Couching

Begijnhofkerk Sint-Jan Baptist Interior 14

Error creating thumbnail:

Bayeux tapestry laid work detail.

Error creating thumbnail:

Tahriri work

Error creating thumbnail:

Couching

Couched filling

Couching is an ancient method of treating cataracts, a common eye disease characterized by the clouding of the lens of the eye, leading to decreased vision. The practice of couching dates back to antiquity, with evidence of its use in civilizations such as ancient Egypt and India. Despite its historical significance, couching is now considered obsolete and unsafe compared to modern cataract surgery techniques.

History

The earliest records of couching can be traced back to around 600 BCE in ancient India, as documented in the Susruta Samhita, a foundational text of Ayurveda, the traditional system of medicine in India. The technique was later adopted in other parts of the world, including ancient Egypt, the Middle East, and eventually Europe, where it was practiced until the 18th century.

Procedure

Couching involves the use of a sharp instrument to dislodge the clouded lens from its normal position in the eye and push it away from the line of vision into the vitreous body of the eye. This procedure was performed without anesthesia and was highly risky, often leading to severe complications such as infection, blindness, and eye inflammation.

Complications and Decline

The lack of sterility and precision in the couching technique led to numerous complications, making it a dangerous practice. With the advent of modern surgical techniques, particularly the development of intraocular lenses (IOLs) and advanced cataract surgery methods in the 20th century, couching became obsolete. Modern cataract surgery involves the removal of the clouded lens and its replacement with a clear artificial lens, offering a safer and more effective treatment.

Cultural Significance

Despite its risks, couching holds a place in the history of medicine as one of the earliest forms of surgery. It reflects the human endeavor to treat diseases and improve quality of life, even with limited knowledge and tools. The transition from couching to modern surgical techniques highlights the evolution of medical science and the ongoing efforts to enhance surgical safety and outcomes.

Current Status

Today, couching is strongly discouraged by the medical community, and it is considered an unsafe practice. Efforts are made to provide access to modern cataract surgery techniques worldwide, especially in developing countries where couching might still be performed due to lack of resources and access to healthcare services.