Surgery in close up

I am sitting in "business class" in a DC-10, looking up at a screen so big that all 45 of us here could watch an in-flight movie on it together.

The screen blooms into life, filled with one giant eye, framed in what looks like peeled-away metal. Each blood vessel snakes bright red across the expansive white eyeball surface.

The eye never blinks.

My own eye, however, can't seem to stop twitching—especially when a thin scalpel and the pointed tips of a pair of scissors loom on the screen. As both sharp implements move inexorably toward the huge eye, I realize that I'm squeezing my pen so hard that it may burst.

The other 44 viewers, however, don't react like this is a horror movie. And there are no screams on the audio: Instead, the calm steady voice of Dr James Brandt flows out of the speaker, as smooth and easy on the nerves as a Kenny G soundtrack.

"Get the depth right and move out," he murmurs as the scalpel makes an L-shaped incision called a scleral flap. "Go a little more into the cornea ... open wide ... perfect! That's very good."

While we sit in what is now a converted classroom for the Flying Eye Hospital, Brandt himself is a few meters away in the plane's fully equipped and sterile operating room. Brandt has a tiny video camera mounted on his head and a microphone on his collar: He narrates what he's doing as he operates, and even answers questions from the local doctors and nurses who are watching the big screen.

This morning he is coaching a young Chinese ophthalmologist in a textbook trabeculectomy. This is the most common surgery for glaucoma, designed to relieve pressure in the eye by removing a piece of tissue in the "drainage angle" of the eye, allowing the escape of fluid.