The History of Ophthalmology
Part 1: The Ancient World
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The ancient Romans revered Greek medicine and used Greek names for eye conditions. Roman physicians continued writing about ocular anatomy and eye treatments, drawing much of their knowledge from Greek texts.
Examples are detailed descriptions of:
- Removing the eye’s lens to treat cataracts;
- How to treat ingrowing eyelashes, and
- How to treat ectropian (everted eyelids).
One Cornelius Celsus, who lived from 14 to 37 AD, described a procedure like the ancient Indian couching – a surgery to push a cataract lens out of the visual field. He describes it 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 [referring to the two corneal layers, the epithelium and the stroma] … 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, so that the cataract-clouded lens would drop out of the person’s visual field.
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.
Ancient Rome did not develop any new ophthalmological knowledge. Although the Romans knew about myopia (nearsightedness) and presbyopia (“middle-aged vision”), they seem to have developed no spectacles. A myopic slave was worth less than a normal-sighted one, and when an (upper-class) older person developed presbyopia, a slave read to them.
The Dark Ages is a term for the early European Middle Ages, and ran from about 500 to 1000 A.D. As Roman civilization declined, Eastern conquerors surged across Europe, bringing the Arabian language and worship of Allah.Through translations of Greek documents into Arabic, much medical knowledge was preserved. The Arabians (a loosely-used term, as the people came from many countries) built departmentalized hospitals similar to our modern ones. They had large ophthalmology departments which continued procedures developed by the Greeks, but they apparently did not expand or improve them.
How did ancient Greek medical knowledge get from Arabic texts to medieval Christian Europe? Largely through the work of Constantine the African, who lived from about 1020 to 1087. He was a Christian monk in Carthage while it was ruled by the Arabs, and was fluent in Greek, Arabic and Latin. He translated Hippocrates and Galen from Arabic to Latin, and wrote a long book called the Complete Book of the Medical Art.
Was Blindness Prevalent in the Ancient World?
Considering all the factors which impaired vision in ancient times, every nation must have had a large percentage of blind or near-blind people:
- Eye injuries from war
- Blinding as a punishment
- No knowledge of glaucoma
- No knowledge of astigmatism
- Large numbers of poor people who could not have afforded any cataract treatment
- No eye protection from the sun’s UV rays
- No glasses or contact lenses for those who had cataracts removed, and whose eyes therefore had no lenses
- No glasses for people with presbyopia, myopia or hyperopia
However, for people with hyperopia or presbyopia, help was not far away by now.
History of Ophthalmology Part 2: The Middle Ages: Spectacles
History of Ophthalmology Part 3: Anesthesia and Infection
History of Ophthalmology Part 4: The Nineteenth Century: Seeing the Eye
History of Ophthalmology Part 5: The Twentieth Century: Swift Progress
History of Ophthalmology Part 6: What is a Laser?
History of Ophthalmology Part 7: Leading up to LASIK
History of Ophthalmology Part 8:LASIK Into the Twenty-First Century