Eponymous names are familiar to all who have undergone undergraduate and postgraduate training in medicine. The ability to name a few allows one to stand out among your peers and rare, or not so rare, eponymous syndromes are a favourite of college exams and MCQ question books. There are numerous eponyms in medicine and their value in postgraduate training in my experience is similar to the undergraduate years.
In modern medicine opinion is divided as to whether new discoveries should have an eponymous title with current trends favouring a move towards descriptive nomenclature. Some eponymous conditions in medicine with ophthalmic manifestations such as Wegener’s granulomatosis and Reiter’s syndrome are now filled with controversy due to the association between these doctors and the unfortunate events of the Second World War in Germany. Interestingly no studies have ever evaluated whether eponyms aid or hinder learning.
Eponyms – friend or foe?
Some arguments for eponyms might include the fact that they represent an important part of the history of medicine, they can be a convenient shorthand; indeed some thrive on remembering them and there is a good chance you will need a few before the exams. The debate against them includes the fact that they are outdated, descriptive terms allow you to determine some aspects of the disease or syndrome such as pathophysiology, scientific discoveries usually involve a team, there is regional and continental differences for example Morbus Horton’s disease in Germany vs. maladie de Horton in France; Paget’s disease could imply disease of the bone, breast, vulva or penis. There is also overlap in the interpretation of the eponyms with authors describing the same eponym differently.
“Despite the pros and cons of abolishing the use of eponymous syndromes for the foreseeable future they are here to stay.”
I recall my first job in ophthalmology where during my first few weeks in theatre my consultant, who was a brilliant teacher, showed me a small haemorrhage occurring in the angles of the eye during cataract surgery and he proceeded to ask me “What is Amsler’s sign?” I responded with a minute of silence, hoping the answer would miraculously become apparent to me. I then responded it had something to do with the Amsler chart although the humiliation of not knowing was such that I now know what the Amsler sign is and think of this episode every time I hear it mentioned. Would a descriptive name have saved me embarrassment that day? I determined to make a list of all these eponymous syndromes so that other ophthalmic trainees would be spared the same treatment. I am confident this list will also help with exams. I determined to do this through a prospective review of medical literature and major ophthalmic text books.
- To determine the total number of historical eponymous described as lines, dots, spots and rings or the equivalent in the ophthalmic literature
- To determine the total number of these eponymous signs in each ophthalmic subspecialty
The nature of eponyms
Thirty-six eponyms are described as lines, dots, spots and rings. Seventeen (47.2%) eponyms are lines, four (11.2%) are dots, eight (22.2%) are spots, seven (19.4%) are rings. A majority of the eponyms are located on the anterior segment (81%). Fourteen (39%) of all eponyms are described on the cornea. The retina and the conjunctiva have five (14.0%) eponyms each. The lens has four (10%), the angles of the eye two (5.5%), the choroid two (5.5%), the orbit one (3%), sclera one (3%), periorbit one (3%) and iris one (3%). They are described in the table below.
It is important to note these may not be all the eponyms as only major general ophthalmic textbooks and the opportunistic ones are included. There are also likely geographic differences of the same findings.
I hope this list of eponymous syndromes help those undertaking exams to answer those critical questions that are unanswerable using common sense alone. They are disproportionately important for this reason more than any other. Despite the pros and cons of abolishing the use of eponymous syndromes for the foreseeable future they are here to stay and thus knowledge of their meaning is a prerequisite for success.
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