The History of NANOS

Thomas J. Carlow, M.D.

Permission to reprint the following article from the Journal of
Neuro-Ophthalmology 1999;19:219-221 on the NANOS web site has been granted by Lippincott Williams & Wilkins.
To access the journal home page go to www.lww.com

Inspired by the fever pitch atmosphere of the yearly Bascom-Palmer Eye Institute neuro-ophthalmology course and teaching enthusiasm of its faculty (Bob Daroff, Noble David, Lou Dell'Osso, Joel Glaser, Ed Norton, J. Lawton Smith, Todd Troost), a southwestern "clone" was conceived, by a young assistant professor of neurology, and sponsored by the neurology department at the University of New Mexico in Albuquerque. The initial 1975 Santa Fe program was such a success, that the course became a yearly event. The inaugural faculty included Joe Cannon, Tom Carlow, Bob Daroff, Joel Glaser, and Bill Hoyt, with 156 registrants in attendance. Joe Bicknell, Chair of Neurology at the University of New Mexico, and Norman Schatz joined the teaching group to lecture in 1976.

The annual course quickly grew into a symposium for neuro-ophthalmologists. The fledgling organization adopted policies to attract new members, gradually from all parts of the United States and Canada. Once a neuro- ophthalmologist accepted an invitation to lecture, he or she typically returned enthusiastically accompanied by friends and fellows. The list of neuro-ophthalmologists initially lecturing in the first ten years clearly demonstrates how important and successful this policy was for the subsequent growth of organized neuro-ophthalmology. Nancy M. Newman (CA) lectured in 1977; Shirley Wray in 1978; Henry Van Dyke, Bruce Wilson, and Brian Younge in 1979; Walter Cobbs, James Corbett, Lou Dell'Osso, Carl Ellenberger, Jack Kennerdall, George Sanborn, Peter Savino, Stan Thompson, Jon Wirtschafter, and David Zauel in 1981; Terry Cox, Noble David, Jack Selhorst and Jim Sharpe in 1982; Roy Beck, Jim Goodwin, Steve Johnson, Mark Kupersmith, Gerry Maitland, Tom Shults, Craig Smith, and Bob Spector in 1983; with Steven Newman ( baby sister not until 1990) and Bob Sergott rounding out our tenth year in 1984. Membership and participation in our yearly symposia and organizational activities continue to flourish, and grow with the addition of lecturers from all regions of North America and the world.

In 1978, the first formal non-neuro-ophthalmologist guest speaker was A. Earl Walker, emeritus professor of neurosurgery, from Johns Hopkins. Dr. Walker, a colleague of Frank B. Walsh at Johns Hopkins, had retired to New Mexico, and kindly accepted an invitation to participate. His lecture was titled, Pupil in Coma and Cerebral Death. Thus began a tradition of superb, informative, and world class guest speakers that has continued for more than two decades.

The University of New Mexico formally established a Department of Continuing Medical Education in 1979 and requested a surcharge for any program to be held under its auspices. Because all collected funds had always been spent to enhance the course, this policy prompted a transfer of all course fiduciary responsibility outside of the University of New Mexico and necessitated the formation of a society with Articles of Incorporation and Bylaws. The Rocky Mountain Neuro-Ophthalmology Course became The Rocky Mountain Neuro-Ophthalmology Society and was officially incorporated as a nonprofit organization on February 11, 1980 with 132 members. Suddenly, we had limited funds and no administrative infrastructure. Susan Carlow "volunteered" to assist with the yearly meeting. Little did she or the Society comprehend how NANOS would grow exponentially and come to occupy such a significant component of her life.

NANOS has instituted several important and prestigious awards over the past twenty-five years. The first Resident Fellow Award was won by David Zackon in 1983 for his paper titled Vertical Supranuclear Gaze Palsy and Intrathoracic Carcinoid Tumor. John Kerrison received the seventeenth award for his poster titled Congenital Motor Nystagmus Linked to Xq26-q27 at our Snowmass, Colorado 1999 meeting. NANOS received its first endowment in 1996 to sponsor a Young Investigator Award. This award was designed to encourage basic or clinical research in neuro-ophthalmology. It is granted after a review of a developing neuro-ophthalmic investigators total body of work and acceptance of a new research manuscript. Leonard Levin received the first Young Investigator Award in 1997, Jason Barton the second in 1998, and most recently, Wolf Lagrèze in 1999.

After much discussion, the Rocky Mountain Neuro-Ophthalmology Society voted to change its name to the North American Neuro-Ophthalmology Society in 1986 at our Whistler meeting, thus recognizing that we had grown from primarily a national to an international society. By 1987, NANOS had 240 members from 46 of the 50 United States, most Canadian provinces, Australia, and England.

Significant dialogue, to make the yearly meeting accessible to adherents of both a winter and sun-soaked atmosphere, resulted in a change from our prototypic mountainside locale. In 1989, NANOS first ventured out of the Rocky Mountains to then hurricane ravaged Cancun, Mexico. Our site selection committee now chooses two winter/ski venues for every sun/beach resort. This policy has provided an opportunity for all to enjoy the Rocky Mountains and, at regular intervals, warm weather sites in conjunction with our outstanding, informative scientific sessions.

In 1988 Roy Beck proposed that we sponsor a symposium at the American Academy of Ophthalmology. The first NANOS-AAO symposium was subsequently held in New Orleans in 1989. The broad subject of diplopia was presented under the aegis of Tom Carlow, and Peter Savino. This year will mark the eleventh year of joint symposium sponsorship with the AAO. Barrett Katz and Alfredo Sadun are the current co-moderators. The topic to be addressed is A Medical-Legal Primer for Neuro-Ophthalmology: Common Traps, and How to Avoid Them. Attendance continues to soar. Last year there were more than one thousand physicians and paramedical personnel in the audience, with only standing room available.

At Stanley Thompson's suggestion, we had our inaugural poster session at Park City, Utah in 1991. It was an obvious success and has become an essential component of our yearly meeting. The Snowmass, Colorado 1999 session had 73 posters with discussion extending over three hours. It was accompanied by a festive Chinese box dinner.

Nineteen hundred and ninety-one was a momentous and in some ways tumultuous year for organized neuro-ophthalmology. The Frank B. Walsh Society had incorporated, providing NANOS and the Frank B. Walsh Society the opportunity to consider a formal corporate merger. First merger discussions were held in Salt Lake City after the Frank B. Walsh meeting and then, within the same week, at the NANOS Park City meeting. Ultimately, 98% of both societies endorsed a merger in November 1991. New Bylaws were approved by NANOS at our 1992 Rancho Bernardo, California business meeting, and then by the Frank B. Walsh Society at the Los Angeles meeting that followed. The legal document completing the union was signed by Tom Carlow and Bob Daroff for NANOS, and Bill Hoyt and Dave Knox for the Frank B. Walsh Society at the Williamsburg, Virginia, International Neuro- Ophthalmology Society Meeting on June 29, 1992.

Todd Troost, as NANOS publication's committee chair, began negotiations for a NANOS sponsored Journal of Neuro-Ophthalmology in 1992. His effort was rewarded when a contract was signed with Raven Press in January 1994 to assume the role of the official journal of NANOS. Ron Burde and J.Lawton Smith were joint editors for the first year. Ron Burde, along with his editorial board, has directed and developed the Journal of Neuro-Ophthalmology into an extremely valuable and indispensable component of NANOS.

NANOS was officially launched onto the information superhighway in 1995 through the efforts of Preston Calvert and Todd Troost, with the establishment of its own web page. Our Society now has a totally new and powerful dimension to explore and vehicle through which to communicate. NANOS E-mail discussion groups, as listed and described in this year's syllabus, have expanded to currently include: NANOSLTR, NANOSNET, NANOSBIZ, PLACECTR, NANOS HOME PAGE, and an ARCHIVES PAGE.

A particular personal high point, in the organizational development of NANOS, has been to observe the dedication and commitment that each subsequent NANOS president has brought to that office. Jim Sharpe, Steve Feldon, Jon Wirtschafter and currently Jack Selhorst have all contributed not only significant time, expertise and effort, but have imbued NANOS with their own unique personality, attributes, and interests. They have all served NANOS with distinction and each can be extremely proud of their contribution to our subspecialty.

NANOS now has close to 600 members in the United States, Canada, Australia, Argentina, Belgium, China, England, Germany, Israel, Italy, Japan, Scotland, Switzerland, Taiwan, and Thailand. Our organization now represents the subspecialty of neuro-ophthalmology in a truly global sense.

The NANOS Board recently developed a distinguished service award to be given to members of NANOS who have significantly advanced the development, education, and organization of neuro-ophthalmology over an extended period. The first Irish crystal awards were given to Susan Carlow, Tom Carlow, Robert Daroff, Joel Glaser, William Hoyt, David Knox, and Norman Schatz at our 25TH Anniversary meeting in Snowmass, Colorado on St. Patrick's Day, March 17, 1999 (Figure 1).

Several fundamental NANOS principles, not inscribed in our Bylaws, have existed since its conception: learning neuro-ophthalmology can and should be fun; learning neuro-ophthalmology can be accomplished in a relaxed and pleasant environment; and during the annual meeting, time should be made available for members to socially interact with colleagues and their families. Over the past 25 years, NANOS has maintained and fostered these principles. The scientific sessions have consistently been tremendous and exceptional. Participants have all shared important moments with colleagues and their families from the peaks of the Canadian Rockies to the top of the pyramids at Chichén Itzá in Mexico, and from Orlando, Florida to Rancho Bernardo, California. These opportunities would have been impossible without abiding to the above fundamental guiding precepts.

Since NANOS now represents organized neuro-ophthalmology, it must protect the moral imperatives of our times while accepting the educational, political and economic responsibilities that accompany its mission. As we enter the 21st century, NANOS must promote excellence in patient care, become a leader in innovative medical education, support neuro-ophthalmic research, investigate new modalities for our membership to communicate, and continue to represent the ideals of medicine that originally enticed us into our unique profession.

Thomas J. Carlow, M.D. Albuquerque, New Mexico

Addendum from the Editor
A moment in time grabbed by individuals with foresight has produced something for which we should be proud. Thanks to the Executive Vice President and founder of NANOS, Tom Carlow, and special thanks to the winners of the initial NANOS Distinguished Service Award.

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