16/05/2026
🌏🇨🇳🇺🇸 The “Thucydides Trap” — and What It Has to Do with Eye Surgery 👁️
Weekend reflection - Dr Chua Chung Nen 16/5/2026
This week, much of the world’s attention turned to Beijing, where US President Donald Trump finally met Chinese President Xi Jinping after months of delay linked to the Iran War. During the meeting, Xi spoke about the importance of avoiding the so-called “Thucydides Trap” between China and the United States.
The term comes from the ancient Greek historian Thucydides, who analysed the disastrous Peloponnesian War between Athens and Sparta nearly 2,500 years ago.
According to Thucydides, the war became almost inevitable because the rising power of Athens created fear in the established power, Sparta ⚔️
Over time, suspicion, rivalry, pride, and insecurity pushed both sides into conflict.
Today, many political thinkers use the term “Thucydides Trap” to describe the dangerous tension that can occur when a rising power challenges an existing dominant power.
Surprisingly, the same idea can also be seen in ophthalmology 👁️
Throughout medical history, new technologies in eye care have often been viewed with suspicion when they first appeared, particularly when they challenged long-established “gold standards”.
Take cataract surgery as an example.
Many patients today assume modern small-incision phacoemulsification has always existed. In reality, older cataract surgery involved much larger incisions using extracapsular extraction techniques. When phaco first emerged, many surgeons were sceptical. The machines were expensive 💰, the learning curve steep 📈, and complications in inexperienced hands could be serious.
Yet over time, phaco transformed cataract surgery worldwide 🌍 and is now regarded as one of the greatest advances in ophthalmology.
But interestingly, the older technique never completely disappeared.
In patients with extremely dense or advanced cataracts, extracapsular surgery may still sometimes be safer and more appropriate. The “old power” and the “rising power” eventually learned to coexist 🤝
Perhaps the most fascinating example was the invention of the intraocular lens by the British ophthalmologist Sir Harold Ridley 🇬🇧. When Ridley first suggested implanting an artificial lens inside the eye in the 1950s, many colleagues thought the idea was reckless. Some even considered it dangerous to place a “foreign body” permanently into the eye.
Today, millions of people around the world enjoy excellent vision because of his once-ridiculed idea ✨
The same pattern occurred again with diabetic eye disease. For decades, laser treatment represented the gold standard for diabetic retinopathy and diabetic macular oedema 🔥. Then came anti-VEGF injections 💉, which dramatically improved visual outcomes in many patients.
Initially there was resistance, debate, and uncertainty. Yet today, both treatments often complement each other rather than compete.
The lesson?
In ophthalmology, progress does not always require one technology to destroy another.
Sometimes the greatest advances occur when experience and innovation learn to work together rather than seeing each other as enemies.
Perhaps medicine, like geopolitics, should avoid falling into its own “Thucydides Trap
P/S: The three photographs below, from left to right, depict a statue of Thucydides outside the Austrian Parliament Building; a Greek postage stamp featuring Thucydides; and an ancient Greek pottery illustration portraying scenes from the Peloponnesian War.
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🌏🇨🇳🇺🇸 《修昔底德陷阱”——原来也能用来解释眼科手术的发展 》👁️
周末随想 -蔡鐘能眼科医生写于16/5/2026
这个星期，全世界的焦点都集中在北京。由于伊朗局势紧张而一再延迟后，美国总统川普 终于与中国国家主席習近平会面。
习近平在会谈中提到，中美关系必须避免掉入所谓的“修昔底德陷阱”。这个概念来自古希腊历史学家 Thucydides。他在分析大约2500年前的 伯罗奔尼撒战争（Peloponnesian War）时指出，当时崛起中的雅典让原本强大的斯巴达产生恐惧，最终双方一步步走向战争 ⚔️
随着时间推移，猜疑、竞争、骄傲与不安全感，慢慢把双方推向冲突。如今，很多政治学者都用“修昔底德陷阱”来形容：当一个新兴强国挑战旧有霸主时，双方之间容易出现危险的紧张关系。
其实，这种现象在眼科医学里也很常见 👁️
医学历史上，每当新技术出现时，往往都会受到质疑，尤其当它挑战原本长期被视为“黄金标准”的治疗方式时。
最经典的例子之一，就是白内障手术。
现在很多病人会以为，小切口超声乳化白内障手术（phaco）一直都是主流。但其实，以前的白内障手术需要较大的伤口，称为囊外白内障摘除术（extracapsular extraction）。
当 phaco 刚出现时，不少眼科医生其实非常怀疑。机器价格昂贵 💰、学习难度高 📈，而且刚开始时，如果经验不足，风险也可能不小。
但随着技术成熟，phaco 最终改变了全球白内障手术的发展 🌍，如今更被认为是现代眼科最伟大的进步之一。
不过有趣的是，旧技术并没有完全消失。
对于一些特别硬、特别成熟的白内障，传统的大切口手术有时反而更安全、更适合。
最后，“旧霸主”和“新势力”并没有互相淘汰，而是学会了共存 🤝
另一个经典例子，就是英国眼科医生 Sir Harold Ridley 🇬🇧 发明人工晶体（IOL）。
1950年代，当 Ridley 首次提出把人工镜片永久植入眼睛里时，很多同行觉得这个想法太疯狂。甚至有人认为，把“异物”长期放进眼球里是危险的。
但今天，全世界数以百万计的人，因为他的发明而恢复了清晰视力 ✨
同样的故事后来也发生在糖尿病眼病治疗。
几十年来，激光治疗一直是糖尿病视网膜病变与黄斑水肿的黄金标准 🔥。后来抗VEGF眼内注射 💉 出现后，大幅提升了很多病人的治疗效果。
刚开始时，当然也充满争议、质疑与不安。
但今天，激光与注射并不是互相取代，而是彼此配合。
这或许也是医学最重要的一课：
眼科的发展，并不一定需要“新技术消灭旧技术”。很多时候，真正伟大的进步，反而来自经验与创新之间的合作，而不是彼此视为敌人。也许，医学界也应该避免掉入自己的“修昔底德陷
附注：以下三张照片由左至右分别为：位于维也纳国会大厦外的古希腊历史学家修昔底德雕像、一枚印有修昔底德肖像的希腊邮票，以及描绘伯罗奔尼撒战争场景的古希腊陶器图案。
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#蔡鐘能眼科医生 #修昔底德陷阱 #眼科 #白内障手术 #超声乳化 #人工晶体 #糖尿病视网膜病变 #眼科医生 #医学历史 #医疗创新 #古晋眼科医生 #诗巫眼科医生 #马来西亚眼科医生
