Interview with Mr Richard Packard

Richard Packard is senior consultant at Arnott Eye Associates in London. He has recently retired as senior surgeon at the internationally known Prince Charles Eye Unit in Windsor and is a keen fisherman.

Richard shares his love of fishing

On the day in December 1978 I started as senior registrar at Charing Cross Hospital in London, I observed a phacoemulsification procedure – a type of cataract surgery hardly yet performed in the UK – and recall this as my ‘road to Damascus’ moment. I had been planning a career in ocular oncology but changed my mind instantly. Within one month, I had performed my own first phaco surgery.

It was the American ophthalmic surgeon Charles Kelman who developed phacoemulsification which made it possible to remove cataracts through a tiny 3mm incision, removing the need for long hospitalisation post-operatively.

Until then, cataract surgery required the surgeon to make a 12mm incision in the eye which required extensive stitching. Patients were subsequently forced to spend two weeks in a hospital bed with sandbags around their heads to restrict movement.

Charlie Kelman practised on an endless amount of cats, failing miserably for three years until one day when he visited the dentist. The guy was using an ultrasonic tool to clean his teeth and Charlie realised he could use this device to inscribe small cuts on the lens.

Charlie’s ideas were not popular with the American establishment, however, who saw them as controversial. The US health department reported that his surgery was experimental so insurance companies would not cover his work.

He was a self-publicist and even appeared on television on The Tonight Show with Johnny Carson which served to make him even more popular with the public, if not his peers.

Like Charlie Kelman, Eric’s ideas were also met with resistance. They had met in 1969 and Eric brought the procedure back to the UK, raising the money to buy the very expensive equipment. That year, he also performed the first phacoemulsification procedure in the UK, at Charing Cross Hospital. I worked alongside Eric as a senior registrar and eventually we achieved excellent results which overcame the resistance of the profession.

Today almost all cataract surgery is carried out using variations of this technique although the technological advances have been incredible. Surgical procedures which once took four hours can now be completed in ten minutes. I believe I have seen more progress in my 50 year career than there has been in the last 1,000 years of ocular medicine. We are now able to take a cataract out of an eye with immediate recovery, incredible precision and many patients do not even need to use spectacles after the procedure.

Eric created the specialist Arnott Eye Centre over 25 years ago. In 1996 we were on a phacoemulsification course going up the Nile together called “Phaco with the pharaohs” in Egypt. Eric took me to the stern of the boat and over a glass of really bad local wine, asked me to take over the centre in 1999 when he reached 70. I sold the practice last year but continue as a consultant.

I spend lots of my spare time preparing medical lectures – I have spoken at 14 meetings so far this year and given over 50 lectures – but I am lucky to have enough time to enjoy fishing.
We have a house in the far North of Scotland but one of my favourite locations to fish is the River Spey. Sadly June was hopeless this year as it was just too dry for the fish to return to the river.

We had better luck this winter on the very tip of South America in Tierra del Fuego in Chile. It was bleak with challenging conditions as the wind was blowing at some 40-50mph. I’ve also been to Cuba last year near to the Bay of Pigs and we landed 120 bonefish and 50 tarpon.

My youngest daughter caught her first salmon in October on the River Forss near our house in the north, which was a proud moment. She may have inherited my interest in angling but none of my children have followed my wife or me into medicine!

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