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HomemifeatureCelebrating 150 Years: The Royal Eye and Ear Hospital

Celebrating 150 Years: The Royal Eye and Ear Hospital

When Dr. Andrew Sexton Gray opened Melbourne’s Eye and Ear Infirmary in 1863 with “£5 and one bed”, little did he know that 150 years later, the Australian community would celebrate its success as the country’s only specialist eye, ear, nose and throat hospital. Known today as the Royal Victorian Eye and Ear Hospital (Eye and Ear), the institution has been instrumental in caring for the public, training medical specialists, and discovering breakthrough medical treatments to fight disease.

It was the 1860s and, faced with a housing shortage, Melbourne was bursting at the seams. With no underground sewerage system, poor health among the general population was inevitable. Miners, cashing in on the Gold Rush yet living in squalor, were particularly susceptible to eye diseases and injuries.

Dr. Gray saw the need and established an Eye and Ear Infirmary which he furnished with his own equipment to treat commonly held diseases such as blight, strumous ophthalmia and trachoma.

However, without the ability to personally fund his work, Dr. Gray was unable to meet increasing demand and so, in 1866, the Infirmary became a publicly funded institution, and accordingly, it was renamed The Melbourne Institution for Diseases of the Eye and Ear (MIDEE).

In the 1860s, the average patient stay was three months – and some would stay on for a year

Then, in 1873, in an effort to better reflect its services and status as a not-for-profit, the MIDEE changed its name again, this time to The Victorian Eye and Ear Hospital. Eighty years later, in 1961, a Royal Charter was received which put the ‘Royal’ into the name.

The Patient Experience

Having opened with just one bed in 1863, Dr. Gray experienced massive and rapid growth in patient numbers. In 1867 the infirmary saw 50 in-patients and 2,008 outpatients, 419 of whom were children. Dr. Gray performed 86 operations that year.

During his time with the hospital, one of the most famous people he treated for a hearing problem was one of Australia’s favourite sons, Henry Lawson.

In 1926, 2,000 patients were admitted to hospital and 17,000 patients attended clinics, often multiple times during the year. All were attended by the 12 honorary surgeons and three resident doctors on staff. Forty years later, inpatient figures had reached 4,000 with 30,000 outpatients annually.

As you’d expect, the average patient stay has shortened considerably over the years. In the 1860s, the average patient stay was three months and some would stay on for a year.

By the 1900s, surgical recovery times had improved and the average stay for men was 22 days, with women, on average remaining in hospital for 26 days. Patients of this Victorian era were made to rise early and abide by the strictest code of conduct outlined by the matron. Those who were physically able were enlisted to perform light duties during their stay. Family and friends who visited patients after hours paid 6d for the honour. This fee was later extended to all visitors as a way of generating funds during difficult economic times. Today, visits are free, patients are likely to stay overnight or the same day and they just need to follow instructions at home to speed up their recovery!

Understandably, in the early years of the hospital, surgery itself was highly complicated. Due to a lack of understanding about how infections are spread through microscopic germs, ophthalmic surgeons would often hold instruments in their mouths during operations to free up their hands. In one document, Dr. William Orr recalls Dr. Gray’s “unclean thumb” pressed against a patient’s eyeball during surgery.

Fortunately for the patient experience, doctors soon became more aware of issues surrounding hygiene, and anaesthetics and surgical procedures became more sophisticated. In fact, over time, the hospital has become internationally recognised for its adaptation and discovery of breakthrough medical treatments.

Medical Breakthroughs

One breakthrough treatment that Dr. Gray adapted back in 1885 was the administration of cocaine drops onto the eye, for use as an anaesthetic during an iridectomy. Until then, patients would be administered chloroform rather than anaesthesia, which often induced nausea and was not wholly effective at blocking the pain of surgery. Later, in the 1920s, cocaine was replaced by Novocain injections.

In 1978, the Eye and Ear achieved a milestone when the first bionic ear implant surgery was performed on a patient by Prof. Graeme Clark.

By the 1990s, the implant was already being used to treat around 18 profoundly deaf patients a year and in 2007, the first simultaneous dual cochlear implant operation was performed on a 20-month old child.

Most recently, in 2012 the hospital’s Dr. Penny Allen led a surgical team to perform the first pre-bionic eye implant in a patient. Another internationally acclaimed procedure to have been performed at the hospital in recent times was the first paediatric ‘auditory brain stem implant’ surgery in the Southern Hemisphere in 2007.

The hospital was also recognised for its work in Penicillin in the 1940s. Following the discovery that Penicillin could reduce infection following ENT surgery, and in some cases reduce the need for ENT surgery at all, the Eye and Ear began to create Penicillin Nitrate in its pathology lab. Penicillin Nitrate was used throughout the hospital and later, around the country, at the request of the Commonwealth Serum Laboratories.

Working with the Eye and Ear

The Eye and Ear was forward thinking when it came to employing women in senior medical positions.

In 1907, Dr. Mary Henderson was promoted to Senior Resident Surgeon and Dr. Eileen Fitzgerald to Junior Surgeon. Drs. Henderson and Fitzgerald were among the pioneers for Australian women in medicine. By the time of the First World War, when many senior male medical staff began to volunteer for military duty, more women stepped in to take on the roles of practitioner and surgeon.

One woman to do so was Dr. Mary Glowery who, in 1914, was appointed the hospital’s Honorary Refractionist and resident Medical Officer. Later, in the 1920s, Dr. Jean Littlejohn joined the hospital as Resident Medical Officer. In 1933, Dr. Littlejohn became the first female to be appointed Honorary Surgeon. The hospital’s Deafness Clinic, where Dr. Littlejohn served as an otologist until 1974, was renamed
in her honour in the late 1950s.

Eye and Ear as a leading Training Hospital

The Eye and Ear earned a reputation as a quality teaching hospital in 1882 when it first began to admit medical students. It was officially recognised by Medical Superintendent Alan Cunningham for its contribution to clinical teaching, and the high standard of training for medical students in 1935.

In 1944, as the Second World War came to an end, the Hospital became a training school for medical personnel from the armed forces who required specialised training. During the 1960s, orthoptic students began training at the hospital as part of a Diploma of Orthoptics.

Today the hospital continues to train undergraduate medical, orthoptic and optometry students; postgraduate nursing students; postgraduate optometry students, ophthalmology, ear, nose and throat and anaesthetic students; and emergency medicine students.

Continuing the Work

And as for the future… in 2013, as the RVEEH celebrates 150 years, it will undergo major redevelopment,
this time funded by the state government.

While much has changed since 1863, essentially, the hospital continues in the footsteps laid out by Dr. Gray – in breaking new ground to provide treatments for eye, nose, ear and throat disease.

Donations and Contributions

Throughout its history, the RVEEH has raised funds to expand its patient capacity, pursue specialisations, develop specialist clinics and invest in state of the art equipment. Funds have come from multiple sources.

Upon being established as a public institution and charity in 1866, the hospital began to receive donations
from community groups, Shire Councils, Road Boards and Friendly Societies. Local church groups would host Hospital Sundays to raise funds on the hospital’s behalf. As a result, by the 1870s, the Institution had ten beds for in-patients and was able to open three days a week for out-patients.

Donations from groups, individuals and government continued to support the ongoing work and expansion of the RVEEH.

In 1884, the Melbourne Comedy Club raised £46 (equivalent of AUD$2,500 today) and continues to raise money for the hospital today. In the 1880s, Dr. Beaney bequeathed £100 and an eighth of his estate to the VEEH, with an expected value of £38,000. And in1893, Dr. Aubrey Bowen died, bequeathing £3,500 to VEEH for building a new wing.

Later, in the 1960s, a donation of AUD$30,000 from Maud Gibson funded lecture series covering ENT procedure and practice. The lectures were named in honour of Maud’s father, William Gibson. In the 1890s, the Smorgon family donated AUD$1.4 million to help build the new outpatients building and provide equipment to other areas of the hospital. Then in 1991, the Lions Club of Victoria raised AUD$1m to open the Lions Eye Bank, which through research, has increased the success of corneal grafts as well as helping raise awareness for organ donation. The Hospital’s Opportunity Shop, which operated until 2005, contributed AUD$2m to the hospital over its 36 years of operation.