For those within optics, the word ‘Chavasse’ is mostly synonymous with a frosted lens (although a Chavasse lens is of superior cosmetic appearance). But what a story lies behind that little-considered item! In fact this occluder bears the name of an ophthalmic surgeon who also edited a classic text book, devised new surgical instruments and committed at least one act of outstanding bravery during the First World War. Yet even his wartime exploits were outshone by one of the brothers in his quite extraordinary family.
Francis Bernard Chavasse (known as Bernard) was born on December 2, 1889, the second youngest of a family of seven children that contained two sets of twins. The family name derived from a French ancestor who had come to England and become involved in the 1715 Jacobite Rebellion. Although a Roman Catholic, within two generations the family had converted to Protestantism. The Church figured prominently in the Chavasse family, with Bernard’s father becoming Bishop of Liverpool and instilling a strong Christian faith in his offspring. Surgeons featured prominently too, while other members went into the Army and the Law. Medicine and the military were to feature in Bernard’s life, as also they were to combine heroically – and tragically – for his older brother, Noel.
Bernard followed Noel and the latter’s twin brother, Christopher, to Oxford, but studying at Balliol rather than his brothers’ college, Trinity. Together with Noel he joined the university’s Officer Training Corps. After graduating with a First in Natural Sciences – as did Noel – in 1912 (winning the prize in Anatomy along the way), he continued his medical studies at Liverpool University in the city in which he grew up. On the outbreak of war he volunteered to join the Royal Army Medical Corps (RAMC) and was then transferred to the First King’s Liverpool Regiment.
There he served as a medical officer in Egypt and Gallipoli, before arriving on the Western Front in 1916. By now all four male Chavasse siblings were serving there: Noel’s twin, Christopher, as an army chaplain, Noel and Bernard as medical officers and the youngest child, Aidan, who served in Bernard’s battalion.
All the boys were athletic and had a strong sense of duty. The twins, Noel and Christopher, represented Oxford University at athletics and lacrosse and ran in the 1908 Olympic Games, while Aidan won sports honours at his school. All were conspicuous in their bravery; yet they saw their acts as nothing more than their duty to help their fellow soldiers. Noel gained a Military Cross (MC) in May 1915, followed by the award of the Victoria Cross for his actions in rescuing wounded soldiers while under heavy fire at Guillemont in August 1916. Then Christopher and Bernard were both awarded an MC, although Bernard revealed in a letter to his sister, Marjorie, that his superiors had actually nominated him for a VC. Some felt Christopher’s actions also merited a VC; but he was honoured with the Croix-de-Guerre for his distinguished service.
Both Noel and Bernard carried out incredible feats of valour time and again to rescue and treat the wounded under conditions of extreme danger with no thought for their own wellbeing. After yet another selfless act, Noel was seriously injured and later died from his wounds. In the midst of his grief at the news, his father received word that Noel was to receive posthumously a Bar to his VC, thus becoming the only man to be honoured with two VCs in that war. One wonders how the Chevasse family coped with their loss, given that not long before, Aidan had been reported wounded and missing in action. The official report stated that Lt Chavasse had led eight men on a patrol when they were fired upon; Aidan was injured and sent his men back without him. Bernard went out twice to try to locate him without success. He was never found. Within a period of two months, the Chevasse family had gained two MCs, a second VC but, sadly, lost two sons.
After the war, Christopher helped his father to establish St Peter’s Hall, the aim being to provide an opportunity for students of limited means to gain an Oxford education. He later progressed in the Church of England to become Bishop of Rochester, and became a leading light of its Evangelical wing. He was able to witness St Peter’s become a full college of Oxford University just a year before his death in 1962.
Binocular vision
Bernard returned to Liverpool, where he specialised in ophthalmology, in which he excelled. The papers he delivered to the Ophthalmological Society and at the Northern and Oxford Congresses cemented his reputation. That reputation led to an invitation to edit a new edition of the classic text Worth’s Squint when the author’s health began to fail. Applying his ideas relating to new developments in physiology and pathology he largely re-wrote the book, bringing it up to date and including descriptions of some of his own surgical procedures. He challenged Worth’s prevailing theory of an innate weakness of a faculty for fusion being responsible for the inability of some children to attain binocular vision. Instead he proposed that the inability to fuse was the consequence of abnormal development of binocular reflexes, and that surgery to correct a squint and align the eyes could allow proper development of these reflexes to occur.
Chavasse was not a great believer in orthoptics as treatment, but he did feel that, applied rigorously and systematically, orthoptic investigation could be a useful aid in diagnosis and for binocular re-education between stages of surgery. The seventh edition of the book, published in 1939, became Worth and Chavasse’s Squint.
In addition to novel surgical techniques, Chavasse invented several surgical instruments, including fixation forceps, a strabismus hook and a marginal myotomy retractor. His best-known device, though, is his eponymous lens. It is often used as an alternative term for a frosted lens, but the ‘hammered’ surface of a Chavasse lens is less opaque. The British Standards definition of a Chavasse lens is as follows: ‘A lens with an irregular surface used to depress the visual acuity while permitting the eye to be seen from the front’.
[CaptionComponent="1226"]A few words deserve to be said about the Chavasse sisters. Dorothea, the eldest of the seven children, died in 1935, a rector’s wife, aged 52. Edith Marjorie (known as Marjorie) and Mary Laeta (May) were a second set of twins, born after Noel and Christopher. They both volunteered for nursing duties during WWI at a convalescent home run by their aunt. Marjorie was a source of supplies to her brothers in France and dealt with some financial matters on behalf of Noel’s men. She later worked for Barnardo’s. May travelled to France to assist at a mobile field hospital, receiving a mention in dispatches. She later qualified as a nurse and was active during the Second World War as a member of the Queen Alexandra’s Military Nursing Service. Marjorie and May celebrated their 100th birthdays in 1986, passing away one and three years later respectively.
Keith Lyle, who took over editorship of Worth and Chavasse’s Squint for the eighth edition, says in his Preface that ‘Chavasse has unquestionably made a valuable and original contribution to ophthalmology and has placed the aetiology, diagnosis and treatment of strabismus on a sound physiological basis. Ophthalmology owes Bernard Chavasse a great debt of gratitude.’ The reason Lyle had taken over? Sadly, Chavasse was killed in a car accident in 1941, aged 52.
David Baker is an independent optometrist
