Couching (ophthalmology) facts for kids
Couching is a very old way to treat cataracts. A cataract is a cloudy spot that can form in your eye and make it hard to see clearly. This surgery involves gently pushing the cloudy part of the eye (called the lens) out of the way. This helps light get into the eye again, making vision clearer. It was one of the first eye surgeries ever done!
A Look Back in Time
Couching is one of the oldest known surgeries for eyes. People have been doing it for thousands of years. Some historians think this procedure might be mentioned in the ancient laws of the Code of Hammurabi from around 1792–1750 BC.
An ancient Indian surgeon named Sushruta wrote about couching in his medical book, the Sushruta Samhita, around 800 BC. After that, the technique spread all over the world. There is proof that couching was done in places like China, Europe, and Africa.
After the 18th century, newer and better ways to do cataract surgery were invented. Because of these modern methods, couching became less common. However, it is still used today in some parts of Asia and Africa.
Sushruta described how a curved needle was used to push the cloudy material in the eye out of the way. He also wrote about how the eye would then be treated with warm, clarified butter and bandaged.
Couching Today
Couching is still used in some developing countries. This is often because modern eye surgery might be hard to get there. Also, some people prefer to use traditional treatments. For example, in parts of Sub-Saharan Africa, couching is still common.
In countries like Mali, couching is sometimes more popular than modern surgery. This is even though modern surgery often has much better results. In Burkina Faso, many patients didn't know what caused cataracts. They sometimes thought it was due to fate. Couching is usually done by local healers or traditional practitioners, not by eye doctors.
How the Technique Works
In couching, a sharp tool, like a thorn or a needle, is used to make a small hole in the eye. This hole is usually made near the edge of the cornea (the clear front part of your eye) or the sclera (the white part of your eye).
Then, the cloudy lens is pushed downwards and out of the way. Once the person can see shapes or movement, the procedure is stopped. After couching, the patient no longer has a lens in their eye. This means they need very strong glasses to see clearly.
What Are the Results?
Couching is usually not a very successful surgery. Most people who have it done do not get good vision back. More than 70% of patients are left with very poor vision, often worse than 20/400. This means they are considered legally blind.
Studies have shown that couching can also lead to other problems. These can include secondary glaucoma (high pressure in the eye), bleeding inside the eye, and damage to the optic nerve. Because of these risks and poor results, couching is not as good as modern cataract surgery.
