The Legacy Collection

2018 Legacy Inductee

Alexander Duane, MD (1858–1926)

Legacy Summary Statement

Known for his great intelligence, extraordinary kindness, and generosity, quiet modesty, and patience, Duane was described by friends and colleagues as highly ethical and intensely industrious. In ophthalmology circles, he is best known for his eponymic syndrome of abduction limitation with globe retraction and for his contributions to physiological optics.


Born in 1858 in Malone, New York, Alexander Duane came from a prominent family of generals, judges, and the first Mayor of New York. His father was West Point graduate U.S. Army General James Duane. As part of an army family, Alexander’s childhood was spent in various locations, including Portland, Maine where he developed skills as a strong swimmer and learned to sail.

He was tutored at home until he was fifteen, achieving excellence in mathematics from his tutors and advanced English skills from his mother. He was well versed in the classics, reading and writing both Latin and Greek. He also loved music and was a competitive athlete. He attended high school briefly in Portland, passing his college entrance exams at fifteen and was accepted at Union College in upstate New York. This was his father’s alma mater and his great-great-grandfather was a founder. He graduated in 1878, was married in 1891 and had three sons, one of whom was killed in World War ll.

Following the family’s strong military tradition, Duane served in the U.S. Naval Reserve during the Spanish American War in charge of the signal service off the Maine coast, and in World War I as a lieutenant and chief signal officer.

Duane received his medical degree in 1881 from Albany Medical College and the College of Physicians and Surgeons in New York (later Columbia University’s medical school.) He was introduced to ophthalmology when assisting Dr. George Stevens and Dr. Hermann Knapp (grandfather of the late Philip Knapp.) Duane’s education, classic training, and personal diligence set him apart from others in his grasp of optics and refraction. He published several early scientific articles and was a good writer, thanks to his mother’s influences. He became a lexicographer, composing definitions and medical terms for several dictionaries, including the precursor of the Oxford English Dictionary, Webster’s International Dictionary and a Student’s Dictionary of Medicine. He wrote many chapters in books authored by colleagues and quickly became known as an expert on accommodation, extraocular muscles, and physiological optics. He also wrote a textbook on signaling techniques for his navy peers!

His major publications addressed binocular asthenopia, an early form of the cover test, and his “excursion” test, a form of oculocephalic testing. German ophthalmologists Jakob Stilling (1817) and Siegmund Türk (1896) first described some features of the retraction syndrome that subsequently became better known as Duane syndrome. He also became a leading authority on the mechanisms, normal variations and anomalies of accommodation. In 1903, he translated Dr. Ernst Fuch’s Textbook of Ophthalmology, which went through 8 editions before 1924. Duane’s thorough editing of the ocular motility chapter became the authoritative work on the subject, resulting in his own book, A New Classification of the Motor Anomalies of the Eye.

He is perhaps remembered best for his detailed description in 1905 in the Archives of Ophthalmology of “Congenital deficiency of abduction associated with impairment of adduction, retraction movements, contraction of the palpebral fissure, and oblique movements of the eye.”

He received many honors, including an honorary doctorate from his alma mater in 1919. He became a member of the American Ophthalmological Society in 1902, was awarded the Howe Medal in 1923 and became AOS president in 1924. In 1926, when working on several manuscripts and two books, he died of meningitis. One of the books was on physiological optics and the other on the extraocular muscles. Some of these chapters were published posthumously in the Archives of Ophthalmology. His sudden loss generated five obituaries from his long-time friends and colleagues in that journal alone.

Alexander Duane Headshot