Forgive the cliché, eyes are a window
Out of which we see all around, we take
This for granted, till age muddies the glow
As the lens becomes cloudy, then opaque
Like church’s stained glass, slowly vitrifies
And cataracts disturb the flow of light
Eyes being surrogates for our body’s demise
Can we reverse the trend, restore the sight?
Emulsify the cloud, remove the blur
A rolled implant through a slit is placed
Unravels in the capsule, vision clear and pure
A new lens, advancing blindness replaced
In so many people, this plastic pane
Darkness becomes lightness, a window again
Backstory
Cataracts are areas of protein deposition within the eye that lead to increasing cloudiness and blurring of vision. Although they may involve genetic factors, or be associated with certain diseases such as diabetes, or with life-style matters such as smoking, they are essentially a consequence of ageing. Until the late 1940’s, the end stage of cataract treatment was simple removal of the affected lens and ‘correction’ of vision by eye-glasses. Around 1946, Harold Ridley, an ophthalmologist in London, considered the possibility of replacing the lens with a piece of transparent plastic. He had observed that RAF pilots in the second world war often sustained eye injuries because of shattered cockpit windows, and fragments of the plastic material used for these structures, made of polymethylmethacrylate (usually known as Plexiglas or Perspex) remained in the eye and were well tolerated. He arranged for lenses to be made from this material, and the Intraocular Lens was introduced into ophthalmological practice. By 2020 over 20 million IOLs were being implanted annually, with a market size of around $5 billion. The technique of implantation was improved by the introduction of phacoemulsion, that simplified and enhanced lens removal, by the use of foldable silicone lens that allowed for insertion through smaller incisions, and by the development of specialized implants for use in astigmatism and other rarer conditions. Today, in excess of 95% of treated patients have remarkably improved vision through the use of the IOL.
