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NEWS: Lynn Eaton Former BMJ artist demonstrates the effect of cataract BMJ 2007; 334: 177-a [Full text]

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Cataracts and painting; perception and expression

James S Huntley   (31 January 2007)

Monet's cataracts

Stephen A. Madill   (1 February 2007)

My Cataract Experience follow up to responses

Yvonne MM Fuller   (15 May 2007)

Cataracts and painting; perception and expression 31 January 2007
James S Huntley, Lecturer New Royal Infirmary Edinburgh EH16 4SU Send response to journal: Re: Cataracts and painting; perception and expression	Yvonne Fuller is to be congratulated on her compelling artistic pamphlet concerning recovery of sight after cataract removal and lens implantation[1]. It is a brief and moving visual story. However, the interpretation of the before- and after- operation pictures in Eaton's article[2] fail the intelligence test set by Peter Medawar, in his Advice to a young scientist[3]: 'To many eyes, some of the figures (particularly the holy ones) of El Greco's paintings seem unnaturally tall and thin. An ophthalmologist who shall be nameless surmised that they were drawn so because El Greco suffered a defect of vision that made him see people that way, and as he saw them, so he would necessarily draw them.' This is an unlikely explanation because drawing them as he saw them would render them as they were in life - rather than elongated. Otherwise when he looked at his elongated figures on the canvas they would appear even more elongated![3] There is a similar perception-expression problem occurring in paintings performed before and after cataract operations[1,2]. Blurred perception would make clear representation difficult. However, the colours used should not be mismatched, because those mixed and selected from the palette should match those in the scene, and this contemporaneous matching should occur whether the cataracts are present or not. A similar but still more ambiguous interpretation of paintings pre- and post- cataract operations was given in Minerva nearly a decade ago[4]. Ophthalmologists (again!) highlighted the benefit of cataract operations for enhanced performance in colour-painting. The artist painted the same flower twice, after viewing the flower with each eye in turn (one eye with cataract, the other with implanted lens). Interpretation of their experiment is impossible, because no mention was made as to whether she viewed the palette (to mix and select colour) using the same eye, the other eye, or both eyes. JS Huntley Lecturer in Orthopaedics and Trauma, Edinburgh References 1. www.lenstec.com/lenstec/PDFs/YvonneFullerBook.pdf[accessed27January2007] 2. Eaton L. 2007. Former BMJ artist demonstrates the effect of cataract operation on her eyesight. BMJ 334:177 3. Medawar PB. 1981. p.2, in Chapter 2, Advice to a young scientist. Pan Books Ltd, London 4. Cates C, Moore A. 1998. Minerva. BMJ 317:958 Competing interests: None declared
Monet's cataracts 1 February 2007
Stephen A. Madill, Consultant Ophthalmologist Princess Alexandra Eye Pavilion, Chalmers Street, Edinburgh EH3 9HA Send response to journal: Re: Monet's cataracts	It is gratifying to read of a patient’s delight following her cataract operation [1]. Changes in visual function immediately after surgery can be remarkable. However misunderstanding the transient nature of some phenomena has led to a popular misconception (to which the author is alluding). It has previously been hypothesised that the maturation of Claude Monet's cataracts may have influenced changes in his style of painting especially with regard to colour [2]. Could yellowing lenses produce a visual percept which led to the more abstract colour contrast effects seen in later works such as 'The Japanese Bridge at Giverny' (1918–1924)[3]? Was Monet merely painting what he saw? Work by Delahunt et al.[4] suggests not. Although immediately following cataract surgery patients often report a shift in colour perception with a particular increase in blue saturation, this is a short lived phenomenon[4]. The visual system uses 'adaptive renormalisation' to recalibrate the colour percept such that a patient's spectral sensitivity (after the period of recalibration) is similar to that before surgery[4]. Maybe we can finally put to bed the myth of Monet's cataracts. References 1. Eaton L. Former BMJ artist demonstrates the effect of cataract operation on her eyesight. BMJ 2007;334:177. 2. McLellan MF. Literature and medicine: the patient, the physician and the poem. Lancet 1996;348:1640-41. 3. Marmor M. Ophthalmology and Art: Simulation of Monet's Cataracts and Degas' Retinal Disease. Arch Ophthalmol 2006;124:1764-69. 4. Delahunt PB, Webster MA, Ma L, Werner JS. Long-term renormalization of chromatic mechanisms following cataract surgery. Vis Neurosci 2004;21:301-7. Competing interests: None declared
My Cataract Experience follow up to responses 15 May 2007
Yvonne MM Fuller, subject of Cataract article Middle Warren St Mawes TR2 5DR Send response to journal: Re: My Cataract Experience follow up to responses	To the two eye specialists James S Huntley and Stephen A Madill responding to the article of 31st January 2007. I have only just found your responses. From my personal experience I think it would probably be right to deduce that El Greco's elongated figures were not due to an eye defect as both the real figures and the painted images would be viewed with the same distortion. Likewise with colour. After my operations I was very pleased to discover that the paintings I had already painted, and which I now saw much more clearly, were as bright and colourful as I would have wished, and that they were tonally well balanced. Blurring is rather different. Because I had good, modern multi-focal lenses to help me see both the subject and the painting clearly I could overcome this difficulty, though it was extremely tiring. Monet would not have had this help, and I suspect he found a way to paint as best he could in a different, less sharply focused way. Tonally and in terms of colour they are very positively painted, but sharply drawn detail is avoided. It seems to me something similar may have happened with Renoir in his later work. The comment about things having a blue bias immediately after the operations is true and it becomes less apparent with time. However it does also persist - for instance, I have an old pair of woollen gloves which I always thought were battleship grey; they now appear mauvish navy blue! I am glad you found the 'Cataract Experience' of interest and hope it is also helpful. Competing interests: None declared