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A medieval fallacy: the crystalline lens in the center of the eye

机译:中世纪的谬论:眼睛中央的晶状体

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Objective: To determine whether, as most modern historians have written, ancient Greco-Roman authors believed the crystalline lens is positioned in the center of the eye. Background: Historians have written that statements about cataract couching by Celsus, or perhaps Galen of Pergamon, suggested a centrally located lens. Celsus specifically wrote that a couching needle placed intermediate between the corneal limbus and the lateral canthus enters an empty space, presumed to represent the posterior chamber. Methods: Ancient ophthalmic literature was analyzed to understand where these authors believed the crystalline lens was positioned. In order to estimate where Celsus proposed entering the eye during couching, we prospectively measured the distance from the temporal corneal limbus to the lateral canthus in 30 healthy adults. Results: Rufus of Ephesus and Galen wrote that the lens is anterior enough to contact the iris. Galen wrote that the lens equator joins other ocular structures at the corneoscleral junction. In 30 subjects, half the distance from the temporal corneal limbus to the lateral canthus was a mean of 4.5 mm (range: 3.3–5.3 mm). Descriptions of couching by Celsus and others are consistent with pars plana entry of the couching needle. Anterior angulation of the needle would permit contact of the needle with the lens. Conclusion: Ancient descriptions of anatomy and couching do not establish the microanatomic relationships of the ciliary region with any modern degree of accuracy. Nonetheless, ancient authors, such as Galen and Rufus, clearly understood that the lens is located anteriorly. There is little reason to believe that Celsus or other ancient authors held a variant understanding of the anatomy of a healthy eye. The notion of the central location of the lens seems to have arisen with Arabic authors in 9th century Mesopotamia, and lasted for over 7 centuries.
机译:目的:确定古希腊罗马作家是否像大多数现代历史学家所写的那样,将晶状体定位在眼睛的中央。背景:历史学家已经写过,塞尔苏斯或佩尔加蒙的盖伦关于白内障卧榻的说法暗示了一个位于中央的晶状体。 Celsus特别写道,放置在角膜角膜缘和外侧can之间的卧床针进入了一个空的空间,该空间被认为代表了后房。方法:分析古代眼科文献,以了解这些作者认为晶状体的位置。为了估计Celsus建议在就寝期间进入眼睛的位置,我们前瞻性地测量了30位健康成年人从颞角膜角膜缘到外侧can的距离。结果:以弗所(Ephesus)和盖伦(Galen)的鲁弗斯(Rufus of Ephesus)和盖伦(Galen)写道,晶状体足够向前方接触虹膜。 Galen写道,晶状体赤道在角膜巩膜交界处结合了其他眼部结构。在30名受试者中,颞角膜角膜缘到外侧can的平均距离为4.5毫米(范围:3.3-5.3毫米)。 Celsus和其他人对卧榻的描述与卧榻针的平面入口一致。针的前角度将允许针与晶状体接触。结论:古代的解剖学和卧床描述并不能以任何现代的精确度建立睫状区的微解剖关系。但是,诸如Galen和Rufus之类的古代作家清楚地了解到晶状体位于前方。没有理由相信Celsus或其他古代作者对健康眼睛的解剖结构有不同的理解。镜头中心位置的概念似乎起源于9世纪的美索不达米亚阿拉伯作家,历时超过7个世纪。

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