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Old meets new at 23rd ESCRS Winter Meeting

We take a look back at medical approaches to cataract in Ancient Greece

Aidan Hanratty

Posted: Friday, December 21, 2018

The 23rd ESCRS Winter Meeting will take place in Athens in February, 2019. This will be the fourth Winter Meeting in the city, once the centre of the ancient western world. There will be many topics up for discussion including ocular surface disease, complications in corneal graft surgery, advances in glaucoma as well as didactic courses and practical workshops.

The Hellenic Society of Intraocular Implant and Refractive Surgery will also host a symposium entitled “Advanced technology – better results?” This is an interesting question, especially in the context of the history of medicine in Greece.

The term “glaukos” was a non-specific descriptor meaning blue, green or light grey, and its use in medical terms came from the colour produced in angle-closure glaucoma. The goddess Athena was referred to throughout Homer’s Iliad as “Glaukopis Athena” for her bright or “flashing” eyes. Speaking more generally, the word “ophthalmos” was the Greek for eye, and combined with “logos” meaning word or study, it forms ophthalmology.

Writing about “The Cataract Operation In Ancient Greece” in Histoire des sciences médicales in 1982, Jean Lascaratos and Spyros Marketos describe the understanding of and methods to treat cataract in Ancient Greece.

Hippocrates, known as the father of western medicine, mentions the term “glaucosis”, they write, but it is believed that he was in fact referring to what we now call cataract. Galen, who came several hundred years later in the 2nd Century AD, believed that hypochyma (as cataract was then called) was a coagulation of the aqueous humour, while glaucoma was the transformation of humours existing in the eye to a sea-green colour.

Galen wrote that a treatment for cataract was discovered by accident: “That is, a goat suffering from hypochyma saw again when it fell upon a thorn that pierced its eye.”

His standard was as follows: “We pierce the cornea with a needle on the periphery until it has entered the anterior chamber. Then we pierce the hypochyma, which we push aside.” Another method described by Galen was called depression, which consisted of moving the cataract away from its original position. He also writes that some doctors tried to remove the cataract by opening the cornea, yet this was a rare, risky approach.

To think it would be some 1,600 years before Jacques Daviel successfully extracted cataracts, and another 100 after that before the advent of phacoemulsification, the Ancient Greeks deserve a lot of credit for their efforts. What they might make of the advances made today, and on show at the 23rd ESCRS Winter Meeting, we will never know.