Robert Maloney, MD, MA, revisits the legacy of Harold Ridley at CIME 2025

At this year’s Controversies in Modern Eye Care (CIME) meeting in Los Angeles, one of the most compelling sessions, given by Robert Maloney, MD, MA, wasn’t about the newest device or drug—it was about history. Specifically, the moment 75 years ago when Harold Ridley implanted the first intraocular lens (IOL) in a human eye. This landmark event reshaped ophthalmology forever. Yet, as emphasized during the talk, Ridley’s innovation was not immediately embraced—it was denounced, criticized, and feared. And for good reason.

The early IOLs were fraught with problems. They caused inflammation, had not been properly vetted in preclinical trials, and violated emerging ethical norms—particularly those outlined in the Nuremberg Code, which was only beginning to influence medical research in the post-WWII era. Ridley’s decision to proceed was audacious, some might say reckless. But it also marked the beginning of one of the most impactful advances in ophthalmic surgery.

Maloney invited ophthalmologists to reconsider this tension between innovation and regulation. “The process of invention is really a conversation between the radical who wants to push boundaries and the establishment who must protect patients,” Maloney said. This balance remains crucial today. Whether evaluating new gene therapies, surgical techniques, or AI-driven diagnostics, ophthalmologists must weigh potential against harm—often in real-time and with incomplete data.

History, as the talk suggested, doesn't repeat itself exactly—but it does spiral. Understanding the Ridley story isn’t just about honoring the past. It’s a framework for making better decisions today. The progress of ophthalmology has always depended on risk-takers, but it has also relied on rigorous standards, peer critique, and course corrections after early missteps.

The CIME meeting’s approach reflects that philosophy. Rather than offer textbook-style lectures, CIME explores ambiguity, debate, and clinical judgment. “Too many conferences deliver resident-level lists and bullet points,” Maloney noted. “Here, we focus on the places where the field is still uncertain—where practice is evolving.”

For practicing ophthalmologists, CIME offers something uniquely valuable: a space to reflect critically, engage with controversial ideas, and return to clinic with sharper insight.