Cataract operations, like all surgical procedures, have come a long way since I trained as nurse well over sixty years ago, between 1955 and 1958.
Now that I’ve had cataract surgery on both eyes and proudly wear new spectacles, I’m in a good space to write about the recent history of the operation which makes an enormous difference to the lives of millions of older people around the world.
Royal Perth Hospital was Perth’s major training hospital for nurses and doctors. Fremantle and Princess Margaret Hospitals also trained nurses, and the one which would become the Sir Charles Gairdner Hospital opened in 1956 as the Perth Chest Hospital.
Trainee nurses worked in an apprenticeship system while sixth year medical students did ‘placements’ and newly graduated doctors were appointed to positions as resident doctors..
The history of cataract surgery goes back to ancient times. You can read the history here.
During my nursing training over sixty years ago, I did a compulsory stint in the newly opened eye ward in the new block at Royal Perth Hospital. Ward 22, the Eye Ward, was a state-of-the-art facility, although In those days no one undertook cataract operations lightly, least of all patients.
Long-suffering men and women were admitted the eye ward the evening before their operation. Anaesthetists administered a general anaesthetic before surgery began. Surgeons operated on both eyes on the same day. Wounds in eyes required sutures.
Back in the ward after their surgery, patients lay on their backs, confined to complete bed-rest in a darkened room for a week after their surgery. For most of that time, we wedged their heads between sand-bags to prevent movement, to ensure that their new lenses remained in place.
A nurse sat beside them, ready to attend to their every need, 24 hours a day. This process is called ‘specialling’. The descriptor ‘special’ applies to a nurse who performs the duty, although he or she may not have specialist skills in a particular area. The practice is meant to minimise harm to the patient and can it also be therapeutic.
One of my daughters tells me that when she worked as a nurse-in-training at Sir Charles Gairdner Hospital twenty-five years later, three or four patients shared a room, cared for by two nurses around-the-clock for three days.
When my father had cataract surgery in the late 1980s, he was in hospital for three days, then came to my house where I cared for him for a few more days. When his bandages came off in the surgeon’s rooms, he exclaimed,
Oh! I’d forgotten all about mauve!
Failed eye examination
The only examination I have ever failed was the one that related to the health of eyes, their diseases and treatments.
After working seven gruelling nights in a busy gynaecological ward, and three hours sleep that morning, I fronted up for the exam, scheduled for 1.00 p.m. my heart wasn’t in it, and my energy was low.
That evening I returned to the gynaecology ward for another two nights’ work before my nights off duty. The apprenticeship system of nursing took no account of our working hours nor our need to study as well as to work 48-hour weeks in the wards. Lectures and exams happened in a random fashion, so a nurse did not need to be working in an area to have to go to lectures and sit examinations.
Hooray for university education of nurses!
Cataract operation 2018
How cataract operations have changed! Six of us in a row in recliner-rocker chairs submitted to admission procedures, a chat with the anaesthetist and eye drops administered at quarter-hourly intervals. We made small talk while we waited.
One-by-one, at about half-hourly intervals, staff pushed us in wheelchairs to an anteroom, where cannulae were inserted in our arms, before taking us to the operating theatre. A pleasant state of altered consciousness followed the introduction of intravenous drugs.
‘You do know I’m awake,’ I said.
‘Yes, but you can’t feel anything,’ someone answered.
‘True,’ I thought. ‘But I am looking at a very bright light. Quite pleasant, really.’
Back in my recliner-rocker with a patch on my eye, someone gave me sandwiches and coffee to break my fast before being collected and taken home.
The following morning
The next morning, the patch came off.
Many people report being able to see immediately. My vision, on the other hand, recovered over a week, which the ophthalmologist said was a satisfactory outcome, given the density of my cataracts.
I’d been told by friends who seemed to know that the cataract operations would be no more traumatic than a trip to the dentist, but it was more involved than that. But certainly not unpleasant except for the betadine in my hair and the prohibition on swimming for two months.
The result is amazing. Now that both eyes have their new plastic lenses, I can see into the distance. One eye responded by being able to read tiny print, as well. Bonus! The next step, very soon, will be new spectacles. Then there’ll be no stopping me from reading all those books I’m saving.
My experience has been very different from that which people experienced all those years ago when I was young. Then, cataract operations included major inconvenience and disruption to people’s lives. Now, it is hardly worth talking about. But how could I resist sharing this story?
Here’s a video of the procedure of a modern cataract operation from All About Vision.