relating to healthcare in Taiwan The ophthalmologists working at these private medical centers provide high-quality eye care to their patients and also conduct substantial medical training and research International cooperation The Ophthalmological Society of Taiwan was involved in the founding of the Asia-Pacific Academy of Ophthalmology, which was established in 1960, and became a member of the International Congress of Ophthalmology a year later In 2011, an English version of its official journal, the Taiwan Journal of Ophthalmology, was launched Taiwan has hosted several international and Asia-Pacific conferences since 1998, such as the 7th International Myopia Conference in 1998, the 18th Congress of the AsiaPacific Academy of Ophthalmology in 2001, International Workshops on Granulomatous Uveitis and Ocular Behce ˛t’s Disease in 2013, and the 4th Asia Cornea Society Biennial Scientific Meeting in 2014 The Taiwan Academy of Ophthalmology was established in 2006, and several of its subsidiary subspecialty societies are affiliated with other international ophthalmic societies Taiwan ophthalmologists are also very active in global health and humanitarian medical assistance initiatives Taiwan’s basic premise of foreign assistance work is to honor friendships and promote international cooperation.34 Starting with a delegation of military doctors sent to Libya in 1962, other missions include helping to establish hospitals in Saudi Arabia in 1979, providing eye care at the N’Djamena Freedom Hospital in Chad, and more recently performing cataract surgery and other eye care services in Sri Lanka In 2012, as part of the Taiwan International Cooperation and Development Fund’s “Medical Mission” ophthalmologists provided clinical training in several countries in the Pacific regions Taiwan ophthalmologists have also been involved in saving eyesight through ORBIS International initiatives.35 1030 Since 2009, Taiwan has been invited to attend the World Health Assembly as an observer and to participate in a number of WHO programs.36 As international exchanges have increased over the years, Taiwan ophthalmologists have been better able to contribute to the global ophthalmic community by participating in cross-border conferences, collaborative research projects, and publication Medical education Today, there are 11 medical schools in Taiwan, most of which have a 7-year curriculum including undergraduate studies and a 1-year internship.37 All graduate medical students are required to pass the medical board examination before they can become medical doctors Since 2011, all graduate medical doctors have been required to attend a 1-year postgraduate year program before they start residency training Medical education reform with a 6-year plus 2-year postgraduate training program was implemented in 2011 to strengthen the professional competencies of medical students Since 1988, Taiwan ophthalmologists (about 40 new residents each year) have been required to complete a 4-year residencytraining program and pass a board examination After residency training, a few ophthalmologists choose 1-year subspecialty training Many ophthalmologists in teaching hospitals go abroad for their subspecialty training Conclusion The evolution of ophthalmology in Taiwan was driven by changes in sovereignty, contributions by medical missionaries, and by the efforts of a number of dedicated ophthalmologists over the years The modernization of Taiwanese ophthalmology has been deeply influenced by Japanese and Western medicine Currently, there are about 1600 ophthalmologists serving 23 million people in Taiwan In recent decades, many subspecialty societies have been established that serve to educate future Taiwanese ophthalmologists and to connect globally with other international ophthalmic societies Ophthalmologists in Taiwan contribute to the advancement of ophthalmic knowledge globally by publishing papers (> 2000 since 1990)31 based on their clinical and basic research, both in national and international journals Taiwanese ophthalmologists keep current of advances in the field by attending local and/or international meetings, and continue to welcome this interaction and collaboration Acknowledgments The authors thank Dr Hunson Kaz Soong for valuable opinions and comments This study was supported by Department of Ophthalmology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan Y.-C Hou et al References Lai JY Cultural identity and the making of modern Taiwanese painting during the Japanese colonial period (1895e1945) Ann Arbor, MI: University of Michigan; 2008 Chuang YM Tai wan yi liao shi d yi tai da yi yuan wei zhu zhou (History of Taiwanese Medicine d mainly on National Taiwan University Hospital) Taipei, Taiwan: Yuan Liou Publishing Co., Ltd; 1998 [In Chinese] Thompson LG Earliest Chinese eyewitness accounts of the Formosan aborigines Monumneta Serica 1964;23:163e204 Bureau of International Cooperation Hospital care in Taiwan Taipei, Taiwan: Department of Health, Taiwan; 2006 Lin CL The Presbyterian church in Taiwan and the advocacy of local autonomy Sino-Platonic Papers 1999;92 Available from: http://www.sino-platonic.org/complete/spp092_ presbyterian_church_taiwan.pdf [Accessed March 8, 2016] Rev George Leslie Mackay Available at http://thetaiwanese blogspot.com/2006/03/rev-dr-george-leslie-mackay.html [Accessed March 6, 2014] Forsberg CRJ The life and legacy of George Leslie Mackay: an interdisciplinary study of Canada’s first Presbyterian missionary to Northern Taiwan (1872e1901) Newcastle Upon Tyne, UK: Cambridge Scholars Publishing; 2012 Lai CS, Chen AD, Lai YW, Kuo SJ The love surrounding the first skin graft in Taiwan: “British skin” that will stay in Taiwanese hearts Ann Plast Surg 2012;69:594e7 Roland CG George Gushue-Taylor and the medical missions of Formosa J Med Biogr 1996;4:82e93 10 Chen CF, Shum YC, Yang SP The modernization of traditional Chinese medicine in Taiwandpast, present and future Adv Exp Med Biol 2004;546:35e42 11 Chin HY Colonial medical police and postcolonial medical surveillance systems in Taiwan, 1895e1950s Osiris 1998;13:326e38 12 Dai DY, Chuang JY Tai da yi yuan yi bai nian (A century of National Taiwan University Hospital) Taipei, Taiwan: National Taiwan University Hospital Press; 1995 [In Chinese] 13 Ho TC, Hu FR, Hou PK, Chen MS Response to “Medical leaders in Taiwan during Japanese colonization” J Formos Med Assoc 2011;110:794e5 14 Li YD, Jhang SR, Fan BY, Li FJ tai wan gong li yi yuan bai nian ji (A centennial history of Taiwanese public hospitals) Taipei, Taiwan: Taiwan Public Hospital Association; 2004 [In Chinese] 15 Chen MS Tai da yan ke bia nian shi (A centennial history of Ophthalmology, National Taiwan University Hospital) Taipei, Taiwan: National Taiwan University Hospital Press; 2001 [In Chinese] 16 Motegi T Ultraviolet-induced conjunctivitis in North Taiwan ACTA Soc Ophthal Jpn 1931;35:483e6 [In Japanese] 17 Motegi T Eye influenced by seasonal wind ACTA Soc Ophthal Jpn 1943;47:817e8 [In Japanese] 18 Yang YF, Ko LK Treatment of retinal detachment: I The effect of the electrocoagulation on retinal detachment Trans Ophthalmol Soc (ROC) 1962;1:3e14 19 Li PF Mass screening for glaucoma among Chinese Trans Ophthalmol Soc (ROC) 1962;1:19e25 20 Li PF Brief review in ophthalmic microsurgery Trans Ophthalmol Soc (ROC) 1969;8:80e2 21 Lin HM Lin-He-Ming yan ke lun wen ji (The collection of HoMing Lin works in Ophthalmology) Taipei, Taiwan: Leaderbook; 1980 22 World Health Organization (WHO) Expert Committee on Trachoma: first report World Health Organ Tech Rep Ser 1952;60:1e22 23 Assaad FA, Sundaresan TK, Yang CY, Yeh LJ Clinical evaluation of the Taiwan trachoma control programme Bull World Health Organ 1971;45:491e509 History of ophthalmology in Taiwan 24 Ko LS, Liu HS, Yang YF Study of the refraction on primary school students in Taipei J Formos Med Assoc 1959;58: 336e53 25 Lin LL, Shih YF, Hsiao CK, Chen CJ Prevalence of myopia in Taiwanese school children: 1983 to 2000 Ann Acad Med Singapore 2004;33:27e33 26 Yang YF, Tsai WF Aspiration technique for soft cataract Trans Ophthalmol Soc (ROC) 1972;11:1e6 27 Tsai YH Enzymatic zonulolysis in intra-capsular cataract extraction Trans Ophthalmol Soc (ROC) 1962;1:38e43 28 Chen TT Results in 100 intraocular lens implantationsepreliminary reports Trans Ophthalmol Soc (ROC) 1980;19:132e40 29 Tu SL Phacofragmentation and irrigation of cataracts by using dental ultrasonic apparatus a preliminary case report Trans Ophthalmol Soc (ROC) 1974;13:73e6 30 Na Y Report on 23 eyes (21 cases) of penetrating keratoplasty Trans Ophthalmol Soc (ROC) 1962;1:57e67 31 Hsu WM, Liu JH Ophthalmology in Taiwan Taiwan J Ophthalmol 2014;4:59e62 1031 32 Lin SM Chuen qi Ling huen zhi chuan: Chen-Zhen-Wu yi liao feng xian zhi lu (Reopen the window to the soul: the Chen-Wu Chen medical contributions) Taipei, Taiwan: Chen-Zhen-Wu Prevention of Blindness Foundation; 2015 33 Chen CW Enhanced intraocular pressure controlling effectiveness of trabeculectomy by local application of mitomycin C Trans Asia Pacific Acad Ophthalmol 1983;9:172e7 34 Li TW, ICDF d Taiwan Medicine Beyond Borders Annual Report 2002 Taipei, Taiwan: International Cooperation and Development Fund (ICDF); 2002 35 Executive Yuan Public Health, Chapter 14 Republic of China yearbook, 2010 Taiwan: Executive Yuan; 2011 36 Wood R Taiwan’s Participation in the World Health Assembly April 29, 2009 Available from: http://www.state.gov/r/pa/ prs/ps/2009/04/122401.htm [Accessed December 8, 2015] 37 Lai CW Experiences of accreditation of medical education in Taiwan J Educ Eval Health Prof 2009;6:2  ... graduated from NTUCM in 1947 and continued practicing in the Department of Ophthalmology of this institution Dr Chen was devoted to treating and preventing the spread of trachoma and became a government... training and research International cooperation The Ophthalmological Society of Taiwan was involved in the founding of the Asia-Pacific Academy of Ophthalmology, which was established in 1960, and. .. furthering of medical services in Taiwan In 1865, the first Presbyterian medical missionary, Dr James L Maxwell (1836e1921), arrived from England and began preaching and practicing medicine in Tainan