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 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. 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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