The Horrors of Ancient Cataract Surgeries

Author: Gross Science

Lots of people get cataracts in their eyes as they age. And for most of human history, surgeons couldn’t really help... But that didn’t stop them from trying. I’m Anna Rothschild, and this is Gross Science. The lens of your eye is a clear structure that sits just behind the iris and helps focus the light coming in.

But sometimes the aging proteins in the lens clump together and form a white spot. This is a cataract, and it makes your vision cloudy. This happens to more than half of Americans by the time they turn 80, and it’s not a new phenomenon. Surgeons started operating on cataracts thousands of years ago—long before they knew what the lens even did. And before anesthesia. So patients could feel every slice and jiggle. An early description of cataract surgery comes from the Indian doctor Sushruta, over 2500 years ago. First, he said, use a sharp tool to poke into the eyeball.

Then, sprinkle the eye with breast milk. The last step is a little unclear, but while the patient blows air out of one nostril, the doctor should attempt to either remove the lens or push it down into the eyeball. Dislodging the lens and pushing it into the eye is called “couching.” And doctors in many countries throughout the ancient world practiced it. You might think the surgery became so popular because it worked well—but you’d be wrong.

Couching did let light back into people’s eyes. But because it left their lenses out of place, their vision was completely unfocused. They often went blind from the procedure, assuming they didn’t first die of infection.

The Horrors of Ancient Cataract Surgeries

Believe it or not, couching is still performed in some countries in the developing world. But today, most people with cataracts are lucky to have some better options. Surgeons can use a tiny incision of just two or three millimeters to reach the cloudy lens and break it up with ultrasound before removing it. Then they can slide in a brand-new lens. Interestingly, the first artificial lenses were inspired by World War II fighter pilots. Sometimes shrapnel from shattered windshields got lodged in these pilots’ eyeballs. A British eye doctor realized that the windshield bits could stay in their eyes without a problem, so he used the same material to build the first replacement lenses. So now, when patients have cataract surgery, they can actually see afterwards.

Eyeballs are gross... Ew.

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The Horrors of Ancient Cataract Surgeries

Lots of people get cataracts in their eyes as they age. And for most of human history, surgeons couldn’t really help... But that didn’t stop them from trying. I’m Anna Rothschild, and…

By: Gross Science