Donald Gass – The Immaculate Man Behind the Macular Multiplex

His long-term colleagues fondly eulogise him, reminiscing about his extensive work on macular diseases, “Don described it first and described it best. The list runs from A to Z, from APMPPE to AZOOR [acute posterior multifocal placoid pigment epitheliopathy to acute zonal occult outer retinopathy].”[1] Heralded as the father of macular diseases, Donald Gass is known for his description of various complex retinal pathologies and is one of the most significant ophthalmologists to emerge in the last 100 years.[2] John Donald MacIntyre Gass was born in Prince Edward Island, Canada, to the prominent tuberculosis specialist R.S. Gass. His family then moved to Nashville, Tennessee, United States of America, where he spent the rest of his childhood. He did his bachelor’s degree at Vanderbilt University in 1953 and served the next 3 years in the US Navy during the Korean War. He went on to do his MD from the Vanderbilt University School of Medicine in 1957. Following various stints at Johns Hopkins Hospital, Armed Forces Institute of Pathology, and Bascom Palmer Eye Institute, he returned to his home roots in Nashville, where he served as a professor at the Vanderbilt University School of Medicine.[3] ACADEMIC PURSUITS His tenure at the Armed Forces Institute of Pathology was reflected in his academic work, where Gass relentlessly pursued in identifying the pathological basis of various clinical cases. At the Palmer Eye Institute, he researched majorly into the usage of fluorescein angiography and demonstrated its clinicopathological correlation with disorders of the macula and retinal vasculature. Both these extensive research works created a unique blend to Gass’ brand of academic work, which reflected a healthy blend of ophthalmology, pathology, and technology.[4] Gass is recognised as a prolific writer, having authored numerous reference books on macular diseases and intra-ocular tumours. Two of his most classic books, “Stereoscopic Atlas of Macular Diseases: A Fundoscopic and Angiographic Presentation” and “Differential Diagnosis of Intraocular Tumours: A Stereoscopic Presentation”, remain authoritative texts in the field to this day. He has also authored 12 book chapters and 250 articles in peer-reviewed journals, many of which are recognised as landmark contributions.[5] It stands to note that Gass’ work is behind numerous retinal pathologies that are encountered every day in clinical practice. He is known for establishing the sub-types of choroidal neovascularisation in neovascular age-related macular degeneration based on its anatomical relation to the RPE and retina. He designed a fenestrated muscle hook for the scleral buckling procedure. In the late 1980s, Gass presented the tangential theory of vitreomacular traction to explain the pathogenesis of macular holes. These observations were confirmed later by optical coherence tomography (OCT), paving the way for the genesis of macular hole surgery.[6] AWARDS AND ACCOLADES Gass has been the recipient of numerous honours in his lifetime. He was awarded the American Medical Association’s Knapp Award in 1966 and medal in 1975, the Wilmer Eye Institute’s Distinguished Scientific Award in 1975, and the Clun Jules Gonin’s Hermann Wacker Prize in 1980. Don Gass served as the president of the Macula Society from 1980 to 1982. He received the highest honour bestowed by the American Ophthalmologic Society – The Lucien Howe Medal in 1983. In 1986, he was honoured with the Award OF Merit in Retina Research by the Retina Foundation. In 1987, the Macula Society formed the Gass Medal award for exceptional work in the field of macular diseases. In 1999, he was named one of the ten most influential ophthalmologists of the 20th century by the American Society of Cataract and Refractive Surgery. He was the recipient of the coveted Helen Keller Prize for Vision Research in 2001.[7] Don Gass is fondly remembered for his modest and humble nature and his effervescent interest in imparting his learned knowledge to fellow ophthalmologists. Following a magnificent and fulfilling career, he took up partial retirement while continuing to work at Vanderbilt University. Among his other pursuits, he was also an accomplished craftsman who engaged in numerous woodwork projects. He was married to Margy Ann, and they were blessed with four children and five grandchildren. With a healthy mix of worldly knowledge, grounded attitude, outstanding clinical skills, and remarkable contributions to the field of ophthalmology, Donald Gass stands as a testament to his bestowed title of being an influential ophthalmologist of the 20th century. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

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