Alistair Adams, maverick eye surgeon

Alistair Adams claimed to be the first eye surgeon in Scotland to perform laser surgery for shortsightedness, using a procedure known as photorefractive keratectomy (PRK). Before long he had given up, concluding that too many people were having to return with complications.
“I did approximately 100 cases of PRK, but I stopped doing it five years ago because around 10 per cent of people I treated didn’t want to have their other eye done and were happy sticking with their contact lens,” he told Scotland on Sunday in 2004. “That was mostly due to their vision at nighttime, driving in the dark or dim light, as their vision wasn’t as good as it was with their contact lens.”
While other techniques for alleviating shortsightedness have since emerged, Adams remained sceptical. “I have a question mark over the long-term results, and I think there may well be complications which we haven’t suspected,” he said. He instead developed a technique for small-incision cataract surgery that did not require expensive and potentially temperamental technology.
Adams, who had tousled hair and an eagle-beak nose, cut an artistic figure that made him appear uncannily like Delacroix’s portrait of the composer Chopin. Thanks to his skill at devising functional and elegant structures from the most unlikely materials, he was known among friends as Heath Robinson. Learning to pick locks was not enough for this restless and inventive maverick; he also used a slender fibre-optic cable to create an instrument for examining the interior of safes and opening them from within.
Such practical skills were put to more professional use with his invention of clips to help anaesthetists identify their different syringes. He also created a delightfully simple apparatus for performing a vitrectomy, a form of eye surgery, that for many years was favoured by surgeons in the Princess Alexandra Eye Pavilion in Edinburgh, where he was a consultant for more than three decades. However, he felt ignored by the big pharmaceutical equipment companies whose commercial products sold for more than 16 times the cost of his device.
Friends with wayward Sim cards in their telephones could rely on Adams’s ever-present Swiss army knife to come to their rescue, while on one long-ago occasion, he stepped in to help a colleague who could not remember the code for his suitcase at customs in Jeddah airport. “Alistair, a fragment of hacksaw in his pocket against just such a need, cut open the padlock while the fearsome border guard gaped in silence,” Hector Chawla, a fellow eye surgeon, recalled.
Alistair David Adams was born in 1943 in Edinburgh, where he won a scholarship to George Heriot’s School. He took the first year of his medical degree while still a schoolboy, entering the University of Edinburgh in the second year of the course. He was awarded a bursary based on an enigmatic examination question to which he was quick to spot that there was no actual answer. Despite such academic bravura, he passed through life tormented by self-doubt.
As a student he worked as a hospital porter, pushing a trolley around Edinburgh Royal Infirmary. This helped to cover the cost of lessons at the Victor Sylvester dance studio, where he was awarded a bronze medal. In 1970 he married Anne Crerar, an occupational therapist. They had two children, Jonathan and Caroline, who survive him. The marriage was dissolved and he later married Margaret Irving at a ceremony held among the penguins at Edinburgh Zoo. She also survives him.
Although a first-class clinician, Adams was at heart a scientist. He spent 18 months as a fellow at Stanford University, California, where he discovered a new concept about the function of conjunctival mucus, publishing his findings in Archives of Ophthalmology in April 1979. His research was also published in the British Journal of Ophthalmology.
Back in Edinburgh he ran a private ophthalmology practice in Moray Place, in New Town, and was an expert witness for the Law Society of Scotland. He also used his persuasiveness and charm to encourage donations to the Eye Pavilion Treatment of Blindness Fund, raising more than £2 million over 15 years to help pay for expensive equipment and the construction of a third operating theatre.
As chief examiner for the Royal College of Surgeons of Edinburgh, Adams organised examinations in Britain, India, Hong Kong and Singapore. During this time the college’s role in training, and the nature of its examinations, came under scrutiny. The upshot was his complete redesign of the entire process with structured exam questions, a syllabus detailed as never before and a logbook to record the exact nature of a candidate’s experience and training.
Having studied the art of silversmithing, Adams put together exquisite pieces of jewellery. He was also adept on the water, though on one occasion he misread the weather on a yachting trip with friends to the Western Isles and they were hit by a raging gale in Coll harbour. Two yachts ran aground while theirs tugged fiercely at a frayed mooring rope. Adams, the expedition chef, produced a fishing rod and, held fast by his legs over the heaving bows, dropped a plumb line through the equally heaving mooring ring, an intact rope following like thread into a needle.
Alistair Adams, consultant eye surgeon, was born on July 3, 1943. He died from cancer on May 17, 2024, aged 80