YOUR HEALTH Dr James Le Fanu: 7 March

How cataract surgery has changed since Claude Monet’s operation, a diagnosis for muscle twitching and a charming remedy for warts
I can remember to this day the moment the nurse removed the bandages from my eyes,’ recalled Dr AE Clark- Kennedy, who a few days earlier had had a cataract removed. ‘The first thing that struck me was the face of the pretty nurse removing the bandage. The second was the almost dazzling whiteness of the surgeon’s coat. And then I realised the appalling vulgarity of my multicoloured, striped pyjamas.’

Dr Clark-Kennedy’s initial impression of being overwhelmed by the sense of colour is typical. But not just any colour. Cataracts have a yellow tinge, cutting o€ff light at the blue end of the spectrum to which over the years the retina adapts by increasing its sensitivity to blues and greens. Thus, when a cataract is removed, the world appears clean and blue.

This alteration in the perception of colour is well illustrated in the paintings of the French Impressionist Claude Monet. His favourite subject, the Japanese bridge in his garden at Giverny, painted at the age of 60, is full of detail but, 10 years later, the colours are confused and the shape of the bridge scarcely discernible. ‘I no longer perceive colours with the same intensity,’ he wrote in 1918. ‘Reds appear muddy, pinks insipid. When I compare it to my former work I am seized by a frantic rage and slash at my canvases with a penknife.’

Soon after, Monet sought the help of a Parisian eye surgeon who advised an operation – which in skilled hands took  ve seconds: his eye was anaesthetised with cocaine, a knife inserted and the lens with his cataract scooped out. Now, with his visual acuity restored, ‘I no longer see red or yellow, only blue,’ he wrote. ‘This annoys me terribly because I know they are there on my palette.’

Almost 30 years later, Harold Ridley, an ophthalmic surgeon at St Thomas’ Hospital in London, inaugurated the modern era of cataract surgery. He had noted, during the Second World War, how penetrating glass injuries to the eye sustained by fighter pilots, had elicited virtually no in˜flammatory reaction. Why not, he speculated, remove the yellowing lens and replace it with a plastic implant; thus obviating the need to wear spectacles or contact lenses. This is now the commonest of all eye operations. It takes 50 minutes rather than five seconds – but thanks to microsurgical stitches, the patient usually returns home the same day.

This week’s medical query comes courtesy of a woman in her mid-20s who for the past few months has been troubled by intermittent twitching of the muscles in various parts of the body, lasting a few minutes. ‘Is this due to anxiety or stress?’ she asks. ‘Or might it be a sign of some more serious condition such as multiple sclerosis?’

This muscle twitching is almost certainly Benign Fasciculation Syndrome, due to a (as yet unidentified) disorder of the nerves controlling muscular contractions. It can be exacerbated by stress, but has no serious adverse consequences. It usually responds to a daily dose of a beta blocker such as Atenolol.

VANISHING ACT
There’s no more striking testimony to the power of suggestion than the ‘charming’ of warts – as a reader recalls when taken by his mother to see ‘a local countryman’.

‘He asked me to return on the night of a full moon. I did so and was taken into the garden where he took my hands in his and fingered the warts while gazing up at the moon and muttering an inaudible invocation. He then said, “Don’t thank me and don’t pay me or the charm will not work.”

I didn’t believe this rigmarole but in a few days, the warts had vanished.’

Email drjames@lady.co.uk