The word cataract comes from the Greek for waterfall. Until the mid 1700s, it was thought that a cataract was formed by opaque material flowing, like a waterfall, into the eye. We now know that the clouding of the lens usually occurs as a result of natural aging processes, metabolic changes, injury, various forms of radiation, or toxic chemicals or drugs.
The oldest written record of eye diseases dates back to the year1500 B.C.: numerous diseases of the eye are referred to in the Ebers Papyrus discovered between the legs of a mummy in the Theban Necropolis in Egypt by the German professor Georg Ebers in 1872. And does the description" rising water in the eye“– as Albertus Magnus says – refer to cataracts
Bronze Instruments that would have been appropriate for cataract surgery were excavated in Greece.
Couching.This technique involved using a sharp instrument to push the cloudy lens to the bottom of the eye. Perhaps this procedure is that which is mentioned in the
articles of the Code of Hammurabi (Cotallo & Esteban, 2008; Ascaso et al., 2011).
Hammurabi (ca. 1792-1750 BC), the greatest ruler in the first Babylonian dynasty became king of all Mesopotamia, the land what is today known as Iraq.
The earliest written description of (self) couching is in The Apochrypha of the Bible, in the book of Tobbit3, fragments of which persist in the Dead Sea Scrolls4, and can be dated very close to 612 BC, the fall of Nineveh within Tobbit's lifetime. Tobbit
Couching (depression of the lens) This is an account of self couching by rubbing [hard] in response to severe irritation of the gall (Bile), producing an immediate return of vision. Bile is highly irritant but also contains detergents and enzymes (i.e. chymotrypsin) which would weaken the zonules.
The earliest written reference to cataract surgery is found in Sanskrit manuscripts dating from the 5th century BC. They are thought to have been written by the Hindu surgeon Susruta. He practiced a type of cataract surgery known as couching or reclination, in which the catatactous lens was displaced away from the pupil to lie in the vitreous cavity in the back of the eye.
Modern cataract surgery, in which the cataract is actually extracted from the eye, was introduced by Jacques Daviel in Paris in 1748 and
Samuel Sharp of London introduced the concept of intracapsular cataract surgery in 1753 by using pressure with his thumb to remove the entire lens intact through an incision. Small suction cups (erysiphakes) were introduced for this purpose in 1902 as well as various capsular forceps to grasp the lens for removal.
In 1957 Barraquer of Spain used alpha-chymotrypsin to enzymatically dissolve the zonules for removal of the lens.
Cory-surgery was introduced by Krawicz of Poland in 1961 to remove the lens with a tiny probe that could attach by freezing a small area on the surface of the cataract.
Dr. Charles Kelman – A new york Ophthalmologist who developed the groundbreaking cataract surgery procedure known as phacoemulsification, in which a surgeon uses a vibrating, ultrasonic tip to break up the cataract and suction it out with a small needle,Kelman technique has been improved upon and is now used to remove tumors from the brain and spinal cord in children, and who was awarded the National Medal of Technology from George H.W. Bush in 1992, Dr Kelman died June 1 of lung cancer in Boca Raton, Florida at the age of 74.
(prior to this procedure, cataract removal required a 10 day hospital stay after a painful operaiton),
In the late 1960s Charles Kelman of New York developed a technique for emulsifying the lens contents using ultrasonic vibrations and aspirating the emulsified cataract. In recent decades, there has been a rapid evolution of designs, materials, and implantation techniques for intraocular lenses, making them a safe and practical way to restore normal vision at the time of surgery.
The phemtosecond laser was introduced for ophthalmic use to assist in cataract surgery
The first Ophthalmic FS laser system was designed by Dr Juhsaz in collaboration with Dr Kurtz at the University of Michigan in the early 1990s
ca 1750 BC
At a Glance History of cataract Surgery by W Satar, MD
BY F.J. Ascaso1 and V. Huerva2
1University of Zaragoza,
2University of Lleida,