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Origins of cataract surgery

29/08/2017

Butter, breastmilk and blunt instruments: the origins of cataract surgery

It’s amazing how much we, as a society, take science and technology for granted. Given the state of medicine in the past, we are infinitely blessed to be living in an age which can grant us painless and guaranteed results. This article will take you through a history of cataract surgery, from its shaky beginnings to the remarkably safe procedure that it is today.

Back to India

The history of cataract surgery can be traced all the way back to 5th century BC in India, where they pioneered the procedure called ‘couching’.

The cataract would be dislodged into the back of the eye using a sharp object, such as a knife or needle – and was an excruciatingly painful process with poor results. Medicinal journals suggest that Indian doctors applied clarified butter and even breast milk to the patient’s eyes to speed up the recovery process.

“When in Rome”

The earliest recorded mention of cataract treatment in Western medicine was found in 29AD in Ancient Rome. They were leading the way in advancements in eye care at the time, with remedies not only for cataracts, but also short-sightedness and conjunctivitis.

The Roman ophthalmic doctors would use a range of variously sized needles, which would be carefully inserted into the eye to break up the cataract into smaller particles. The sharp end of the needle would assist in the surgical process, whilst the blunt end would be used to cauterise the wound. Peculiarly, this was accompanied by administering blows to the patient’s head to assist the extraction process.

The birth of modern cataract surgery

18th century France marked the beginning of modern cataract surgery. The Industrial Revolution brought radical developments in medicinal technology. Scientists were discovering vaccines for all sorts of deadly diseases from cholera to the plague, and various anaesthetics became available (nitrous oxide, cocaine).

The invention of hypodermic needles allowed doctors to extract and properly remove the cloudy cataract from the eye, and this formed the basis for many of the same procedures that doctors still use today. Unfortunately, the procedure still had its flaws. As the entire lens of the eye would be dislodged during the surgery, the eye would lose its ability to focus. As a result, the patient would have to wear thick and cumbersome ‘coke-bottle’ glasses.

In hindsight

Without a shadow of a doubt, technology has vastly improved medicine and it is reassuring to know that it can only get better from here. In fact, the technology described here is still in its infancy compared to the exciting developments of the last twenty years. The next part of this article will highlight some of the more sophisticated technologies that have been developed, including the invention of highly-advanced synthetic lenses and laser technologies.

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