The Early Years and Expansion

By 1945, the University of Iowa's Ophthalmology Department had already established itself as a leader in eye care and research. Dr. O'Brien, who had been at the helm since 1925, was instrumental in this development. His vision for the department included not only clinical excellence but also a strong emphasis on research and education.
 
In the immediate post-war years, the department faced the challenge of outgrowing its existing facilities. The need for more space was evident, and by 1946, plans were underway to expand. This expansion was completed in 1949, providing the department with a newly remodeled clinic area that included modern equipment and dedicated spaces for both patient care and research. 

The newly remodeled and expanded space in 1949 was an improvement. The new Clinic area was a 24 by 40 foot room. Each resident was provided with a small desk and a chair for the patient to sit in. The Snellen eye charts were on the south wall and the 20 foot line was marked on the floor with a piece of adhesive tape. There were two examining chairs with head rests in the clinic, each with a nearby equipment stand. These two chairs were used in the event that an eyelid needed to be everted, a conjunctiva needed to be cultured, or perhaps a lacrimal duct probed. The "dark room" was a 12 by 20 foot room just beyond the back wall of the clinic. It had four slit lamps with stools, a keratometer and a table-mounted binocular ophthalmoscope. Later, a cot was added for indirect ophthalmoscopy. There were four 20 foot refraction lanes with plywood partitions that did not reach the ceiling. The 12 by 24 foot sun porch at the south end of the ward was converted into a department library by bricking up most of the windows and lining the walls with bookcases. Lectures for the residents were given in this room. 

Leadership Transition and Challenges

The late 1940s brought significant changes to the department's leadership. Dr. O'Brien, who had been the only head of the ophthalmology department at Iowa and director of the American Board of Ophthalmology since 1937, announced his retirement from the University of Iowa in 1949. His departure marked the end of an era, but it also sparked a contentious search for his successor.

The O’Briens had always gone off to Florida for a couple of weeks in January, and in 1949 they came back to Iowa where the matter of his successor was still far from settled.

O’Brien had given the Dean his opinion that he would support Dr. James Allen’s application for the position. Dr. Allen had been an O’Brien resident, and they had done some projects together. However, the ophthalmologists of Iowa did not know him well. On the other hand, they had grown to know and like Dr. P.J. Leinfelder because he had often, when asked, gone to an ophthalmologist’s office to see a patient or two, and then stayed overnight as a guest. These trips had often involved a small gathering of a few local ophthalmologists, to whom Dr. Leinfelder would show some slides on the living-room wall.

Dr. Allen demonstrated his academic enterprise by arranging to put together, with O’Brien’s support, a meeting in Iowa City in May 1949 on the management of strabismus. He managed to get on the program almost every ophthalmologist in the country who had developed a reputation as a specialist in straightening children’s eyes.

Thus, the Eye Department in Iowa City, the Dean’s Search Committee, and the practicing ophthalmologists of the State had all fallen into two camps regarding the succession to the Head: it was to be either P.J. Leinfelder or Jimmy Allen. The Dean hesitated until somebody finally suggested that Alson Braley might be interested; he was an Iowan, and trained by O’Brien – but he had just accepted the chairmanship of the Eye department at New York University, in New York City. The Dean's Search Committee agreed that Braley seemed a better choice.

Al and Hazel Braley were both Iowans and they were eager to take the job, but he felt that he should honor his commitment to NYU for at least a year, and it was arranged that he would spend all of 1949 in New York City, and move back to Iowa City at the end of the year. The Braleys returned to Iowa City in January 1950.

"I have corn coming out of every ear. You can't get the corn out of an Iowan." —Dr. Alson Braley after being asked why he wanted to return to Iowa after 10 years in New York.

When the O’Briens left Iowa City in 1949, just about everyone had decamped. Some of the residents left. Jimmy Allen went to New Orleans and Lee Allen went with him. The story goes that Jimmy Allen did not get the job he had hoped for, so that he had, at first, little power or financial support. This resulted in Lee Allen, who followed Jimmy Allen to New Orleans, also having a rotten time there. He got a tiny room with bad light and no running water to develop film. He had no money for a good camera (he borrowed one from one of the residents) and no budget for film, so he got his hands on only two rolls of Kodachrome in the 10 months he was there.

When Lee Allen heard that Braley would be returning to head the program in Iowa, he said “that’s it—I want to go back to Iowa!” So he called Glenn Walker (the acting head), and Walker said, “I’ll be calling Dr. Braley this evening, I’ll ask him about it.” Braley of course said “Wonderful! Wonderful! I couldn't be happier!” So in the Fall of 1949, Lee Allen packed his family in the car and drove back to Iowa.

Otis Lee, O’Brien’s protégé, who was now the main anterior segment surgery teacher, soon decided that without O’Brien, Iowa would never amount to anything, and had zero prospects of ever again being “One of the best places in the country to learn Ophthalmology.” He decided to bail out in 1949 and moved to Tulsa, OK.
 
When Al and Hazel Braley got back to Iowa in January 1950, the Department was empty. Glenn Walker had already moved to Burlington, and Dr. Leinfelder was the last remaining faculty member, and he was on his winter holiday. Lee Allen had also recently arrived back in Iowa City, and Elsie Laughlin, the nurse-orthoptist, was still there.
 
Naturally, the first thing that Braley did was to go pay a visit to the Dean. On hearing Braley voice concerns about there being only one other faculty member, the Dean said, “I suppose that a hospital Eye Department needs only one faculty member; what, after all, is there to do but keep the hospital employees in glasses?”

To this point the department had been primarily general ophthalmology—everyone in the department did everything. During Dr. Braley's time in New York, he saw that sub-specialization was beginning to take place in the field of ophthalmology. Braley was able to secure some federal funding from grants to support sub-specialization and started hiring anyway. The exact sequence of his recruiting is impossible to determine because it happened so fast.

Braley knew Fred Blodi from post-war days at Columbia in New York. VA funds were used to bring Fred Blodi to Iowa in 1950. The breakup of the Dartmouth Eye Institute dispersed a very talented faculty and Hermann Burian was recruited to the University of Iowa as an Electrophysiologist and Strabismologist. Paul Boeder came to Iowa City with his wife Evelyn and joined the Iowa faculty to teach optics. Boeder was still supported in part by the American Optical Co. in gratitude for his work on the mathematics of optics. Braley found himself doing retinal detachment surgery—so he recruited Ed Ferguson. Within a year, Ferguson was swamped with retina work and suggested that Robert Watzke join the Department. Dean Nelson (formerly medical Dean at the American University of Beirut) encouraged Braley to take Mansour Armaly, a young ophthalmologist from Beirut, who eventually started the Iowa Glaucoma Service.