Virginia Keeney, M.D.
Professor of Family Practice,
Emeritus Chairman of Dept. of Family Practice Emeritus
University of Louisville School of Medicine


I really have been a little uptight about this. Not only is it in Power Point which was so new to me that Jim really is the one who got it into this machine but also this scholarly group kind of gives me the jitters when I think about presenting something to you.  I said to Bob Arnold, you know I am really awfully uptight about this and he said oh Ginny, relax, don’t worry about it.  He said just to relax.  He said don’t be intelligent or witty or clever or attractive.  He said just be yourself.  Now you all know that Bob Arnold would never say anything like that but I had to have a joke.

It reminds me a little bit of the time when Lucy and Schroeder, you remember Schroeder plays that piano, and Charlie Brown were sitting on a hillside looking out a blue sky with fluffy white clouds and Lucy said, Schroeder what do you see in those clouds and Schroeder said over here I see the magnificent dolomite of Meriden, Italy and here the Burghers of Calais by Rodin.  Well, Lucy was very pleased.  She turned to Charlie Brown and she said Charlie Brown, what do you see in those clouds and Charlie Brown said well I was going to see a horsy and a ducky but I changed my mind.

Well, it is too late for me to change my mind so here goes….

I am starting this evening with a quote from a former member of this Society, one Arthur H. Keeney, M.D., to whom I am very indebted for any scholarly interests I have at all.  He saved me from being a playgirl all my life.

I think you can read it faster than I can and I will give you something like 10 more seconds (1,2,3,4,5,6,7,8,9,10) and where is that button.  Here we go.

We teach medical students to look at a patient.  Really look closely at a patient and we call it inspection.  I tell my medical students to look at a face as an artist looks at a face.  To look for the details.  To try to get some feeling not just for the physical diagnosis although you can diagnose six of the cranial nerves just from looking at the face but also something of the feeling of what a person is like inside that face.  Just as an artist does.  But what the affect be if an artist has eyes that betray him?  And this evening we are going to look at a few well-known artists, actually two mainly, with eye problems and a couple of their colleagues and see what if any differences they might have made in their work.

There are a couple of caveats.  These are very difficult interpretations to make.  For example, an artist’s early work always differs from their later work so it is hard to know when the eye pathology was the cause.  Medical knowledge at that time was always limiting because not only did they not know much, they are limited but we don’t always understand when they describe what they did know and an artist’s proclivity to change subjects makes it very difficult to know when it is a result of eye pathology.  It helps a great deal when an artist has left us notes or letters, notes and diaries and notebooks and when we have their physician’s notes in their charts helps us to understand very much more clearly how the art is affected by the eye.

The first one I want to talk about is Edgar Degas who was born in 1834 into a family that was very, of I guess, middle to upper bourgeoisie in banking and business.  His two grandfathers were both bankers.  One in New Orleans, Louisiana and the other in Paris and Milan.  His father was also a banker and he was a very cultured gentleman, interested in music and art and conveyed those interests to his son.  Degas started by studying in the law but he didn’t stick with it very long.  He wanted to be an artist and he studied art.  He volunteered in 1870 to serve in the National Guard during the Franco-Prussian War when Paris was threatened.  He never married.  He visited the United States in 1872 and there he met a very significant person, Estelle Degas, who was married to his brother, Rene.  Now, Estelle was a first cousin of both Rene and Edgar and she was nearly blind of an undiagnosed progressive eye disease.  We don’t know what it was be we know that in her early 30s she became totally blind.

Degas fought his continuing and increasing blindness all his life and finally in 1912 he had to give up painting.  He struggled with is but finally had to give it up and became enormously depressed.  So for that last five years of his life he was so down and so blind that it was pitiful and he wrote and said to many of his friends death is all I think of.  He died in 1917 during World War I.  This is his self-portrait when he was 23 years old and this is the major painting that he brought back with him from New Orleans, The Cotton Office.  This is the office of one of his grandfathers and it is an interesting painting because it is quite modern in the figures, the costumes and in the picturing of his uncle up here in the very front who examining minutely little tufts of cotton but the figures are arranged much the way they would have been arranged in one of the old academic paintings but he rather soon turned to ballet dancers and the theater and he loved to do race track paintings, horses, riders.  Not so much the race itself but the groups before the race and after the race were his main interests.

After 1880 he began to do some sculpture now and again and that became his chief interest n the last part of his professional life.  He loved to do nudes in domestic scenes and it is kind of strange business to my way of thinking, not that I am trying to be psychiatric about it but just think of this…he liked to do models and have them take a bath in his presence and try to forget that he was there.  Well, the reason that he wanted to do this was he wanted to see the human body in natural motion.  The kind of things that people do when they don’t think anybody is watching them and as we will see he was quite successful in some of these.  He turned to pastels more and more as his vision deteriorated saying at first he liked pastels because they were more suited to his delicate work.  For example, in the ballet.  But actually they are easier to work with than oils and they became the only painting modality that he was able to use.  He was a master of drawing the human figure in motion.  Bathers in pastels and in sculptures continued into late life as did the ballet dancers.  This is one of his early oil paintings.  Very studied, very careful.  The Spartan girl challenging the boys in the painting in 1860.  This was one of his five major oil paintings on historical subjects.  This is one of his portraits that happens to be of his grandfather, Helia Degas and incidentally, Degas as we know it began life as De Gas and he just combined the De and the Gas and had Degas.  This in an early painting of his and I don’t think it shows what I wanted to show you and this is he was able to paint details with great clarity.  The fingers, the flowers, the face.  All of them show in clear detail exactly what he was trying to portray.  This is one of his racehorses.  It is fairly early.  Before his eye pathology had progressed very far.  The colors are not showing well on this slide because of the projector I guess but they are quite naturalistic, green grass and a sky that looks like a sunset beginning.

His visual problems began quite young.  In 1870, at age 36, his problems first became apparent.  In 1871 he reported that he couldn’t see the target with his right eye.  This was when he was in the National Guard.   He reported in 1872 a problem with glare and he said what lovely things I could have done if the bright daylight were less unbearable for me.  In the 1870s and 1880s he developed a central scotoma and complained mightily about the big black spots that he had to look around when he was trying to do a painting.  His vision progressively grew worse and in 1891 he reports that he can no longer read and he had a maid who read to him.  These are just a few examples of his paintings.  This is Two Dancers which he did in 1874.  There is considerable detail in this painting, in the ballet slippers and the flowers in the girls hair and so forth.  This projection system is not ideal.  We could see things a whole lot better last night at home and I am sorry about that.  We will do the best we can.


This is another ballet, about four years later and the ballet dancer is as graceful and lovely as ever but the people in the background have just become blurs.  There is a man, you may be able to get an idea of a man standing on the left and some ballet dancers who are not indicated as figures at all, just blurs.  In 1873 he said “my right eye is permanently damaged.”  Later that year, “I expect to remain in the ranks of the infirm until I joint the ranks of the blind.  Sometimes I feel a shiver of horror.”  And you know, I can imagine a young artist facing blindness and indeed, he must have felt a shiver of horror.  The next year he wrote to James, “my eyes are very bad.  My oculus has allowed me to work just a little.  I do so with much difficulty and the greatest sadness.”  He was allowed to work just a little because he had a series of paintings that were almost finished and he was allowed to finish them.  He saw the best ophthalmologists around, distinguished, imminent and even Edmund Lando who was famous not only in Paris and Europe but also in the United States.  Founded the French Ophthalmology Society, the archives in France.  He was an art collector and I knew him early in my life, I did a little work in ophthalmology, for his Lando Rings and other things that he invented for ophthalmology.  The diagnosis of Degas’ eye problem is very uncertain.  At the time, the word chorioretinitis was used but that was simply a general kind of term like a basket term which was in use at the time.  We might think today of some kind of retinopathy, severe, progressive but we can’t be specific even from the information we have, from Degas’ many letters and notes.  We don’t know for example whether they thought it was acquired or inherited but if you will think back to Estelle Degas in New Orleans you can’t help but wonder with a first cousin blind at such a young age and his onset at such a young age, you can’t help thinking about genetic inheritance.

The theories about Degas’ blindness included retinal disease which it surely was, hereditary degeneration which it may have been, corneal scarring because of the glare problem but I think that the corneal scarring was more a result of his main problem.  Age related macular degeneration, the onset was so young I really have never understood why that has even been raised.  No treatment for his problems was available during Degas’ life but his doctors tried.  They prescribed some spectacles.  The first were stenopaics.  Now stenopaic glasses have a slit across a blank so that the patient can only see through that little slit.  Sometimes the other eye is totally occluded.  Sometimes there are slits in the occlusion on both eyes.  He got around with it but he said that he wasn’t able to work with it.  There was other prescriptions, mild astigmatism and mild myopia and some lenses even had no power.  I was interested in the mild myopia because about 20 years ago, maybe 30 now, I ran into a theory that his blindness was due to having been a high myope and in a high myope the overly long eye of this very nearsighted person is prone to have retinal detachments and some people thought that is what started his illness and progressed to blindness but with such a mild myopia that is probably not even thought about today.  Lenses with various tints were tried to soften the light.

Art and I had the fun of seeing the spectacles of ponsenays that were prescribed for Degas when we were in the Musse d’Orsay in Paris and that was very exciting, especially to Art.  The impact on Degas’ art, well his earliest work was in oils and he had to give up oils because he wasn’t able to continue in that medium.  He changed to pastels.  He continued in oils for quite some time incidentally and while he was still doing oils his tubes of pigment were very carefully labeled as to the color and they were in exact placement on his pallet so that he could find them without even having to read the labels.  He tried sculpture.  He tried photography.  He tried prints.  He made some beautiful etchings actually but he didn’t continue in either photography or print work.  He did continue in sculpture and I will show you some of his very latest work which was in that field.  In the pastels as he continued to do them and his blindness was becoming quite severe the colors become quite intense as he tried desperately to show colors as he thinks they should be but with his dimming vision he can’t really see what they look like to other people.  His later work showed progressive loss of form and detail even exactly as you might expect.  His last works were in sculpture and I think I’ve got a few slides of those.  This is a late ballet scene.  If you will notice the arms of the dancer of one of the group on the right just like a continuous circle.  There is no real delineation of the hands.  The faces are not shown at all except in profile.  This was one of his later works.  He worked until 1912 but the cataracts had developed pretty far by 1907.  This is one of his bath scenes, After the Baths, in 1885 in which the lady is drying herself.  This is one to the more odd ones, eccentric to me.  The lady is resting her foot on the edge of the bathtub and why she is doing it I don’t know, perhaps you can figure it out.  A maid is combing her hair.

This is my favorite of all his sculptures.  It is The Little Dancer, 14 years old, which he did in 1881 and he caused a furor in the art world in Paris by putting a tutu on this little blonde statue, satin top and gauze skirt and when I have seen it she is still wearing that tutu years later.  This is in 1910 and remember he gives up in 1912.  It is a dancer looking at her right sole and he writes to one of his friends that he is using calipers to measure the models body, her arms, her legs and so forth and transfer that to the clay that he is working in and so the forms of some parts of the body are not too bad but the hair and the head are just kind of a mass, not very clearly delineated at all.

And this is one to the last of his sculptures.  To my eye it is clumsy and not very good at all but Renoir said he felt that these last sculptures were extraordinary and innovative and I don’t know whether he was trying to be kind or what was happening but this is one of them and you can see them in the Hershwein Museum in the National Gallery in Washington.  There is a nice little group of them.  Well, that is as far as we are going to be able to go on Degas tonight.

I wanted to point out that intraocular problems were not the only visual problems that affected artists.  For example, Camille Pissarro had a tear duct blockage and frequent infections so that ultimately his eyes were so sensitive to wind and weather and so forth that he could not work outdoors and was forced to work indoors but you talk about a person adapting well to a hardship.  He became famous for his views of Paris from his studio window.  This is his self-portrait and this is the Palas de Caruselle which he painted in 1900 and it shows the little park that he was overlooking and he did some other beautiful scenes of Paris looking out over the red roofs of Paris toward a cathedral or some other important building.


The next person I want to address is Charles Monet.  His self-portrait in 1886 when he was 23 and the photograph in his garden in 1923, just about he year when he had his cataract surgery.  He was born in 1840, the son to a Parisian grocer and his father moved the family when he was just a child and his father went into business with his father’s brother, into a grocer and ship chandlery business so Monet’s childhood and adolescence were spent there on the sea coast and we will see later his love really for scenes of the sea and the water and little sailboats and other things along the coast.  His mother died when he was 15.  By 19, he was committed to becoming an artist.  I think we all think of him as a major impressionist and he was the first painter to be called an impressionist.  He stayed active with the movement and a leader in the impressionist movement all his life.  Camille was a model of his and they had an affair before they married and their son Jean was born and finally they did marry in 1870.  In 1878 they made a strange move or actually Monet made this move.  He had had a patron named Houshad, Alice and Ernest Houshad.  Ernest had been quite wealthy but he lost everything.  His estate, his art collection, everything.  And in 1878 he and his wife and six children moved in with the Monets.  At that time Monet’s wife Camille was dying.  She died of cancer of the uterus, I believe, in terrific, terrible pain and was cared for by Alice Houshad.  Very strange, strange setup.  This ménage au duex was carried for by a maid and a cook and a gardener.  Now Alice and Monet may or may not have had some kind of an affair before her family moved in with the Monets.  We don’t really know that.  We do know that her husband left a year after Camille died.  I think they were divorced but Monet and Alice thought they lived together were not married until 1891.  That was a real love affair.  No doubt about it.  She died in 1910 and he was distraught.  Missed her dreadfully.  Monet painted for more than 60 years, one of the longest active careers among artists and finally because of his long history of smoking he died of chronic obstructive pulmonary disease and cancer of the lung.  These are just a few of his paintings to kind of reacquaint you with him.  This is Camille incidentally, doing her embroidery, Women At Work, Claude Monet in 1875 and John Schwab, this is one of those we were putting in when you arrived.  Jim found of this paintings last night and we came here and he put them into the machine for me just before we had dinner today.  Oh my goodness, that doesn’t show up well at all.

Monet did several series of objects that were intended to show the effect of light on an object at different times of day or different seasons and he did a series of hay stacks, sometimes called wheat stacks.  He did poplars along the river nearby, one after another.  This one is in the sun.  There are others.  He loved his seascapes and this is the Rough Sea at Ontrataub and there are other paintings.  Monet’s ophthalmologists were also quite imminent.  Not quite the imminence of Degas but very fine, very well liked but he was a doctor shopper.  If they didn’t tell him to do what he wanted to do he went on to somebody else.  For example, Richard Levovak, who is the best known today of those that he want to wanted him to have surgery long before he did and he just wanted to do it but finally Charles Gatella talked him into the surgery and he was assisted in this by Clementso and you remember Clementso was premiere of France during World War I and many thought he led France to victory in that war and Clementso and Monet were good close friends for many, many years and when Monet continued to resist surgery Clementso tried very hard to urge him to go ahead so finally in December of 1922 Dr. Gatella operated on Monet’s right eye and later prescribed aphacic lenses.  Now do you remember aphacic lenses?  They are like the bottom of Coke bottles.  You know they are thick and unwieldy and they magnify many, many times and they also have kind of images around the edges of them and flashes of light that are quite distressing.