Josef Flammer

Josef Flammer (born April 21, 1948) is a Swiss ophthalmologist and long-time director of the Eye Clinic at Basel University Hospital. Flammer is a glaucoma specialist who developed a new pathogenetic concept of glaucomatous damage according to which unstable blood supply leads to oxidative stress, which in turn plays a major role in apoptosis (cell death) of cells in optic nerve and retina in glaucoma patients.

Josef Flammer was born on a farm near the village of Bronschhofen in the Canton of St. Gallen. He attended secondary school in Wil and boarding school in Gossau. In 1968 he began to study medicine, first in Fribourg, then in Berne. Flammer spent his junior doctor years in the fields of internal medicine, neurology and ophthalmology - he finally decided to become an ophthalmologist and completed his education at the Department of Ophthalmology of the University of British Columbia in Vancouver before returning to the University of Berne. In 1984 he was appointed chief physician of the University Eye Clinic Berne, in 1987 he accepted an appointment as chair of ophthalmology and director of the University Eye Clinic Basel, over which he presided until his retirement in December 2013.

Flammer's scientific and medical endeavors were generally interdisciplinary. His first research focus was automatic perimetry for which he established normal values; he studied short term and long term fluctuations of the human visual field and described influencing factors. Together with Hans Bebie he developed the so-called Bebie curve, which plays a major role in the diagnosis of visual field loss due to glaucoma. Flammer was onr of the first researchers to demonstrate systemic side effects of locally administered beta blockers (i.e. eye drops) in ophthalmology. Flammer and his collaborators found that intraocular pressure variation is as important for the development of glaucoma, one of the main causes of blindness worldwide, as a constantly elevated intraocular pressure, long considered the main, if not the only, cause of glaucoma. In numerous research projects he demonstrated that glaucoma could be caused by a dysregulation of ocular blood flow, even at normal levels of intraocular pressure. Flammer discovered that vasospasms in the eye are a manifestation of a general vasospastic syndrome. Later, he noted that such spasms are only the tip of the iceberg and an indication of a much more generalized vascular dysregulation in the human body. This increases the risk of eye disease, in particular of normal tension glaucoma. Flammer noted that people with a primary vascular dysregulation have other symptoms and signs; this led to the establishment of the term Flammer syndrome. Flammer also demonstrated the relationship between eye disease and heart disease. In numerous laboratory studies, he contributed to the understanding of the role of endothelin and nitric oxide in ocular perfusion.

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