The End of An Era

A strange thing happened at the National Eye Institute (NEI) on July 17, 2000. Staff arrived for work as usual. Meetings were held, lunch eaten. Funding decisions were made, notices of grant awards issued. It was a day much like any other day at the NEI, with one notable exception. Carl Kupfer was no longer the Director. Dr. Kupfer is the only person to ever serve as NEI Director, and he has stepped down after 30 years at the helm of the U.S. Government's leading vision research agency. Ruth Kirschstein, MD, acting director of the National Institutes of Health (NIH) said “During Dr. Kupfer's long tenure, the NEI has been critical in the shaping of vision research in this country, and his outstanding leadership has contributed enormously to the fabric of the NIH.” Dr. Kupfer served under 6 NIH Directors and 6 U.S. Presidents and has witnessed the NEI budget grow from $24 million in 1970 to more than $450 million in 2000. During his tenure, the number of federally funded vision researchers nationwide has increased steadily. Today, the NEI supports more than 1600 investigators throughout the U.S. The United States Congress established the National Eye Institute in 1968 and Dr. Kupfer was appointed as Director in January 1970. He moved quickly to identify important areas in vision research. Dr. Kupfer insisted that the area of central visual processing should be part of the NEI mission, a decision that was accepted eventually by the NIH leadership. He also stressed the importance of the individual research grant as opposed to the more generally accepted, larger, umbrella-type program projects and center grants. This process resulted in the first of many 5-year strategic plans that greatly accelerated the progress of vision research in the U.S. and ultimately became a model for other institutes at the NIH. Dr. Kupfer established a strong intramural program, including the Office of Biometry and Epidemiology. The Institute launched the landmark Diabetic Retinopathy Study, setting a standard for modern clinical trials in vision research. An outspoken and effective advocate for high-quality clinical research at the NIH, Dr. Kupfer expanded research at the NEI by establishing programs in molecular biology, immunology, neuroscience, and molecular genetics. As Director, Dr. Kupfer also oversaw the development of the NEI's innovative National Eye Health Education Program (NEHEP), a partnership of approximately 60 professional, civic, and voluntary organizations and government agencies concerned with eye health. The main focus of NEHEP is to conduct public and professional education programs that help prevent blindness, reduce visual impairment, and increase awareness of services and devices that are available for people with low vision. Dr. Kupfer views the program as a natural extension of the Institute's activities in vision research Dr. Kupfer will not leave the NIH entirely. He will be devoting time to completing a catalogue of the Cogan Collection, a compilation of clinical cases and pathology reports of over 50,000 patients. He will also continue to see patients as part of his clinical research activities at the NIH Clinical Center. “My journey at the NEI and the NIH has been richly rewarding,” Dr. Kupfer said. “As a scientist, clinician, and administrator, I have been wonderfully blessed with experiences that have brought me to the cutting edge of vision research. One of my most satisfying achievements has been helping to shape the direction of this research during the past 30 years. We have seen great advances in treating eye disease and preventing vision loss, and as a researcher, it is immensely fulfilling to know that the sight-saving treatments we developed have helped prolong vision and improved people's quality of life. I know that in the near future, NEI-funded studies and clinical trials will lead to more significant breakthroughs. These have been exciting and challenging times for vision research, and I am fortunate to have been a part of it.” With Dr. Kupfer's departure, thoughts turn to the search for his successor. NEI Deputy Director Jack McLaughlin, PhD, will serve as Acting Director until a permanent replacement for Dr. Kupfer is found. A search committee has been formed with broad representation from the vision community but, as former Deputy Director Ed McManus stated, “It is scary to even think about who might be able to fill those giant shoes.” Indeed, without such a powerful advocate for vision research as Dr. Kupfer there are concerns that eye research will not fare well in the federal budget. Even with his vision and strong leadership, the NEI ranked in the lower half of institutes in terms of budget increases between 1990 and 2000. It is interesting, albeit frivolous, for the vision research community to speculate as to the potential or likely successor to Dr. Kupfer. Will he or she be a basic scientist or patient-based researcher? Will the second Director of NEI necessarily hold a clinical degree? It is unlikely that an optometrist will be appointed, although the profession is well represented on the search committee. Regardless of the appointee, it will be some time until many of us will be able to dissociate the words “Director” and “Kupfer.” Dr Kupfer's influence on vision research will be remembered and felt for even longer.