Lest We Forget
In this Remembrance Week, thoughts turn to the horrors of war. Man’s inhumanity to his fellow men knows no boundaries. Yet, despite all the carnage, or more probably because of all the carnage, major technological and medical advances happen in times of conflict.
In the Great War knowledge of neuro-anatomy and brain function increased exponentially following on from the huge numbers of head wounds. In the Second World War plastic and reconstructive surgery took giant strides forward. More recently, major advances in the rehabilitation of brain injured service personnel have occurred. The foundation of our knowledge of visual function is based on studies of these badly injured service men and women.
Having the optics of our eyes fully functioning is a prerequisite of an efficient visual system. But vision is not just the ability to see clearly. It is how our brains process and interpret the information falling on our retinas. One of the greatest recent advances in knowledge of brain function is the concept of “neuro-plasticity”. When I trained many years ago we were indoctrinated with the idea that the visual system stopped developing at around the age of six years. Hence little effort was made to help older children and adults with squints and amblyopic “lazy” eyes. Following on from treating brain injured war veterans we now know the brain never ceases to adapt. The concept of “plasticity” of the visual system has enabled treatment regimes for patients with longstanding squints and “lazy” eyes to be developed. It is now possible for older patients with no depth perception to develop stereopsis (3D vision). It is even possible to train patients with squints to voluntarily straighten their eyes without the need for surgery. We are truly living in exciting times. Our debt to our service personnel is huge.