Contributed by: Arhum Mahmood, MD (cand)

Jules Gonin was born in Lausanne, Switzerland on August 10, 1870. He was raised in a family who placed grave importance on culture and religious faith. In secondary school he began to reveal his remarkable ability to learn languages. He spoke French, Swiss, German, and then later added Latin, Greek, English, Spanish, and Italian.[2]

In 1888, Gonin joined the College of Science and studied medicine at the University of Lausanne. He completed many research studies on butterflies, earned a distinction from the University, and then entered the institute of Pathology in Lausanne. After travelling to hospitals all around Europe between 1894-1895, he developed an interest in ophthalmology. In 1896, he began training under Dr. Marc Dufour, the first professor of ophthalmology in Lausanne and director of the Eye Hospital. While working at the Eye Hospital, Gonin became more prominent and was given the title of Privat-Docent which implied great teaching commitments. Subsequently, in 1908, he became the first president of the Swiss Ophthalmological Society which he cofounded. Finally, in 1918, he became director of the Lausanne Eye Hospital and two years later was appointed Professor of Ophthalmology at the University of Lausanne. [2,4]

While working in the outpatient clinic, Gonin worked on research projects on diverse topics such as bacterial conjunctivitis, ocular tumors, and hereditary retinopathies. From 1902 to 1921, he immersed himself in research about retinal detachment. Gonin and Dufour focused on not only seeing the retina was torn, but also finding the cause and treatment of retinal detachment. In 1902, Dr. Dufour assigned Gonin with the task of writing a chapter on retinal detachments for the French Encyclopedia of Ophthalmology. Gonin’s first publication discussed the topic of the pathogenesis of spontaneous retinal detachment which he studied in 3 enucleated eyes. In 1904, he presented a paper to the International Congress in Lucerne about the role that the vitreous may have in traumatic retinal detachment. The fourth volume of the French Encyclopedia of Ophthalmology was released in 1906, and Gonin’s work was well received due to his detailed illustrations. Gonin explained the necessity of understanding the pathogenesis of spontaneous detachment in order to find a treatment for the condition. [4]

Between 1919 and 1934, Gonin published 40 papers on the pathogenesis and surgical treatment of retinal detachment and its outcomes. He emphasized that the hole was not a result of the retinal detachment, rather, the hole was the cause of the retinal detachment. Thus, concluding that retinal detachment could be treated by closure of the hole formed by the retinal break, leading him to develop his trademark breakthrough known today as the ignipuncture, a technique of treating retinal breaks using cauterization to induce a chorioretinal scar resulting in closure of the break. [5]

In this procedure, first, Gonin would carefully localize the breaks in the retina with direct ophthalmoscopy. He then ordered strict bedrest  with the eyes patched and in a position to allow resorption of subretinal fluid. Once the subretinal fluid has resolved, Gonin would incise the conjunctive, and mark the site of the break on the sclera. Then, he would inject novacaine into the subconjunctival space, pierced the sclera with the Graefe knife and then apply the curve thermocautery to theretinal break through the sclerotomy. The thermocauterization induced a chorioretinal scar where it was applied to help close the retinal tear. Finally, the conjunctiva was closed with sutures. [5]

Using the ignipuncture technique, Gonin first treated a traumatic retinal detachment in 1913 and in 1916, he treated an idiopathic retinal detachment. With this new method of managing retinal detachment, the cure rate of retinal detachment from rose 1% to 30-40%. [6]

However, it was not until 1929 that Gonin received worldwide recognition at the International Ophthalmological Congress in Amsterdam for his surgical procedure, along with being awarded the Benoitprice, the highest scientific honor in Switzerland

In his final years, Gonin was particularly busy with his daily position as chairman of the Hospital as well as management of difficult cases from around Europe that came to him to benefit from his expertise. Despite his increasing demands from work, Jules Gonin published his book on retinal detachment surgery called “Ledιcollement de la rιtine” Today, his legacy lives on by the University Eye Hospital in Lausanne which was named after him and by the Gonin Medal, an award established by the University of Lausanne and the Swiss Ophthalmological Society that is awarded by the International Council of Ophthalmology every four years for the highest achievements in ophthalmology. [6]

As surgeons of today use state of the art vitreoretinal technology for the treatment of their diseases, they must remember the advancements that were made possible through scientists such as Jules Gonin.