March 2008
Volume 49, Issue 3
Lecture  |   March 2008
Introducing David L. Guyton, the 2007 Recipient of the Weisenfeld Award
Investigative Ophthalmology & Visual Science March 2008, Vol.49, 846. doi:
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      David G. Hunter; Introducing David L. Guyton, the 2007 Recipient of the Weisenfeld Award. Invest. Ophthalmol. Vis. Sci. 2008;49(3):846. doi:

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      © ARVO (1962-2015); The Authors (2016-present)

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David L. Guyton is a doctor, a problem solver, a clinical innovator, an inventor, a teacher, a communicator, and above all, a warm and generous man. Dr. Guyton grew up learning optics by burning leaves with his magnifying glass in the hot summer sun of Mississippi. After graduating summa cum laude from the University of Mississippi (winning the Taylor Medal in Physics), he followed his grandfather, father, and uncle into medicine, graduating magna cum laude from Harvard Medical School (winning the Maimonides Award for outstanding achievement), and becoming the first of a record 10 siblings to be a physician. 
After receiving his medical degree, he completed a fellowship in the Laboratory of Neural Control at the National Institutes of Health, publishing one of his first research papers in the journal Science. In subsequent years he completed a residency in ophthalmology at the Wilmer Ophthalmological Institute, followed by a fellowship with Gunter von Noorden at Baylor College of Medicine. He then returned to Johns Hopkins as Wilmer Chief Resident before taking over as the Director of Strabismus and Pediatric Ophthalmology, where he continues to serve as the Zanvyl Krieger Professor of Pediatric Ophthalmology and Director of the Krieger Children’s Eye Center at the Wilmer Institute. 
Dr. Guyton’s internationally recognized contributions to clinical strabismus and optics permeate seemingly every clinical encounter for those in our specialty. His expertise in clinical optics has given us, among other things, the proper techniques for prescribing cylinders, measuring strabismus with prisms, and centering corneal surgical procedures, as well as the Potential Acuity Meter for assessment of visual acuity potential in cataract patients. His fascination with fundus torsion has given us the exaggerated traction test for assessing oblique muscle tightness, key insights into understanding the cyclovertical strabismus that can develop after administration of local anesthesia, and a comprehensive treatise that explains the long-elusive origins of oblique muscle overaction and A and V patterns in patients with strabismus, part of which he will share with us today. 
Dr. Guyton has always been able to take the most complicated and seemingly arcane topics in optics, give them relevance, and make them understandable, even for the mathematically challenged. Through his contributions to the Lancaster Course, the Stanford Course, and numerous other courses and reviews of ophthalmic optics across the world, he has contributed to the optics education of virtually every ophthalmologist trained in the past three decades. He produced two superb videos on clinical refraction, one of which won first place at the John Muir Medical Film Festival. His humorous and insightful reviews of the “Optical Pearls and Pitfalls” or “Optical Tricks and Traps” in strabismus and ophthalmology have provided invaluable advice to residents and practicing ophthalmologists. Less well known, perhaps, is his ability to teach writing skills. His red pen has long been feared by coauthors subjected to yet another round of extensive manuscript revisions. But the red pen is rarely challenged: He once received a “perfect 10” from a journal when a paper he submitted did not require modification of a single word despite peer review and copy editing. He has trained more than 50 pediatric ophthalmology fellows at Wilmer and scores of students and international observers, and those whose lives he has touched remain a devoted and supportive group. 
Dr. Guyton has also generously contributed time and energy to professional societies including the National Eye Institute, the National Academy of Sciences, and the American Academy of Ophthalmology (AAO). He has served on the Board of Directors and as President of both ARVO and the American Association for Pediatric Ophthalmology and Strabismus.. He was one of the founding developers of the important commercial self-interest policies now used by AAO and ARVO. 
Despite all of his accomplishments in clinical ophthalmology and teaching, Dr. Guyton’s deepest devotion is to his research. He has had a long-standing infatuation with automated refraction, building and demonstrating his first optometer (and giving himself his first refraction) as a medical student. He subsequently built an award-winning automated refractor programmed to provide accurate subjective refinement. He has published extensively in the area of remote optical systems and automated measurement of strabismus and has designed and built, in his basement workshop, numerous remote optical devices that simplify or increase the accuracy of eye examinations. Together, we developed the technique of retinal birefringence scanning and applied it to produce the Pediatric Vision Screener, a device that promises to allow for automated detection of children at risk for amblyopia. Dr. Guyton has been awarded 11 U.S. patents. He has received the Alcon Research Institute Award, the Research to Prevent Blindness Senior Scientific Investigator Award, the RPB Disney Award for Amblyopia Research, and two industry research and development awards. 
How can one man be so accomplished in such a diverse range of areas in ophthalmology? In addition to his natural ability in many areas, Dr. Guyton constantly questions assumptions, and he simply cannot stop thinking about a problem once he sets his mind to solving it. He has amassed more than 250 publications, and during this period of extraordinary productivity, he and Jan Guyton, his wife of 39 years, have been prolific as well, bringing three Guyton boys into the world who have now made them proud grandparents six times over. The good news for all of us is that David Guyton is continuing his quest to understand disease and devise new ways to examine patients. Those who know his present work say that some of his greatest accomplishments lie ahead, as evidenced by his provocative new insights into the role of vergence tonus and muscle length adaptation. His important efforts to decode the clues provided by ocular torsion, thus revealing the mechanisms of cyclovertical strabismus, is the subject of his 2007 Weisenfeld Lecture. 

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