Early History of Vision Correction

Jennifer Kimberley

We humans have been developing eye and vision problems as long as we’ve been here on Earth. Aging was the same problem millennia ago that it is today, and there have always been nearsighted and farsighted people, and eye problems like cataracts.

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Early cataract treatment
Cataract treatments can be traced back to the fifth century BC in India. There is a Sanskrit manuscript, thought to have been written by a Hindu surgeon called Susruta, about couching. This was a surgery to push the lens out of the visual field, so that the cloudiness of its cataract did not impair vision. A needle was used, or a hard blow to the eye or head. The patient then had no functioning lens and no glasses or contact lenses of course, but at least had no cataracts.

The ancient Romans had their form of couching too. One Cornelius Celsus, who lived from 14 to 37 AD, described the procedure in some detail in his treatise entitled De Medicinae, and here is part of it:

The needle used is to be sharp enough to penetrate, yet not too fine, and this is to be inserted straight through the two outer tunics … When the spot is reached, the needle is to be sloped against the colored area itself and rotated gently, guiding it [the lens] little by little below the pupil … After this the needle is drawn straight out; and soft wool soaked in white of egg is to be put on, and above this something to check inflammation; and then bandages.

The needle was a multi-use implement, as the blunt end was heated and used to cauterize the wound. This procedure was trying to break the zonules (fibrous strings) which suspend the eye’s lens behind the iris.

Present day archaeologists have found Roman ointment sticks in Britain, stamped with the ointment ingredients and the eye doctor’s name. They were used to combat eye infections, either conjunctivitis or potential infection as the eye healed from a surgery. One such stick contained a vinegar lotion and another had copper oxide.

In France in 1748, one Jacques Daviel advanced cataract surgery from these ancient techniques. He performed what we call an intracapsular cataract extraction (ICCE), removing the lens and its surrounding capsule in one piece from the eye. Anesthesia was still unknown.

Eye glasses
The earliest known eye glasses were invented in the ninth century for nearsightedness. Not until the 15th century is there any historical reference to glasses for farsightedness, when Nicholas of Cusa (a German cardinal well-known for his work in mathematics, astronomy and philosophy) mentioned them in 1451.

Monofocal lenses were worn for several centuries as monocles, attached to a gentleman’s waistcoat with a chain and kept in his breast pocket when not in use. In the U.S., inventor Benjamin Franklin played a role in this story by inventing bifocals in 1784.

Also in the 18th century, the first attempts were made to surgically open the eye to remove the cataract lens, but the success was mixed. Handel, the court musician in London and writer of the famous Messiah we hear so often at Christmas, had this procedure done towards the end of his life, but it was not successful and blinded him.

From the 18th century we must jump forward to the twentieth century, when refractive surgery starts to develop. Please see our article History of LASIK: Part 1.

If you are thinking about having LASIK and would like your questions answered first, please visit an experienced ophthalmologist.