Couching: ancient eye surgery

• Posted on: Oct 15 2020
• By: Jim Wiegand

It’s Halloween season and that means scary, frightening ghosts and goblins are on the way. Thankfully there’s nothing spooky when it’s time for cataract surgery, not to mention anything to be afraid of. But centuries ago, that wasn’t always the case.

Before modern cataract surgery came to be, even before slightly less modern cataract surgery came to be, there was a technique to deal with cloudy lenses called couching.

Couching is the oldest documented technique for dealing with cataracts, and among the oldest performed surgical procedures. It was first documented back to the 6^th century B.C. in India by the surgeon Shushruta, though couching was likely performed by the Egyptians for centuries before. Over the years, the procedure was later used by the Greeks, Romans, Arabs and Europeans, and in some remote areas around the world it continues to be used today.

If you’re squeamish, perhaps you should stop here.

The couching procedure is simple and involves and long, sharp object similar to a needle or a thorn that is thrust into the eye near the limbus. The clouded lens (cataract) is pushed back into the eye, which allows light to enter. As a result, the patient is only able to see movement or basic shapes, though the cloudiness is gone. For the patient to see well again, glasses with a strong prescription would be required – technology that wasn’t available in the past!

So, imagine a shaman or “surgeon” jamming a pointy object into your eye without anesthesia OR probably much training OR sterilized equipment – to help you see better. Now we think that’s scary!

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