C. Stephen Foster, MD, FACS, is an extraordinarily productive academic ophthalmologist, a highly skilled cornea and anterior segment surgeon, and the acknowledged authority in uveitis and ocular immunology in the world today. We are delighted to award him the John Milton McLean Medal here at Weill Cornell Medical College.

Dr. Foster was born in Charleston, West Virginia, and later attended Duke University, graduating in 1965 with a degree in chemistry, with distinction. He continued at Duke Medical School from 1965 to 1969, with a simultaneous concentration in immunology and biochemistry, and, continuing his captivation by the charms of that campus, subsequently completed his internship in internal medicine at Duke University Medical Center in 1970.

Wishing to augment his already-considerable research skills, but initially selecting internal medicine as his focus, he moved to the National Institutes of Health, where he participated in research studies for two years (1970-72) in the Blood and Vasculitis Branch. His experience there, though undoubtedly providing formative and valuable training as a future clinician-scientist, also allowed him to rethink his career direction, and he entered a residency in Ophthalmology at Washington University in St. Louis. At the completion of his residency in 1975, he was accepted into the most prestigious cornea fellowship of its day—the opportunity to study and train for two years at Harvard with Dr. Claes H. Dohlman and his outstanding clinical and research cornea group. During this period, he was quite visibly an outstanding fellow with a universally-accepted promise for an excellent academic career, not only for his superb surgical skills, but also for the intensive and productive research he pursued in the parallel study of ocular immunology during his fellowship.

Dr. Foster was invited to join the Harvard Faculty immediately after fellowship, anchoring (with no evidence of recent-graduate trepidation) the Thursday morning clinic in the star-studded Cornea Service daily line-up at the Infirmary. He also served as Director of Residency Training for the Massachusetts Eye and Ear Infirmary Ophthalmology Department during this early faculty period until 1981, and many former residents recall his morning rounds with the first-year residents on the wards as their first exposure to the examination of the eye and its mysteries. All of these activities were first-rate and would have easily launched him to an outstanding career as an academic corneal specialist, but what happened next was unprecedented and extraordinary.

In approximately 1978, he announced--that is actually the precise word—he simply announced that henceforth the Thursday morning clinic would also be home to ocular immunology. Very rapidly, alongside his penetrating keratoplasties and lamellar grafts, patients with all manner of inflammatory conditions were welcomed in ever-increasing numbers. He provided meticulous care and detailed opinions regarding patients with uveitis of any variety, not confining himself to keratitis and scleritis, but also idiopathic iritis, vitritis, retinitis—in short, he encouraged and provided a home for the diagnosis and treatment of all forms of uveitis in what had been a strictly cornea practice. He quickly initiated a dedicated uveitis fellowship program and founded a research laboratory to study basic aspects of ocular inflammations.

From these beginnings, he has developed an expertise that has touched every aspect of ocular immunology. Examples of his impressive and numerous contributions deserve to be enumerated, because they have become so embedded in current clinical practice they risk being genericized and de-branded, like Xerox copy and Kleenex tissue. For examples, Dr. Foster realized quite early the value of systemic chemotherapy for destructive ocular inflammations, and brought this complex, demanding, and highly effective treatment into the practice of ophthalmology. He demonstrated the value and necessity of controlling inflammation in the eyes of patients with juvenile rheumatoid arthritis prior to the performance of cataract surgery, greatly increasing the success of what had frequently been a catastrophic operation. He convinced a legion of doubters of the longterm futility of half-hearted anti-inflammatory treatment for conditions such a Behcet’s and many others with data meticulously assembled from his extensive clinical practice. In short, from uveitis diagnosis to surgery, he has comprehensively elevated the field.

Dr. Foster has personally trained scores of Massachusetts Eye and Ear Infirmary Ophthalmology residents, cornea fellows, and uveitis fellows. He is a most coveted speaker on any program, and, no doubt realizing the unique value of his accumulated clinical material and experience, he has amplified his teaching contributions by his impressive written scholarship; his CV includes over 635 papers, 75 chapters, and 5 books. Not incidentally, but perhaps less well known to colleagues outside of the Infirmary, he became and remains an exceptional ophthalmic surgeon and surgical teacher. In addition to remarkable technical skills and experience (most evident in his surgery for complicated cataract, corneal transplantation, and cicatrizing conjunctival disorders) he practices an impressive attention in the operating room that encompasses every aspect of the ongoing procedure and every member of the OR team—a skill that young surgeons would do well to emulate.

In 2005, he founded the Massachusetts Eye Research and Surgery Institution (MERSI) and transferred his clinical and clinical research activities to MERSI. He remains a most prominent and active member of the Harvard ophthalmologic community, and continues his patient care, clinical research, and teaching in anterior segment surgery and all aspects of ocular immunology. He is joined in this comprehensive endeavor (and in fact, every endeavor) by his beautiful and talented wife Frances, who, as a skilled nursing professional, directs the MERSI infusion center and compassionately cares for the many patients requiring chemotherapy as part of their treatment. Sharing such demanding work, they have no chance of being major hobbyists, but they are surprisingly active devotees of opera and ballet, the latter being a particular interest of Dr. Foster’s since early adulthood, leading him to view the major ballet companies around the world.

We are deeply honored to award C. Stephen Foster, MD, FACS as the 2009 John Milton McLean Medal Lecturer.

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