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Part III: Can We Cure Nearsightedness?

In part two of “Can We Cure Nearsightedness” we went over ways to control the progression of nearsightedness by spending more time outdoors and getting more exposure to daylight, as well as, reducing the amount a patient accommodates or focuses by practicing a safe Harmon distance. As a reminder, the Harmon distance is the distance from the eyes to the patient’s elbow while the fist is on the chin. The Harmon distance is best utilized in conjunction with the 20/20/20 rule, which relaxes the accommodative or focusing system by looking 20 feet away every 20 minutes for 20 seconds. In addition to spending time outdoors, using the Harmon distance, and practicing the 20/20/20 rule, specialty soft contact lenses, hard contact lenses and diluted Atropine eye drops can also slow the progression of myopia.

As previously discussed, axial length, which is the length of the eye from front to back, is directly correlated with nearsightedness and its progression. The longer the eye the more nearsighted a person will be. Recent research has demonstrated that eye growth or axial length is regulated by the peripheral retina. Current standard prescription methods; soft contact lens, hard contact lens and glasses, primarily produce a clear focus on the central retina (macula) resulting in crisp clear distance vision. It is now believed however, that because the peripheral retina under these circumstances is not as stimulated with a clear focus, this scenario triggers an increase in eye growth or axial length.

To combat this, Cooper Vision developed the first FDA approved soft contact lenses called MiSight, to slow the progression of myopia. This lens is a daily disposable lens that works by bringing the image from behind the peripheral retina directly onto the peripheral retina decreasing the stimulus for the eye to become longer. Studies show this soft lens design can reduce nearsighted progression by 40-55%.

Another contact lens fitting method, orthokeratology, uses hard contact lenses to both reshape the cornea reducing nearsightedness as well as, reduces the shift in nearsightedness secondary to peripheral retinal defocus and increased axial length as described above. Orthokeratology requires sleeping in hard contact lenses at night while being contact lens free during the day. It is important to note that corneal reshaping requires more visits in order to get the right fit and typically, it takes a few days or weeks for vision to remain clear enough to function without correction during the day. Orthokeratology can reduce myopia progression on average by about 50%. It is important to know this method requires long-term contact lens wear for maintenance.

Next week in Part IV of Can We Cure Nearsightedness, we will discuss diluted Atropine eye drops. If you think someone in your family would be a good candidate for myopia control, please call our office today at 405-372-1715. If you missed Part I or Part II of Can we Cure Nearsightedness, we invite you to visit our website at and afterwards message us on Facebook or Instagram at Cockrell Eyecare Center!

Part II: Can We Cure Nearsightedness?

In part one of “Can We Cure Nearsightedness” we discussed myopia, its incidence and the expected increase over the next 30 years. Currently there are a number of clinical approaches to preventing or slowing the progression of nearsightedness. These approaches include spending more time outdoors, reducing the focusing demand on the eyes by holding reading or gaming materials at a specific distance, or by frequently looking in the distance to relax the eyes. To make sure the eyes are relaxed while performing near work, reading or computer glasses are also an option. New to the market this year, MiSight, a specialized soft contact lens not only corrects distance vision, but it also reduces the stimulus causing the progression of myopia. Orthokeratology, which has been around for years, uses a specially designed gas permeable contact lens patients sleep in the lens to reshape the steep curvature of the eye resulting in reduced nearsightedness. There is also a pharmaceutical option. Low-dose Atropine drops can be used on a daily basis to slow myopia progression. These options may be used alone however, for the best outcome are used in combination

Two of the simplest ways to reduce the progression of myopia with the least amount of effort would be to have your children spend more time outdoors and/or control their accommodation. Accommodation is the ability of the eye to change its focus from distance to near objects (and vice versa). This process is achieved by the lens of the eye changing its shape and the eyes converging together as a person looks up close. The closer the reading material is to the face the more accommodation and convergence is required.

With respect to spending more time outdoors studies revealed that for each additional hour per week that children spent outdoors, their risk of being nearsighted dropped by two percent. Nearsighted children in this study spent on average 3.7 fewer hours per week outdoors than those who either had normal vision or were farsighted. The study also investigated whether children who logged more outdoor time also spent less time performing near work, such as playing computer games or studying, but no relationship was found.

Another study showed that the rate of eye growth in children (axial length) varied in relation to exposure to daylight. As described in last week’s article, the longer the eye or axial length the more likely the person is nearsighted. In the study, children’s eyes grew normally during the long days of summer, but grew fast during the short days of winter. The benefit of spending more time outside appears to be related to exposure time to daylight, but the exact reason is unclear. It was clear though, that the children who spent more recess time outdoors were less likely to become nearsighted.

Reducing the amount a child has to focus or accommodate during near work has long been theorized to slow myopia progression. Although the clinical value of this is limited, it does have some effect. This can be accomplished by having the child keep his or her reading distance at what is termed the Harmon distance. The Harmon distance is the distance from the eyes to the patient’s elbow while the fist is on the chin. In addition practicing the 20/20/20 rule further relaxes the accommodative system for brief periods. Children are educated to look 20 feet away, every 20 minutes, for 20 seconds.

Counselling children and teenagers to perform these habits are limited in success. Therefore, prescribing reading or computer glasses for the same effect of reducing accommodation can be beneficial. There are many designs of reading or computer glasses; single vision, bifocals, blended bifocals and progressives. Non-glare and blue light blocking lenses add additional comfort for these lens designs.

These are just some of the clinical approaches to reducing myopia progression. Over the next two weeks, we will discuss MiSight soft contact lens, orthokeratology and low-dose Atropine. If you missed Part I of Can we Cure Nearsightedness we invite you to visit our website to view it at If you have questions about our articles please contact our office in Stillwater at 405-372-1715 or message us on Facebook at Cockrell Eye Care Center!

Part I: Can We Cure Nearsightedness?

Nearsightedness, or myopia, is a visual condition in which patients cannot see clearly in the distance however, can see clearly at near. The level of vision a person has at distance or near varies depending on if the patient has mild, moderate, severe, or extreme myopia. A mildly myopic person for example, may just lack fine details while looking in the distance where as a moderate to severely myopic person may only see color and movement looking at the same distance. Near vision can be very good in a mildly myopic patient allowing them to see an object clearly at 16 inches however, a severely myopic person may have to hold the same object an inch in from their face to see it clearly.

Nearsightedness occurs for a combination of reasons. In general, the power of the eye is too strong so the focal point of the eye is very close to the face. The reason the focusing power is too strong is due to one or more of the following factors. Either the eye is too long, the lens of the eye is too powerful, or the curve of the cornea is too steep. All three result in a very short focal point. The more nearsighted, the shorter the focal point.

For children the risk factors for becoming nearsighted include having one or both parents who are myopic, performing excessive near work such as reading or using digital devices, and spending little time outdoors. Individuals that typically become moderate to severely nearsighted are children that are more nearsighted than the age expected normal and those that show progression of nearsightedness more than 0.75 diopters (D) per year.

Current statistics and predictions regarding nearsightedness are alarming. Researchers at the Brien Holden Vision Institute in Sydney, Australia, analyzed data from 145 studies on nearsightedness from 1995 to 2000. The analysis concluded that 23% of the total global population or 1.4 billion people are nearsighted. The same research group looked at data trends from 2.1 million study participants and predicted that this figure will climb to 4.8 billion by the year 2050. That would account for 49.8% of the world’s population!

Nearsightedness and its progression is a concern because of several factors. Most importantly, the increase in incidence of myopia among young people is exploding. Most of us take for granted that we can wake up see the alarm clock, watch TV, drive and play sports and work without vision correction. Nearsighted people cannot perform these activities without glasses or contact lens. Myopic individuals also have a higher incidence of eye health complications associated with nearsightedness. For example, as a person becomes more nearsighted, the axial length of the eye increases causing the retina to stretch and become thinner. Stretching and thinning of the retina makes the eye more susceptible to retinal holes and tears. These conditions can lead to retinal detachment resulting in total or severe vision loss. Glaucoma, the second leading cause of blindness in the US, is also more common in nearsighted patients. Finally, myopic macular degeneration, which is similar to age-related macular degeneration, may also occur and result in central vision loss. Research shows that reducing nearsightedness by 1 diopter can reduce these risks by 40%.

At Cockrell Eyecare, our goal is to play a role in reducing the incidence of nearsightedness and help our patients become educated on how this works. We are calling March Myopia Control Month for our Eye-To-Eye column. Please plan to visit our column every Sunday this month we will discuss the research associated with the current clinical approaches to reducing the incidence of myopia. If you have questions please contact our office in Stillwater at 405-372-1715. We also invite you to visit our website at and like us on Facebook at Cockrell Eye Care Center!

Nyctalopia (Night Blindness)

Night blindness, also called nyctalopia (nik-tl-oh-pee-uh), is the inability to see well at night or in poor light. It was first described over 2000 years ago. Nyctalopia is not a disease, but rather a symptom of many different conditions, some treatable, some not. Historically, it was known as “moonblink” and believed to be a temporary condition caused by sleeping in the moonlight of the tropics.

Nyctalopia is due to a disorder or disease of cells in the retina called rods. Rods are responsible for our ability to see in dim illumination. By contrast, cones of the retina are responsible for our ability to see detail and color vision in lighted conditions. Rods contain a pigment called rhodopsin that allows us to see at night. The body synthesizes rhodopsin from vitamin A which is why we are told to eat carrots. The eyes continually produce rhodopsin, but in the daytime it is continually bleached out by light. This is why when you walk from the hallway of a movie theater into the movie, sometimes you have to stop to allow your eyes to adjust to the dark. You can think of this as changing from using cones to rods or, the time it takes to regenerate enough rhodopsin to see in the dark. Maximum dark adaptation can take up to 48 hours. Another common example is when you go to sleep at night the room seems very dark however, when you wake up in the middle of the night it seems less dark or even brighter!

Nyctalopia can vary on a scale from very mild to so debilitating that driving at night or going outside in the dark is not possible. Disorders or diseases that cause nyctalopia include: nearsightedness, glaucoma, diabetes, retinitis pigmentosa, vitamin A deficiency, cataracts, various medications, some refractive surgeries and laser treatment for diabetic retinopathy.

Contrast sensitivity describes the ability of the visual system to distinguish bright and dim components of an image. Nearsightedness, cataracts, various medications and some refractive surgery cases cause nyctalopia through the reduction of contrast sensitivity.

Glaucoma, diabetes, and retinitis pigmentosa result in damaged or diseased rods in the retina resulting in nyctalopia. Laser treatment of the retina for diabetic retinopathy results in damage to the peripheral retina where most rods are concentrated and therefore significantly reduces night vision.

Nyctalopia can be treated by improving contrast sensitivity through quality optical products including digitally surfaced and non-glare lenses. Various tinted lenses may also help. Maintaining control of diabetic retinopathy, glaucoma and having cataracts removed when necessary, can prevent or delay potential night blindness. Diet is also very important not only to control blood sugar, but to avoid vitamin deficiencies particularly vitamin A.

Finally, get an eye health evaluation to rule out all of the above listed causes of nyctalopia. Preventative eye care can be very helpful in avoiding this condition. Please contact our offices in Stillwater at 405-372-1715 for your eye health evaluation. We also invite you to visit our website at and like us on Facebook at Cockrell Eye Care Center!

Include Pre-K Children in Back to School Eye Exams

Children with uncorrected vision conditions or eye health problems face many barriers in life. These barriers can occur academically, socially and athletically. Comprehensive vision and eye health evaluations at an early age can break down these barriers and help enable your children to reach their highest potential.

Vision doesn’t just happen. In fact, a child’s brain learns how to use eyes to see just like it learns how to use legs to walk or a mouth to form words. The longer a vision problem goes undiagnosed and untreated, the more a child’s brain learns to accommodate the vision problem.

Eighty percent of all learning is performed through vision which is why a comprehensive eye examination is so important for young children. Early detection and treatment provide the very best opportunity to correct vision problems so your child can learn vision skills to see clearly. Taking this step will make sure your child has the best possible tools to learn successfully.

Preschool Vision

During the infant and toddler years, your child develops many vision skills and begins to learn how to see. In the preschool years, this process continues as your child develops visually guided eye-hand-body coordination, fine motor skills and the visual motor skills necessary to learn to read.

As a parent, you should watch for signs that may indicate a vision development problem, including a short attention span for the child’s age; difficulty with eye-hand-body coordination in ball play and bike riding; avoidance of coloring, puzzles and other detailed activities performed at near reading distance.

There are everyday things that you can do at home to help your preschooler’s vision develop as it should. These activities include reading aloud to your child and letting him or her see what you are reading; providing a chalkboard, finger paints and different shaped blocks and showing your child how to use them in imaginative play. In addition, providing opportunities to use playground equipment like a jungle gym and balance beam and allowing time for interacting with other children and for playing independently are all very important.

By age 3, your child should have a thorough optometric eye examination to make sure their vision is developing properly and there is no evidence of eye disease. If needed, your doctor can prescribe treatment including glasses and/or vision therapy to correct vision development problems.

Here are tips to make your child’s optometric examination a positive experience:

  1. Make an appointment early in the day. Allow about one hour.
  2. Talk about the examination in advance and encourage your child’s questions.
  3. Explain the examination in your child’s terms, comparing the E chart to a puzzle and the instruments to tiny flashlights or a kaleidoscope.

At Cockrell Eyecare we participate in a program designed to seek out vision problems in Pre-K children specifically, three year olds. The program is called SEE TO LEARN. The goal is to detect vision conditions or eye health issues that require attention at an early age. Studies indicate that more than 20 percent of kindergarten children have vision problems, and this number climbs to 40 percent by the time these children reach high school graduation. Many eye conditions require care before the age of five to avoid a permanent compromise in vision.

The SEE TO LEARN program provides free vision analysis to three year olds. We invite you to contact our office in Stillwater @405-372-1715 for more information about this program. We also invite you to visit our website at and like us on Facebook at Cockrell Eye Care Center!

Why Your Child Needs an Eye Exam

As the first semester of 2014-2015 school year comes to an end, parents are hopeful their children are meeting and exceeding the minimum standards to excel in school. Most have had a parent-teacher conference and have asked this question. It is important from a parent’s perspective to know that reading ability is the single most influential factor that will determine their child’s success in school.

A child’s academic performance determines many of their future opportunities and their ability to read well early on will impact their entire future. Eighty percent of all learning is performed through vision. Statistics show that about 3 out of ten 10 children are at risk for undiagnosed vision problems so this means that 30% of children are at risk for learning difficulties due to uncorrected vision or eye coordination problems. Children with uncorrected visual and eye coordination problems face many obstacles. They can struggle academically or with social activities and in athletics. If their visual difficulties continue to go uncorrected, they continue to fall behind in school until they reach a point where they can’t catch up and become so frustrated they begin acting out. This behavior becomes a self-perpetuating cycle that can significantly influence the course of a child’s life.

An effort to catch these problems is found in school vision screenings. Vision screenings are an important service provided by most schools and the benefits can be far reaching. There are many children who simply need to have reading glasses or help with eye coordination to improve tracking which in turn improves reading ability. Unfortunately, it’s easy for them to be overlooked and put under various labels such as: learning challenged, learning disabled, ADHD, or ADD. Vision screenings work to prevent this; however, screenings should be recognized as having a limited ability to truly assess a child’s ability to function in the classroom.

Vision screenings typically only evaluate visual acuity or how small of letters a child can see in the distance and at near. According to the American Foundation for Vision Awareness, the methods employed in vision screenings only identify 5% of the vision problems in children. Knowing a child has 20/20 vision in the distance does not indicate whether or not his eyes are able to work together to read materials 12 inches away, whether or not they can properly track letters on a page, or if there is an eye health problem or vision perception problem. In addition to that, fewer than 50% of the children identified in a screening as needing professional eye and vision care ever receive that care, and for those who do, the average time between the screening and the exam is 18 months.

While screenings can be very beneficial, they do not replace a full eye exam. Correcting vision problems from an early age is crucial in allowing a child to succeed to the fullest. Children should receive a comprehensive eye exam beginning in Kindergarten. As a child progresses through school, their academic curriculum changes, and with it, their visual needs. For these reasons, it is especially important that children receive a comprehensive vision and eye health evaluation from an optometrist on a yearly basis. Correcting vision problems from an early age is crucial in allowing a child to succeed to the fullest.

If you would like to schedule an eye exam for your child, or if you have questions regarding children’s vision and school screenings, please contact our office in Stillwater at 405-372-1715. We also invite you to visit our website at and like us on Facebook at Cockrell Eyecare Center!

Retinal Detachment: How would you know?

I got a floater a couple of months ago, which I ignored because I’ve had many. I also then got a flashing in my right eye. I was due into the eye doctor and was going to mention this, having no idea this was important………

About three weeks ago, I started seeing a half moon at the lower part of the eye and within about three to four days my vision was half blocked by this moon……….

On a Sunday, I began to notice an area near the nose-side of my left eye. The area was gray, but I could see through it. By Monday, the area had grown to cover the center of my eye……….

About seven weeks ago, I noticed flashing lights in my peripheral vision while driving at night. I mistakenly thought it was a vehicle moving into my lane! Later that evening what appeared to be wisps of dark smoke or cobwebs began floating across my right eye………. .

One week after running into a glass window, thinking it was an open sliding door, I noticed a small, dark spot in the inside corner of my right eye. The spot grew to the point that it covered my pupil……….

You have just read five patient’s accounts of what preceded their retinal detachments. The retina is an extremely thin tissue that lines the inside of the back of the eye. It is responsible for what we see and is thus referred to as the “seeing tissue of the eye”. Objects we look at are focused onto the retinal tissue by the cornea and lens of the eye. Nerve endings within the retina transmit these images to the brain through the optic nerve. If the retina detaches from the inside of the eye vision can be permanently lost unless the retina is repaired in a timely manner.

A retinal detachment is simply the separation of the retina from within the eye. Retinal detachments occur for a variety of reasons however, a common cause is when the vitreous gel pulls loose or separates from its attachment to the retina. This is called a vitreous detachment. A vitreous detachment is something that occurs as we age and is considered a normal aging change. As the vitreous gel pulls loose it can sometimes cause traction on the retina and result in a retinal tear. Retinal tears will progress to retinal detachments if not promptly diagnosed and treated.

Retinal detachments are more likely to develop in people who are nearsighted or those with a family history of retinal detachment. Trauma to the eye, such as a contusion, direct blow or a penetrating wound, may be the cause but in the great majority of cases retinal detachments result from internal changes in the vitreous chamber associated with aging, diabetes, or less frequently, with inflammation inside the eye.

Symptoms of retinal detachment include flashes of light, wavy or watery vision, a veil or curtain obstructing vision, a shower of floaters that resemble spots, bugs, or spider webs, or a sudden decrease in vision. It is critical that these symptoms be reported immediately because timely treatment can greatly improve the chance of restoring vision in the event of a retinal detachment. Immediately upon experiencing symptoms such as these, you should see your eye doctor. In the event you are simply experiencing a vitreous detachment, you will be given additional symptoms to watch for and asked to return for a follow up visit. The follow up visit is as important or, even more so, to ensure the vitreous changes are completed and you are safe for dismissal.

Retinal detachments require surgery to return the retina to its proper position inside the eye. There are several ways to fix a detached retina. The decision of which type of surgery is based on a number of factors including location of the retinal tear or detachment, pre-existing conditions, health of the patient, and cause of the detachment.

If you ever experience any of the symptoms described above, please contact one of our office in Stillwater at 405-372-1715 . If it is after hours or on the weekend, we always have a doctor on call to evaluate you right away. We also invite you to visit our website at and like us on Facebook at Cockrell Eyecare Center!

Sports Eye Injuries

According to the National Society to Prevent Blindness, almost 40,000 eye injuries a year are reported to be related to sports and recreational products. This number only reflects those that were reported, and estimates have been as high as 100,000 injuries a year. The sad part about eye injuries is that they often result in permanent damage, and over 90% of the injuries sustained could have been prevented. Many athletes have lost their careers due to eye injuries. The eyes are probably one of the most important parts of the body needed to effectively compete in sports however; most people don’t take measures to protect them. They protect their head with helmets and their bodies with pads, but few wear eyewear to protect their eyes.

There are many factors that will increase your risk to injury. Those with low skill levels, often found in the younger athletes, are at a greater risk. About 44% of the reported injuries were to children under the age of 14. Thus, young children should be protected, as any eye injury could permanently end a child’s future in sports. Also, those with pre-existing eye conditions are at higher risk. For instance, if a child has poor or reduced vision in one eye and good vision in the other, extra precautions should be taken to protect the good eye at all cost. Injury to the good eye could result in the inability to drive or be employable. Also, those with high prescriptions might be at higher risk for permanent damage due to the inherent weaknesses pre-existing in their eyes. Also, those who have had eye surgery may also be at greater risk, since surgery may have weakened the natural state of the eye.

Other factors that increase your risk are the sport you are playing. Participating in a moderate to high risk sport signals the need for eye protection. Low risk sports usually do not involve a ball or bat, and are more commonly individual sports like competitive swimming, and track and field. Moderate risk sports may involve the use of a ball or bat, and are more often team sports. Sports injuries usually are a result of the ball hitting the eye, or a teammate or opponent poking the eye with a body part. Such sports should require protective eyewear. High risk sports are sports that involve direct physical contact, such as boxing, karate or wrestling. Usually no protective eyewear is worn in these sports. Caution and extra consideration should be taken by those who have an existing eye weakness if and when participating in high risk sports.

Eye injuries may seem rare, but they are not. More aggressive play in sports has resulted in more and more eye injuries being reported every year. The most recent data indicates the top four sport activities where eye injuries occur are basketball, baseball, swimming pool sports (horseplay), and racquet and court sports. Virtually 100% of these injuries could be avoided with proper protection. There are numerous sports goggles available to provide protection and still allow excellent vision. These can be worn over your contact lenses or have your individual prescription in the lenses. Polycarbonate lenses are recommended because of their impact resistance. Various styles and colors to match your taste or your team are available. In addition, for outdoor sports, tints or polarization can be applied to enhance your vision and decrease glare.

At Cockrell Eyecare we have a wide variety of protective sports eyewear. What we don’t have we can usually order. Most major insurance vision plans have benefits for sports eyewear if your prescription is included. Please visit or call our office in Stillwater at 405-372-1715 to inquire about protective eyewear for all activities. We also invite you to visit our website at and like us on Facebook at Cockrell Eye Care Center!

The Hazards of Looking Good

Magazines, newspapers and TV smother us with images of the ideal look. In fact, the average American woman spends 12K a year to look good! This figure may seem high however, consider what you spend a year on all beauty and grooming products, hair and nail appointments, and of course clothing. Expense of these products alone can cause pain however, if you’re not careful, some of these products can cause costly eye health issues. Careless use of eye makeup and hair dye can cause serious harm to your vision. The U.S. Product Safety Commission estimates that over 250,000 product-related eye injuries are treated annually. Hair dye, commonly applied at home by thousands of women, can cause serious damage and vision loss if used incorrectly. Warnings against the potential harm from these products are stated clearly on all packages, but many people ignore them. To avoid chemical burn to the eyes form hair dye, strictly adhere to the warnings on the package and avoid contact with your eyes. In the event contact is made, flush the eyes with cold water for 20 minutes and then seek immediate care from your Optometrist.

Although cosmetics are typically not as dangerous as hair dyes, they can also lead to eye injuries and irritations. Simple precautions, if followed, can eliminate virtually all of these types of eye injuries. To use makeup safely:

  • Wash your hands before application, so bacteria will not be transferred from your hands to your eyes.
  • Immediately stop using eye products that cause irritation. If irritation persists, see your eye doctor.
  • Use disposable applicators if possible and only use them once.
  • Keep makeup away from excessive cold that can break down the preservatives and allow bacteria to grow.
  • Don’t store cosmetics at temperatures above 85 degrees F. Cosmetics held for long periods in hot cars, for example, are more susceptible to deterioration of the preservative.
  • Avoid products that are labeled natural and preservative-free, since they may breed bacteria.
  • Avoid eye cosmetics that are iridescent, glittery, or shiny, as they may contain ingredients that could scratch or irritate the eye.
  • Do not moisten cosmetics with water or saliva, since this may promote bacterial growth.
  • Never share your makeup with others.
  • Do not switch mascara brushes from one container to another.
  • Avoid kohl eyeliners they may contain dangerous levels of lead.
  • Avoid permanent coloring and dyes for eyelashes, as they can cause irreversible eye damage if not used correctly.
  • Use cosmetics labeled fragrance-free, hypo-allergenic or for sensitive skin, to reduce the chance of allergic reaction.
  • Never use a pin or sharp objects to separate your eyelashes after mascara application.
  • Never put your eye cosmetics on while you’re driving or riding in a car.
  • Remove makeup every night. Never sleep with it on.

If you have questions concerning cosmetics and your eyes please call our office in Stillwater at 405-372-1715. We also invite you to visit our website at and like us on Facebook at Cockrell Eye Care Center!

The History of Cataract Surgery

Cataracts have been a medical problem throughout history. In early times, strange concoctions and eye drops were used to treat cataracts until physicians in ancient Babylon and India began surgical treatment. Their highly primitive method, known as couching, involved using a sharp instrument to push the cloudy cataract lens to the back of the eye clearing the visual axis or line of sight. This method is still used in some parts of Africa today.

In the 18th century, surgeons progressed to making an incision in the eye to remove the entire cloudy lens instead of pushing it back into the eye. Surgeons initially tried replacing the natural cataractous lens with a small glass lens, but were unsuccessful. This made it necessary for patient’s glasses to have very thick lenses in order to see because the lens of the eye provides such a large portion of the power of the eye. Therefore, once the natural lens was removed, the only alternatives were to wear thick heavy glasses or contact lens.

By the 20th century, surgeons learned to remove only part of the cloudy lens and leave the outer clear capsule in the eye. Then during World War II British surgeons discovered that pieces of Plexiglas from a shattered canopy of a fighter plane, lodged in a pilots’ eye, did not cause any harmful reaction. That is, the material was not recognized by the body as a foreign substance causing an infection or inflammation. Using this light, plastic material, British surgeon Harold Ridley designed a lens that was successfully implanted in the clear capsule left behind. This made thick heavy glasses unnecessary after cataract surgery.

In 1968, American surgeon Charles Kelman adapted a new technology called phacoemulsification to remove cataracts. This sophisticated procedure uses ultrasound through a tiny probe to gently break up the cataract and remove it from the inside of the eye. Phacoemulsification is performed through a tiny 2-3mm incision that does not require stitches unlike previous methods that required much larger incisions and several stitches.

Cataract surgery was revolutionized when ultrasound and plastic lens implant technology were combined. Today, after decades of development, modern cataract surgery is considered one of the safest surgeries performed with millions of successful procedures completed yearly around the world. As of late last year, lasers can now be used to make incisions in the cornea and lens, as well as, soften the lens material to be removed.

Oklahoma is proud to have one of the first surgeons to actually use artificial lens implant technology. Dr. J. Harley Galusha from Tulsa, Oklahoma was introduced to implants while on a mission trip in Africa. After his trip he went to Europe and was able to acquire some of the implants that he successfully used on 5 patients in 1974. He was only the fourth surgeon in the United States to implant the lenses and since that time millions of implants with hundreds of different designs have been implanted. Lens implants used today are foldable, silicone or acrylic, can correct astigmatism, and in some cases are multifocal, similar to bifocal contact lens. These lens implants can be inserted through a micro-incision and do not require stitches. These techniques result in very rapid visual recovery and healing with little down time. Drops are used to avoid infection and swelling for 3-4 weeks after surgery at which time they are discontinued.

After cataract surgery, glasses are required to fine tune vision in the distance and almost always for reading. Patients who required thick lenses for high prescriptions prior to cataract surgery can enjoy thin light lenses afterwards because the majority of the power required is in the lens implant. Most patients can be fitted with glasses 4-6 weeks after surgery. At this point patients are dismissed for yearly eye health examinations.

If you have questions concerning cataracts or cataract surgery, please contact us in Stillwater at 405-372-1715. We also invite you to visit our website at and like us on Facebook at Cockrell Eye Care Center!