![]() ![]() The Old World skills and techniques in every medical area, including ophthalmology, were gradually transferred to the Americas. Diseases such as smallpox, measles, scarlet fever, typhoid, cholera, diphtheria, and malaria were introduced to the Americas, 1 where the native populations who lacked immunity suffered very high mortality rates. The establishment of European colonies in the New World after 1492 brought about the proximity of indigenous, European, and African cultures, each with distinct approaches to medical care. Other eye procedures described or advertised in America before the 19th century included enucleation, resection of conjunctival lesions or periocular tumors, treatment of lacrimal fistula, and fitting of prosthetic eyes. John Warren at Harvard preferred couching in the 1790s, but, after his son returned from European training, recommended treating angle closure glaucoma by lens extraction. Charles F Bartlett, the son of John, performed cataract extraction but was also a “rapacious privateer.” In 1801, a doctor in the frontier territory of Kentucky observed anticholinergic poisoning by Datura stramonium (Jimsonweed) and suggested that this agent be applied topically to dilate the pupil before cataract extraction. After the war, cataract extraction was imported to America in earnest and academic development resumed. ![]() The American Revolution negatively affected ophthalmology, as loyalist surgeons were expelled and others were consumed with wartime activities. ![]() North American physicians knew of contralateral loss of vision after trauma or surgery (sympathetic ophthalmia), which they called “sympathy.” To date, the earliest identified cataract couching by a surgeon trained in the New World was performed in 1769 by John Bartlett of Rhode Island. In New Spain, surgery for corneal opacity was performed in 1601 and cataract couching in 1611. European settlers used harsh treatments, such as bleeding and blistering, when the eyes were inflamed or had loss of vision with a normal appearance (gutta serena). Indigenous healers rubbed or scraped the eyes or eyelids to treat inflammation, corneal opacities, and even eye irritation from smoke. ![]() New World plants, such as tobacco, tomato, and chili, were held to have beneficial effects on the eyes. ![]()
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