400 BC

400 BC, a man's vision is so clouded he is virtually blind. The lens of his eye is completely opaque, rigid and heavy.  He resorts to a medical procedure - one of the oldest documented successful surgical interventions. It is called "couching".  His eye is struck with a blunt object with such force that his wasted lens dislocates into the vitreous cavity.  His sight is restored, but without a lens it is entirely unfocused.  He believes he is better off.  Over the following centuries this crude procedure was improved upon.  By the 18th century practitioners were able to remove the lens from the eye.  the incision went half way around the circumference of the cornea.  The patient was made to lie still with head immobilized by sandbags until the wound healed.  Upon recovery, still no focus.  Improvements in the 20th century have been spectacular.  The advent of very fine stitching allowed safe removal of the lens and quick recovery.  During World War II the eyes of pilots wounded by shattered windshields inspired development of a replacement lens.  Surgical precision improved both lens removal and artificial lens quality.  Today, a surgical incision of 2mm allows removal of the emulsified lens and insertion of a new lens of artificial material.  I had such a procedure this week.  I have focus, color distance and clarity.  No blunt instruments involved.