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After being used regularly for centuries, couching has been mostly abandoned in favour of more effective techniques, due to its generally poor outcomes, and is currently only routinely practised in remote areas of developing countries. [11] [12] Cataract surgery was first mentioned in the Babylonian code of Hammurabi 1750 BCE. [13]
"Couching for cataract"; Wellcome Collection illustration of Indian doctors performing the technique. Couching is the earliest documented form of cataract surgery. It involves dislodging the lens of the eye, thus removing the cloudiness caused by the cataract. Couching was a precursor to modern cataract surgery and pars plana vitrectomy.
At some point—usually as you enter middle age—most people develop this eye condition, which is a clouding of the eye’s lens that can get progressively worse and impair your vision.
Early symptoms of cataract may be improved by wearing appropriate glasses; if this does not help, cataract surgery is the only effective treatment. [4] Surgery with implants generally results in better vision and an improved quality of life : however, the procedure is not readily available in many countries.
Posterior capsular opacification, also known as after-cataract, is a condition in which months or years after successful cataract surgery, vision deteriorates or problems with glare and light scattering recur, usually due to thickening of the back or posterior capsule surrounding the implanted lens, so-called 'posterior lens capsule opacification'.
Complications after cataract surgery are relatively uncommon. Posterior vitreous detachment (PVD) may occur but does not directly threaten vision. [23] Some people develop a posterior capsular opacification (PCO), also called an after-cataract. This may compromise visual acuity, and can usually be safely and painlessly corrected using a laser.
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