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  • An estimated 20 million cases of blindness worldwide are caused by cataracts,

  • a curable condition affecting the lens that focuses images onto the eye's retina.

  • A cataract occurs when proteins in the lens lose their normal arrangement,

  • clumping together in a way that causes discoloration or clouding,

  • and eventually blocks most vision.

  • Cataracts can be caused by eye injury,

  • certain medications,

  • ultraviolet radiation,

  • diabetes,

  • smoking,

  • or some genetic disorders.

  • But the most common cause is aging.

  • In the United States, more than 50% of people over the age of 80 develop them.

  • Cataracts were treated over 2,500 years ago in India,

  • though similar procedures may have existed even earlier

  • in Ancient Egypt and Babylon.

  • The most common procedure, called couching,

  • involved pressing a sharp instrument into the eye

  • to loosen and push the clouded lens out of the way.

  • Although this could increase the amount of light entering the eye,

  • the lack of a lens would leave the patient's vision out of focus.

  • Despite its low success rate, and high risk of infection or injury,

  • couching is still performed in some parts of the world.

  • Later procedures would also focus on removing the cloudy lens,

  • for example, by making an opening in the cornea to pull out the lens

  • along with the membrane capsule surrounding it.

  • While the invention of eyeglasses allowed for some restoration of focus,

  • they had to be extremely thick to help.

  • Furthermore, such techniques still caused complications,

  • like damaging the retina,

  • or leaving the eye with uncomfortable stitches.

  • But in the 20th century, something unexpected happened.

  • Eye surgeon Sir Harold Ridley was treating World War II casualties

  • when he noticed that acrylic plastic from a shattered aircraft cockpit

  • had become lodged in a pilot's eyes without triggering an adverse reaction.

  • This led him to propose surgically implanting artificial lenses into the eye

  • to replace cataracts.

  • And despite initial resistance,

  • the method became standard practice by the 1980s.

  • Since Ridley's discovery,

  • the intraocular lens has undergone several improvements.

  • Modern lenses can fit into the membrane capsule

  • that the cataract is extracted from,

  • leaving more of the eye's natural anatomy intact.

  • And the ability to fine-tune the lens curvature

  • allows the surgery to restore a patient's normal vision

  • without the need for glasses.

  • Of course, surgical techniques have also progressed.

  • Microscopic procedures use small instruments or lasers

  • to make precise incisions of one or two millimeters in the cornea,

  • while an ultrasound probe breaks up and removes the cataracted lens

  • with minimal trauma to the eye.

  • Low-tech versions of this operation have made the surgery quick and inexpensive,

  • helping it spread across the developing world.

  • Places like Aravind Eye Hospital in India

  • have pioneered high-volume, low-cost cataract surgery

  • for as little as six dollars.

  • Why then, with all these advances,

  • are there still so many blind people in the world?

  • The main issue is access to health care,

  • with poor infrastructure and a shortage of doctors

  • being a major barrier in many regions.

  • But this is not the only problem.

  • In many rural areas with poor education,

  • blindness is often accepted as an inevitable part of aging,

  • for which someone might not think to seek treatment.

  • This is why information is crucial.

  • Increased community awareness programs and the spread of mobile phones

  • mean that many of those

  • who might have remained blind for the rest of their lives due to cataracts

  • are now reachable.

  • And for them, a brighter future is in sight.

An estimated 20 million cases of blindness worldwide are caused by cataracts,

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TED-ED】失明の原因となる治癒可能な状態 - Andrew Bastawrous (【TED-Ed】A curable condition that causes blindness - Andrew Bastawrous)

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    Ann に公開 2021 年 01 月 14 日
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