One hundred years ago, the American Optical Association held its 17th annual convention on July 18-25, 1914 at the Planter's Hotel in St. Louis, MO. This was the first official "Congress" of the AOA, a title which the Association's annual meeting maintained for more than 80 years. In the context of the Progressive Era, the name change was significant. First, the Association's political structure was, as it remains today, a group of nationally affiliated state organizations each represented by delegates. This emphasis on democracy and equal representation dominated the Association during its critical formative years. Second, the era was characterized by great energy for institutional reform through regulation and the improvement of society through education and public health initiatives. The desire for regulation and standardization brought about a flurry of activity among professional and trade organizations in order to define standards, set qualifications for practice and create measures to assess proficiency. The activities of the Association's first Congress clearly illustrate the influence of larger societal trends on the development of the profession.
The 1914 Congress was considered exceptionally successful in terms of content and organization, although attendance was somewhat lower than previous meetings due to fears of July temperatures in St. Louis. The leading optometric publication of the period, The Optical Journal and Review, noted in their pre-convention issues that "rooms with electric fans will be in demand at the hotels" (34(4), July 16, 1914, Convention Notes, p. 245) and The Planter's Hotel assured attendees that "each room has circulating ice water as well as a private bath" (34(2), July 2, 1914, Who's Who in St. Louis, p. 116) Indeed, it was close to 100 degrees during the Congress and at the Annual Banquet men were encouraged to remove their dinner jackets if they were "wearing clean shirts" (34(6), July 30, 1914, Proceedings, p.300).
AOA President Albert Myer, perhaps concerned about the possiblity of a low turnout, issued a "greeting" sent to Association officers which was also printed in The Review. In addition to defining the pre-convention committees, Myer rallied members to attend the conference by invoking the words of the former president, H.J. Cook, who on his deathbed stated, "If I live, I'm going to the optometric congress in St. Louis. If I don't, I will be there in spirit." (OJRO, 34(1) June 25, 1914, Pre-Convention Greeting to A.O.A., p. 39)
Myer's urgency was justified. The Association was engaged in a battle with organized medicine and needed the support of an active and engaged membership to stake out optometry's professional jurisdiction. The pre-convention committees are recognizable as the predecessors of AOA's current sections, centers, groups and departments. These included the 1915 Conference Committee, the Scientific Section, the National Organization State Board Examiners, Education, Publicity, Legislation, Resolutions, Finance, Membership, Amendments, Welfare, Efficiency, Statistics, School Chart, Inspection Dispensaries, Professional Service and a General Committee comprised of Chairmen.
The early structures of the Association reflect a common concern of emerging professions in the early twentieth century when "trades" were being distinguished from "professions". The Association endeavored to determine how the scope of optometry practice and the qualifications of practitioners should be defined and regulated. To this end, the AOA established committees dedicated to setting standards of practice, defining Association positions, educating practitioners and the public about the profession and working to consolidate optometrists under the wing of the Association for the purpose of forwarding beneficial legislation.
The Scientific Section, in particular, performed a critical function. By providing a forum for conducting and disseminating research and building a knowledge base, the Section laid the foundation for the development of educational standards and best-practices, clinical guidelines, and measures of competency (Duchan, 2011). The Section also sowed the seeds of the Continuing Education program, the International Library, Archives & Museum, and the Clinical Resources Group. In the 1914 resolutions, the Scientific Section was given the responsibility of appointing a member in each state to "write optical history" for their home state; here the beginnings of the Optometric Historical Society are evident.
The Scientific Section required the submission of "theses" for membership and worked with the Education Committee and National State Board of Examiners to formulate questions for State certification examinations and to recommend textbooks and standards for University coursework. These latter duties would eventually be taken on by the National State Board of Examiners in Optometry, the Association of Regulatory Boards of Optometry and the Association of Schools and Colleges of Optometry. The American Academy of Optometry had yet to gain momentum as the academic arm of optometry. Indeed, the fledgling AAO was disbanded before 1914 and did not revive until 1922. For the time being, the Scientific Section fulfilled this role as well.
To this end, the Scientific Section provided continuing and technical education for optometrists at a time when only 33 states had laws requiring certification--and, therefore, specialized training--to practice. While independent schools of optometry were operating in a handful of states, University-based programs were few. Columbia University of New York was the first to offer courses in 1910 and Ohio State University founded its two-year program in Applied Optics in 1914. One of the most popular events at the 1914 Congress were the suite of "Post-Graduate" courses held by the Scientific Section. Over 150 participants registered for these courses for a fee of $10 each. Frederic Woll's "Eye Dissection" course was well-attended, as were the others, despite what must have been sweltering conditions in The Planter's Hotel.
The courses began on the first day of the Congress and ended Tuesday, July 21st at noon, when the business of the Congress began. From Wednesday July 22 until the closing session on Friday July 24th, presenters delivered papers, committees and sections their reports, and delegates elected their officers. Congress attendees were given frequent breaks to explore more than 40 exhibitions. Excursions for "ladies" included a Mississippi steamboat ride on The Belle of the Bend, a swimming party at the Lorelei Swimming Pool and a luncheon at Caffereta's Garden. (OJRO, 34(5), July 23, 1914, p. 434-436)
The proceedings of the Resolutions committee reveal the issues which most concerned organized optometry and other professional associations in 1914. Chairman P.A. Dilworth reported on several resolutions including one discouraging the practice of advertising "free eye examinations" with the purchase of spectacles. The committee concluded that examinations were professional services which should require a fee and offering these services as a perk included with the purchase of a product undermined the very purpose of the Association. The resolution stated that optometrists are "professional men" who "charge for their services, and are not mere storekeepers selling merchandise." (OJRO, 34(5), July 23, 1914, p. 408) Thus, the Association, which had restricted its membership to "refracting opticians" in its second year of existence, further delineated the distinction between optometrists and opticians and reinforced visual exams as part of the optometrist's scope of practice.
Resolutions were also passed to commend the organizers of the Panama-California Exposition and the women's magazine Collier's Weekly for their work in prohibiting and denouncing concessions sales of spectacles at expositions. The ban was designed to stop opportunistic retailers from promising cures of various ailments through spectacle use without evidence and selling erroneous prescriptions to uninformed consumers without proper examinations. In this way, the Association sought to solidify the optometrist's standing as uniquely qualified to identify visual anomalies and prescribe corrective lenses or therapy.
The committee also passed resolutions supporting various "fair trade" and "price maintenance" regulatory legislation, such as the Stevens Bill H.R. 13305 and authorized the Secretary to send a copy of the resolutions to Senators and Congressmen in Washington, D.C. In these resolutions, the AOA was joined by the National Association of Retail Druggists and other professional associations whose members operated as small retailers in addtion to providing professional services. As most optometrists were small owners and operators, the maintenance of a fair and level playing field when dealing with manufacturers, "price-cutting" retailers and large institutions--like hospitals which benefitted from economies of scale--was a priority. These actions by the Association illustrate the importance and ubiquitous nature of early lobbying efforts by professional associations on national regulatory policy.
Legal battles in the states without laws regulating optometry and where the American Medical Association was engaged in a turf war with the AOA were also the subject of the resolutions in the 1914 Congress. The "Special resolution on the Situation in Pennsylvania" dealt with the Pennsylvania Bureau of Medical Licensure's attempt to designate optometry a branch of medicine (and therefore illegal to practice unless licensed as a medical doctor). A court decision in October of 1914 would vindicate optometry as a distinct and separate science and the Pennsylvania Optical Society immortalized this decision on their Certificates.
In addition to education, research and jurisdictional issues, the Association began to venture into matters of public health. This had a dual purpose. First, statements on matters of public policy established optometrists as experts and helped to legitimize the profession Second, promoting vision-related regulation in the private and public sector was good for business.
At the 1914 Congress, a resolution on motorist's vision recommended states prevent visually impaired individuals from driving and to require use of glasses in visually impaired "chauffeurs" (Gregg, 1972, p. 60; OJRO, 34(6), July 30, 1914, p. 409). The popularity and affordability of Ford's Model T, first released in 1908 and selling 15 million by 1927, gave optometrists a new concern and new set of customers.
The Publicity Committee under the direction of Chairman Reginald Augustine was also very active in promoting public health and education as a way to increase the scope of practice and find new markets. To this end, the Committee produced a series of pamphlets for distribution to optometrists and the public on various topics. It is worthy of note that "The Conservation of Vision and Modern Optometry" explains "how to obtain correctly adjusted glasses, without the use of drugs" (emphasis added). This directly addresses one of organized medicine's principle arguments against optometry and foreshadowed a long battle to come over optometrists' use of diagnostic and therapeutic drugs. Oculists (ophthalmologists) argued that refraction of the eye required the use of cyclopegic drugs and that the use of drugs should be restricted to medical doctors. Optometrists contended that refraction for the purpose of determining a prescription for corrective lenses did not require drugs and accused oculists of over-using potentially dangerous mydriatics.
Augustine was a dynamic speaker and even after serving three terms as AOA president (1918-1921) he remained on the payroll as a travelling spokesman on behalf of optometry. Of special interest to Augustine was the expansion of practice into schools through regular vision screenings of children. In 1914, Augustine's speech to the Congress was a recapitulation of the forward to his 1910 publication Optometry in the Schools in which he encouraged optometrists and the AOA to reach out to teachers and parent organizations to incite an interest in seeking vision care for children: "You see the teacher has a derived interest in glasses through the fact that progress in the profession depends on the work on is able to get out of students . . . The teacher was the first link in my chain, and next came the parents" (p. 6)
The 1914 Congress came to an end only days before the beginning of World War I on July 28, 1914. The War brought an end to the Progressive Era and ushered in a relatively stagnant period for the growth of the profession. However, the scaffolding constructed during the early twentieth century provided a remarkably stable structure for the future growth of the Association. Furthermore, the Association continued to engage in public health issues and to hold its own against the attempts of organized medicine to curtail the scope of optometry practice.
Augustine, R.C. (1910) Optometry in the Schools. Kansas City, MO: Optometry Publishing Company.
Duchan, Judy. (2011) Emergence of Professionalism in Late 19th and Early 20th Century America. Accessed 6/19/2014 at: http://www.acsu.buffalo.edu/~duchan/new_history/hist19c/professionalism.html
Gregg, J. R. (1972). American Optometric Association: A history. St. Louis: American Optometric Association.
Koetting, R. A., & American Optometric Association. (1997). The American Optometric Association's first century. St. Louis: American Optometric Association.The Optical Journal and Review (1914).Volume 33(11), pp. 729-733.
The Optical Journal and Review (1914).Volume 34(1-6), pp.1-450.
History of the College of Optometry at Ohio State University (2014). Accessed on 7/8/2014 at http://optometry.osu.edu/aboutTheCollege/history.cfm
Illustrations1. Photograph of the 17th Annual Congress, American Optical Association, July 18-25, 1914, St. Louis, MO. The Archives & Museum of Optometry. American Optometric Association Records. 150 AOA Congress. Photo Files, 17th Congress, 1914. Panoramic photo in flat storage.2. Postcard (1920). Fourth Street North from Market Street Showing Courthouse and Planters Hotel. The Archives & Museum of Optometry. American Optometric Association Records. 150 AOA Congress. Ephemera, 23rd Congress, 1920. AOA Congress Ephemera.3. Scientific Section Lecture Course to Proceed the A.O.A. Convention. Excerpted from The Optical Journal and Review (1914), Volume 34(2), pp. 116.4. Neum, Roy H. Photograph of the Scientific Section Class in Eye Dissection at the AOA Congress 1914. The Archives & Museum of Optometry. American Optometric Association Records. 150.024 House of Delegates Sections. Photo Files, 17th Congress, 1914. Flat storage.5. Collier's: The National Weekly 52 (17) January 10, 1914. Cover.6. Driving Goggles. The Archives & Museum of Optometry Collection.7. Certificate to Practice Optometry. Pennsylvania Optical Society. Issued to W.T. Flanagan, 1915. The Archives & Museum of Optometry. Unprocessed Graphic Media. Flat Storage.8. Conservation of Vision and Modern Optometry, 1912. The American Optical Association. Publicity Committee Publications Series, Number 1. The Archives & Museum of Optometry. AOA Records, AOA Publications.