12/7/2023 0 Comments List of entoptic phenomena![]() ![]() Our goal was to determine where and how different cataract surgery techniques began. We reviewed works on ophthalmology relating to the ancient Egyptian, Babylonian, Alexandrian, Greco-Roman, and Ayurvedic periods, the medieval Arabic and European periods, as well as reviews or translations relating to ophthalmology history from China, Japan, India, Tibet, Bhutan, Nepal, New Guinea, Africa, and pre-Columbian America, as cited liberally throughout our paper ( 3). ![]() However, Breton actually reported that the patient was asked to inhale forcefully ( 2). For instance, according to the English translation of Hirschberg, which was 3 steps removed from the 1826 description of Peter Breton in Calcutta, the patient exhaled deliberately after cataract couching. With respect to other languages as well, reviewing original source documents altered the conclusions in some cases. To this end, we enlisted the aid of our co-author (AK), who conducts research into Ayurvedic medicine in the ancient Sanskrit compositions at the Department of Indological Studies, Kyoto University. To better understand these discrepancies, we resolved to review the original source documents whenever possible. However, we noted from the treatise by the ophthalmic historian Julius Hirschberg that many accounts of couching during the Ayurvedic, medieval Arabic, and modern Indian periods involved the patient inhaling during or just after the procedure, rather than exhaling. The ophthalmology literature also states that Susruta performed some type of extracapsular cataract extraction by having patients forcefully exhale in order to expel lens material around the probe while it was still embedded in the eye. The Indology literature tells a much more complicated tale, as we review below. Much of this material is just copied from earlier papers without verification from the original sources. For instance, the ophthalmology literature states flatly that there was a man named Suśruta who lived in 600 BCE, or perhaps 800 BCE, who performed cataract surgery and then wrote about it. Particularly with regard to the Ayurvedic (ancient Indian) literature, we saw great discrepancies between statements made in the medical literature (including ophthalmology), and the most authoritative Indology sources, in particular the encyclopedia on Sanskrit medical literature written by Gerrit Jan Meulenbeld (1928–2017) ( 1). We encountered substantial variation in the literature regarding the ancient and medieval periods. Our goal was to compare compositions from the earliest cultures to describe cataract surgery to clarify when and where the procedure started, and how it evolved. We set out to review the origins of cataract surgery. Keywords: Medical history cataract surgery ophthalmology We review the evidence in favor (and against) each of these types of surgery. Various authors have suggested that multiple types of cataract surgery were practiced in the ancient and medieval periods: (I) couching, (II) discission (division), (III) aspiration through a tube, (IV) extraction through a limbal incision, and (V) expulsion of lens remnants around an embedded probe. Thus, the question of where cataract surgery started has not been resolved. On the other hand, the emphasis on surgical ambidexterity could suggest an origin close to the Mediterranean. The sitting posture of the patient, ocular convergence towards the nose, the more systematized integration of the humoral theory with cataract surgery, and possibly blowing on the eye and putting cotton on the eye are all consistent with an Indian origin for the procedure. In both regions, the lens (or pupillary region) was compared to a lentil, and colored entoptic phenomena were noted. In ancient Greece and India, the words describing the color of a healthy blue eye (glaukos and nīla, respectively) could also characterize a poorly-seeing eye not curable by surgery. Certain idiosyncratic practices are common to early Greek and Sanskrit descriptions of cataract couching, e.g., the requirement for maturity of the cataract, the preference for patients of intermediate ages, comparison of some eyes to glass, rubbing the eye, having a wide portion of the couching instrument shaft, pars-plana puncture with avoidance of the vein, and immediate vision testing. Indian tradition and the Persian author Zarrin-Dast attributed the procedure to the Indians, while pseudo-Galen suggested an Egyptian origin. Policy of Dealing with Allegations of Research MisconductĪbstract: Where and when cataract surgery started have been a mystery.Policy of Screening for Plagiarism Process.
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