The significance of some observations on African ocular onchocerciasis described by Jean Hissette (1888-1965)

One of the most significant contributions to tropical medicine and ophthalmology was made by Jean Hissette: African ocular onchocerciasis. During his extensive investigations in the Babindi country, he found numerous adults with river blindness. Their eye disease was caused by the filaria Onchocerca volvulus Leuckart. He noticed the signs of interstitial keratitis and band keratopathy, faint iritis or iridocyclitis, posterior synechiae and often a downward distortion of the pupil. He was the first to describe chorioretinal scarring of the fundus, what became known as the Hissette-Ridley fundus. People reported to him their entoptic phenomena which he unequivocally interpreted to be the images of microfilariae in the patient's own eye. During his stay in Belgium in 1932, he elucidated the pathogenesis of blindness since he was able to provide histological proof of the presence of microfilariae in various ocular tissues of an enucleated eye from a patient living near the Sankuru river. Like other serious health impairments, the severe inflammatory lesions in the eye occurred only after the microfilariae had died. Hence he realized that dying microfilariae play a key role in the mechanisms leading to blindness. Hissette's precise descriptions were the logical fruit of his outstanding observational abilities and enabled him as a man of great intuition to speculate about causal relationships. He evidently benefited from the fact that he took the native Africans seriously and asked them their opinion. In 1933, his friend and teacher Dr. De Mets in Antwerp already wrote on Hissette's discovery in the Belgian Congo: "This study is of exceptional value to specialists which is not only a tribute to its author, but to our common native country (Belgium)."