Barbara McKay recounts her experience of being an ophthalmic nurse in the 1950s.
I commenced my Nursing Training in 1953 at Repatriation General Hospital Concord, at that time caring for serving members, veterans of both World Wars and War Widows. No children were treated.
The Korean conflict ended in 1953 but there were many servicemen in hospital for some time after that. The Eye Department was always very busy with a number of in-patient beds. Among the surgeons on the Visiting Staff was the well known Dr Reuben Hertzberg whom we thought as being somewhat eccentric as he demanded a jug of freshly squeezed orange juice be prepared for him when attending a clinic. Just another task for the nurses as he was too important to leave this to the kitchen maids.
Ophthalmic nursing was very demanding as the treatment lists were lengthy. On the whole our patients were not ill but they were often in pain and depressed due to their eye diseases. However we bright young nurses did our best to keep everybody cheerful.
Our charge sister, Sister OʼShea, was Moorfields trained so the ward ran most efficiently and all nursing procedures were performed ʻby the bookʼ. I am somewhat pedantic by nature so ophthalmic nursing suited me well. I spent about 6 months altogether our of my four years of training in the Eye Department. Senior nurses staffed the clinic so we were trained to perform fields ( Goldman perimeter), take visions, perform provocative tests and even measure intraocular pressure using the Schiotz tonometer. Today these procedures are done by orthoptists. (An aside here – we placed a Goldman perimeter in our garden at Bundanoon so when asked its purpose we usually say it is an antique astronomical instrument). Undines were used to irrigate eyes and they were delicate things to sterilize.
There were always a number of iritis patients and these were treated by hot spoon bathings, atropine drops and various types of vaccinotherapy including intramuscular injections of boiled milk. These bizarre treatments were designed to stimulate the immunesystem. The hot spoon bathings were usually given 3 -4 times a day so in the treatment room there were be a row of men hunched over metal bowls with a bandaged wooden spoon in hand for 10 or so minutes. The heat treatment was very soothing so no one complained.
Pterygium surgery was very common as we had so many young men who had been out in the sun for years often without hats and who never wore sunglasses – who had sunglasses in WW11.
Ophthalmic surgeons operated without gloves and cataract surgery was an ordeal for the patient and a huge responsibility for the staff. The patient would be admitted to hospital two to three days pre-operatively, have the usual tests and then was placed on a low residue diet. I was told by many patients that surviving on chicken noodle soup, white bread, rice, steamed fish, lots of white sauce and so on was one of the worst aspects of their hospitalization.
Twenty four hours prior to surgery penicillin pools (drops) were commenced and the eye lashes were cut. These antibiotic drops were made by the hospitalʼs Central Sterilizing Department by dissolving crystalline penicillin in sterile water. All the top lashes were removed but on the bottom lid the central lashes were left uncut in case they were turned over under the dressings and damaged the cornea. So off to the operating theatre and on return to the ward the patient finds himself with both eyes covered, head sandwiched between sandbags and his hands ʻmanacledʼ to the bed rails at night with crepe bandages. The bowels would be confined for five days as the low residue diet is maintained with the gradual addition of ʻreal foodʼ. The surgeon performed the dressings for the first few days and the unoperated eye was usually uncovered after 24 hours. The patient was allowed to sit up after five days and was out of bed after eight days – all going well. You can imagine the nursing that was entailed in keeping body hygiene attended to, the feedings and general care. It was not unknown for an older person to exhibit some mania when both eyes were covered.
Little did I imagine that the newly-graduated young doctor I married in 1957 would take up ophthalmology (as did our son David) and that I would work in our rooms as the clinical assistant until we both retired in 2008. As I often tell Al, I was in Ophthalmology long before he was.
Having had cataract surgery myself several years ago I remain deeply grateful to Harold Ridley, Peter Choyce, Cornelius Binkhorst and their disciples for persevering with intraocular lenses enabling the development of modern day implant surgery.