Born on 22nd April 1898 at Tealing, near Dundee, the son of a Scottish minister, Neil Steward Elder, minister of the United Free Church of Scotland, and Isabelle, nee Duke. His early education was at the Morgan Academy, Dundee. He went to St Andrew's University as a foundation scholar in 1915. He graduated MA in 1919 with first class honours in natural science and also took the BSc with distinction in physiology. He qualified with the MB ChB in 1923, obtained the FRCS Enlgland in 1924 and the MD of St Andrews, in which he gained a Gold Medal in 1925. Also in 1925 he obtained a PhD from London University.
After graduating, he went to London to do house appointments at St George's Hospital, but en route he took a locum post for a Dr Arthur, a general practitioner in Wellingborough, Northamptonshire. At St George's he gained the post of resident casualty officer for three months, and then became house physician for six months. He worked as a clinical assistant in the eye department in 1924.
Early in his career he devoted time to researching the physiology of the eye at University College London with Professor Starling and in biochemistry with Dr Drummond. He was consecutively Plimmer Research Fellow (1926), Laking Research Scholar (1926-29), Reittinger Professor (1926), BMA Scholar (1927), BMA Middlemore Prizeman (1929) and Research Associate (1933).
At an early stage in his career he built up a large private practice and in 1932 he operated on the then Prime Minister, Ramsey Macdonald, for glaucoma. He was appointed Surgeon Oculist to King Edward VIII and subsequently King George Vi and then Queen Elizabeth II. He was knighted in 1933 and appointed KCVO in 1946 and GCVO in 1958.
He contributed to medical literature, the first being his Textbook of Ophthalmology, for which he was awarded the Fothergillian Prize of the Medical Society of London. He then brought out a much larger work entitled A System of Ophthalmology in fifteen volumes. Recent Advances in Ophthamology was published in 1927 and Practice of Refraction in 1928. For many years he was editor of the British Journal of Ophthalmology and of Ophthalmic Literature.
The amalgamation of the three main eye hospital in London (Moorfields, the Royal Westminster, and the Central London) and the formation of the Institute of Ophthalmology, was put into action a year before the inauguration of the NHS largely due to his efforts. As early as 1937, Duke-Elder made plans for an Institute of Ophthalmology.
He was Director of Research at the Institute for seventeen years and he was elected a Fellow of the Royal Society. The establishment of a special fellowship examination in ophthalmology at the Royal College of Surgeons in 1947 was mainly due to his efforts. Duke-Elder was one of the pioneers who initiated the Diploma of Ophthalmological Medicine and Surgery. In 1945 he helped to set up the Faculty of Ophthalmologists at the College. He was its first President, holding office for four years. In 1950 he chaired the XVI International Congress of Ophthalmology in London.
In the second world war he was consultant ophthalmic surgeon to the Army with the rank of Brigadier. His duties involved visits to overseas hospitals and units in many theatres of war. He was subsequently civilian consultant in ophthalmology to the RAF and ophthalmic advisor to the Ministries of Health, Supply and Labour and to the London Transport Board.
The many medals he was given included the William MacKenzie Medal (Glasgow) in 1929, the Nettleship Medal (Ophthalmological Society of the UK) 1933, the Howe Medal (USA) 1946, the Research Medal of the American Medical Association 1947, the Donders Medal (Holland) 1947, the Doyne Medal (Oxford) 1948, the Gullstrand Medal (Sweden) 1952, the Medal of Strasbourg University 1962 and of Ghent University 1953, the Gonin Medal (International) 1954, the Lister Medal (Royal College of Surgeons of England) 1956, the Bowman Medal (Ophthalmological Society of the UK) 1957, the Ophthalmiatreion Medal (Athens) 1957, the Proctor Medal (USA) 1961 and the Lang Medal (Royal Society of Medicine of London) 1965. He also received the Bronze Star Medal of the USA and the Star of Jordan (1st Class). He was appointed a Knight Commander of the Phoenix of Greece and a Commander of the Orthodox Crusaders of the Order of the Holy Sepulchre (Jerusalem).
In 1944 he was admitted to membership of the Most Venerable Order of St John of Jerusalem and in 1954 was appointed Hospitaller of the Order in succession to Lord Webb-Johnson.
His wife, Phyllis Mary Edgar, had graduated in medicine in 1926 and worked as clinical assistant in the out-patient clinic at Moorfields. During the second world war she was in charge of the Zachary Merton Hospital at Banstead to which special cases were referred from the army. He died on 27th March 1978.