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183
[1911
It is unfortunate that in such a disease as this the visiting work cannot
be done, as it ought to be, by the Council's own health visitors, instead of by
the nurses of an outside institution, on whom, of course, there is no obligation
to do anything.
The notification of this disease was recommended to the Public Health
Committee by the Medical Officer of Health so far back as June 20th, 1910,
when they ordered the report then presented to them to be forwarded to the
London County Council, together with a recommendation that the disease
should be made compulsorily notifiable.
The nature of this disease and the serious injury that it causes to the eyes
of new-born children may be gathered from the facts which it was the duly of
the Medical Officer of Health to lay before the Council.
Ophthalmia Neonatorum is the most serious, nay, terrible, disease to which the
newly-born child is subject, and is one of the most common causes of blindness in
children. It is also one which may easily be prevented, if due and proper precautions
are taken at birth, during which time the disease is contracted from the
mother by the penetration of certain discharges (some of which may be, but not
necessarily, of a venereal character) into the conjunctival tissues. Sometimes
the infection is derived from the mother after birth; in other cases, if the
child is in an institution, from another infective case.
It is, however, the cases contracted from the mother during or after
birth with which we have to deal.
During the last six years, Dr. N. Bishop Harman has had the oversight of
the schools for the blind and partially blind, and during that time he has
examined over 400 children, noting the condition of their eyes, the degree of
blindness, and determining the cause of it, with the result that he ascertained
that 36.36 per cent, of the cases were due to Ophthalmia Neonatorum, 26.3 to
congenital defects, and 17.6 to inherited defects, while 20.8 per cent, were due
to 9 other causes.
Thus it is seen that Ophthalmia Neonatorum easily heads the list. Great,
however, as the percentage is, it is in reality greater than stated, for many of
the other causes by careful treatment and operation are removed or so
ameliorated as to escape from actual blindness, if, indeed, they do not obtain
fair sight. Thus, if all these cases be eliminated, it is found in later years
that the percentage of blindness from Ophthalmia Neonatorum exceeds 40 per
cent.