Cataract Surgery: Ancient And Modern

A cataract is a clouding of the lens of the eye as though grease were dabbed on the lens of a camera, impairing vision.

The first known reference to cataract surgery was in India, it is thought, in a Sanskrit manuscript from the 5th century BC written purportedly by a Hindu surgeon named Susruta. Dr. Susruta did a type of cataract surgery known as couching (or reclination) in which the lens with the cataract was displaced. The diseased lens was pushed away from the pupil into the back of the eye. This permitted the patient to see somewhat better but by no means normally because the patient's own lens was then of no use and a corrective lens was not available to substitute for it. Couching was still practiced in Egypt, India and Tibet until the middle of the 20th century.

In the West, the first written description of the cataract and its treatment appeared in 29 AD in De Medicinae by the Latin encyclopedist Celsus. Celsus described the practice of needling (also called discission) of cataracts. This was a technique in which the cataract was broken up into smaller particles, which facilitated their absorption.

Modern cataract surgery was first done in France by Jacques Daviel in 1748 who removed the cataract from the lens. Later surgeons removed the clouded lens in its entirety.

Today, most cataract surgeries are performed using phacoemulsification, breaking up the lens with ultrasound and suctioning it out. Then an intraocular lens (IOL) made of plastic is inserted. The operation which takes about an hour and often needs no hospitalization has revolutionized the treatment of cataracts.

The treatment of cataracts has come a long ways from the 5th century BC.

For additional information, please visit the Cataract Center.

This Health Fact is in part based on information from the Museum of Ophthalmology of the American Academy of Ophthalmology.

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Last Editorial Review: 7/7/2004