CHAPTER XXX

CATARACTS

CATARACT is the name given to an abnormal condition of the eye in which there is some opacity in the lens. This happens so frequently in later life that many are familiar with the story of the affliction. Very few however, have any knowledge of the many diverse manifestations of changes in the lens which produce different kinds and degrees of opacities, in young as well as in old. There are so many different types of cataracts that one ophthalmologist jokingly remarked that he thought there were fifty-seven varieties.

The opacity may be found in the capsule covering the lens, as well as in the lens itself. It may consist of a hard, dense tissue, or be of a softer and less opaque consistency. It is found in widely different shapes and sizes, The spots may be sharply defined, or diffused over a large area of the lens. A small, hard spot, in the middle of the lens impairs vision much less than does a soft and thin opacity which is spread through the width of the lens. Some spots on the margins of the lens are hardly discernible, and do not interfere with vision. The various types are subject to a difference in the nature of the changes which take place in the character of the tissues. Some are described as partial-stationary, because they are permanently limited to the same dimensions. Others are called progressive, because they spread progressively over a larger area of the lens.

Cataracts are spoken of as congenital when they are found at birth, or discovered later when they attract attention. Those are supposed to be due to some fault in the development during foetal life. The form which is acquired generally appears in later life, but may appear at any age. A cataract may develop so quickly that the lens may be completely opaque in a few hours. It may develop so slowly that its progress continues during many years. The opacity may develop in most irregular stages—increasing for a time, remaining stationary for a variable period, and then increasing for another period only, or progressing continuously until the lens is completely occupied. That is one reason why, sometimes, it is not possible to estimate the probable outcome and the time the process will take. Cataracts may be hard or soft. They may fill the lens with an excess of fluid until it swells. This excess of fluid ultimately is lost. The lens is then spoken of as being "ripe". Often it is difficult to estimate when a cataract is going to become ripe.

In the text books many conditions are given as possible causes of the development of cataracts. General diseases is a term that is used, and diabetes is mentioned specifically, and toxic conditions, and epilepsy, and hysterical convulsions, poison and injuries.

The treatment described in text books includes the correction of any apparent abnormal condition when it is possible. It is explained, for instance, that when the system is relieved of the excess of sugar present in diabetes, there may be a relief from the cataract. Therefore disturbed chemistry, or the presence in the system of a poison, or some toxic condition, may cause a cataract. Also cataract may be caused by whatever abnormal conditions may be developed by hysterical convulsions. But in many cases where cataracts are present it is not possible to find any indications of the presence of any of these conditions.

There are many facts relating to cataracts which I have not been able to find in text books. A patient of mine who had been treated for developing cataracts during several years, by a well known ophthalmologist, came to me finally with the hope that the Sates method would relieve the condition. She had been taking medicine and visiting her eye specialist regularly until some months before she came to me. She stopped the medicine and all treatment because the cataracts were growing steadily, and she was afraid she would lose all her vision. The ophthalmologist had found no indications of any abnormal condition of the system; and as her family physician, during some years, I had never found any abnormal condition, except a mental tension which showed itself only in her conversation. Heart and blood pressure were always normal, and every examination and analysis indicated was carefully carried out to assure her there was no apparent underlying abnormal condition of organs or chemistry. Although she knew of my work with the Bates method, and discussed it with me and with the eye specialist, she never considered trying it until the increasingly serious difficulty with her vision made her determine to try it as a last resort. Her ophthalmologist had told her the cataracts were not in a condition to be operated upon.

During two weeks of almost constant practice of the various techniques of the Bates method, she secured such an improvement that her eyes were almost normal for near and far vision, and were satisfactory for continued reading, and every other use of daily life. This case was under my care for several years. Her vision continued to be satisfactory, and was better than average for small print and sewing. It was quite variable, however, because her nerve tension became more apparent. Her blood pressure was an average normal when I last took it, at eighty-two years of age, and her heart was in good condition, and there was no evidence of any other organic or functional disorder. Sometimes she came with complaint about some dimness of vision, or change in her power of vision from hour to hour; but even then she would demonstrate by reading fine print readily, and reading the ten-foot line on the Snellen Card at ten feet, that her vision was fine for a woman over eighty years old. She had no difficulty in seeing her way clearly in the midst of street traffic. Nevertheless there remained in her mind the memory of the very poor sight she once had, and these recollections would sometimes impress her mind so vividly that she would have spells of poor vision as a result.

Another case of my own, recorded in the chapter on children, illustrates just the opposite type of cataract, relieved by the same treatment. During an attack of poison oak, with both eyes closed by the swelling of the face, a boy of fifteen developed a cataract which filled his right eye, and was there when his eyes opened. The cataract must have been produced by the toxic condition. During four months of treatment by an ophthalmologist, no least improvement had been secured. Three weeks after I first treated him, three-quarters of the cataract had disappeared, and in a few months there remained no trace.

A different aspect of the subject is illustrated by the case of a woman over eighty, who had very poor vision due to cataracts in both eyes. She discarded her glasses at once, and for the remaining two years of her life she did not use them again, and she could read and write and had satisfactory vision for all purposes. The most significant thing about this case, was that there was very little difference in the appearance of the cataracts. It seemed that the change took place in her visual center. An improvement was apparent at once. Her eyes began almost immediately to respond differently to the same rays of light which before had not registered any conscious impression on her mind. This may seem strange to one who has never deliberated over the many explanations in standard text books on the eye, which point out that better impressions are made on the conscious mind, even with the same rays of light reflected from the same objects, when the visual center is aroused by the attention and desire of the will. This is true in every other field of the work of the mind, and we are all familiar with that fact. It is only because we are not accustomed to giving any attention to the ceaseless functioning of the marvelous mechanism of our eyes, that we are surprised when we are told that they, too, function poorly at times, because our mind is paying no attention to there, and they will respond with more power when we ask them to do so.

Dr. Bates reported a demonstration made by a professor of anatomy before a group of observers. When the professor held the eye of a dead cow loosely between his fingers, the observers could see that the pupil was perfectly clear. But whenever he compressed the eyeball so as to flatten it in the middle, the pupil became completely opaque, and it became clear again as soon as the pressure was released and the eyeball resumed its natural round shape. The opacity was a cataract. Dr. Bates suggested that this experiment can be demonstrated by anyone who is interested. Dr. Bates claimed that patients have increased the density of a cataract by a voluntary effort to harden the eyeball. This was done through the compression of the external eye muscles by means of a tension produced deliberately.

Conversely Dr. Bates claimed, that by relieving an abnormal tension, through the practice of techniques which he described, patients have improved the condition of different forms of cataracts temporarily, and made the improvement permanent by continuing practicing. The various practices suitable for this relief from the tension causing cataracts are given in preceding chapters Palming, and Sunning, and Shifting the Central Fixation, et cetera.