The human eye also belongs to a relatively small group that is equipped to identify different colours. Most insects, fish, birds and many animals can only distinguish different shades and textures. The basis of colour sense is the mixture of three transparent colours — red, green and blue. When they are combined in the correct intensities they make up white. People with a well-developed colour sense can recognize many hues of the same colour, perhaps even as many as a hundred. But colour sense is highly variable, and it is estimated that one male in eight is `colour-blind‘; that is to say, Read the rest of this entry »
In modern times we have learned to manufacture glass of a much higher and controllable refractive capacity. Correct refraction is as important as the shape of the lens for the efficacy of an optical aid.
The grinding and polishing of regular curvatures on to transparent media to produce lenses that minify objects has thus been going on for several hundred years but the scientific principles underlying the measurement and accurate reproduction of thin spectacle lenses belong to modern times. Read the rest of this entry »
In order to maintain its transparency the lens, a living structure, requires nourishment and metabolic activity. Any agency which disturbs the normal metabolism of the lens will cause a greater or lesser opacification, which is by definition a cataract. Nourishment is provided by the aqueous humour in which the lens lies, the necessary substances passing through the outer capsular membrane to reach the cells within. There are no blood vessels in the lens. Most of it consists of a form of protein, rather like egg-white, which does not occur elsewhere in the human body. Lens protein in different animals is exactly the same. This curiosity, which is called organ specificity rather than species specificity, means that if someone becomes allergic to any animal’s lens, he will also become allergic to his own. Read the rest of this entry »
Symptoms
All the symptoms of cataract are visual, the usual complaint being of a general mistiness of sight, more particularly for distance vision, as reading is often unaffected in the earlier stages. One eye is frequently worse than its fellow, but sooner or later both eyes alter. At this stage dazzle may be a cause of great distress. In normal lighting conditions vision may not be seriously disturbed, but in bright sunlight it becomes obscured by dazzle in the same way that a dirty windscreen becomes almost opaque in the headlights of oncoming cars. In this situation patients may be greatly helped by wearing a brimmed hat or tennis shade. Tinted glasses are of limited assistance because it is the direction of the light as much as its brilliance that causes the trouble. Read the rest of this entry »
The first step in the operation itself is the securing of the eyelids. This is usually done with a small spring speculum, which gently holds the lids open without in any way pressing on the eye.
The removal of the cataract can be achieved in a number of ways, the aim being to clear all the opacity from the pupil of the eye. Basically, there are two methods either of which may be used: Read the rest of this entry »
At one time almost all intraocular surgery was performed under a local anaesthetic. For two reasons local anaesthesia is used much less commonly today. First, the whole science of general anaesthesia has greatly advanced and the likelihood of coughing has been considerably reduced. Second, methods of repairing the cataract wound are now better than they used to be. Coughing and sneezing after the operation consequently constitute less of a threat than formerly. Read the rest of this entry »
There is a popular misconception that cataract surgery cannot be undertaken until the cataract has reached a particular ripeness. This was the case many years ago, when the only method of removing the cataract was by the extracapsular method, which involved opening the capsular bag and washing away its contents. If the cataract was very ‘immature’, it was technically rather difficult to do this. Read the rest of this entry »
When examining you an ophthalmologist will test eye-pressure through the simple expedient of placing his fingers on your closed eyelids. The experienced physician will know immediately whether the pressure is unusually high, but even so he is unlikely to be able to distinguish, using this technique, between more than four grades: namely soft, normal, suspicious and high. Accurate measurement requires instruments. Such instruments have to touch the cornea, which is therefore suitably anaesthetized beforehand, using a special kind of drop. Several types of local anaesthetic drop exist, e.g. amethocaine, pentocaine and xylocaine. One instrument blows a puff of air on to the cornea and then measures the degree of corneal flattening that results. This does not require a local anaesthetic. Read the rest of this entry »
There are a group of hereditary or congenital degenerations affecting the cornea. A few of them manifest themselves at birth, but mainly they occur in childhood and adolescence. Their onset is slow, and they are sometimes difficult to diagnose without special instruments. Ophthalmologists consider them to be metabolic in origin, most probably the result of an abnormality in one of the enzymes servicing the cornea. Read the rest of this entry »
Until the advent of contact lenses or intraocular lens implants spectacles were the only means of achieving a finely focused image on the retina after a cataract operation. Although in many cases this is most satisfactory, there are limitations to such correction. At first some patients find that wearing thick cataract glasses causes a number of problems which arise from magnification of the image, distortion in the peripheral part of vision, and some limitation of the field of clear vision.
These all result from the spectacle lens itself rather than from the operation. Read the rest of this entry »
