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Some of the differences in this table are due to the children falling off about 11 at the Belgrave,
but the racial factor comes in at the Middlesex.
Last year the causes of defect in the vision of children attending a school in the neighbourhood of
the Middlesex Hospital had to be enquired into on account of a report of H.M.I. Large numbers of these
children were alien immigrants ; they are seen both in school and at hospital, and the examination of
their eyes shows a very heavy incidence of astigmatism, and particularly myopic astigmatism. In an
examination of the incidence of refraction cases at one of the Moorfields Clinics Mr. Harman found the
proportion of aliens reached 35 per cent., as compared with natives 26 6. Myopia has been shown by
many observers to increase in frequency and degree with age. The Hospital returns show this and also
what kind of eyes become myopic.
Mr. Harman's returns of 618 children 6een at the Middlesex Hospital. H—Hypermetropia.
HA—Hypermetropic astigmatism. M—All varieties of myopia.
Considering in this chart the poor vision due to hypermetropia (H), there is a slow rise in the cases
from 28 to 33 per cent. This slow increase is what naturally occurs from the hypermetropia compensated
in childhood becoming more evident as accommodation decreases with age. This slow increase in hypermetropia
affords evidence of the accuracy of the chart. The curves of hypermetropic astigmatism
(H. A.) and of myopia (M) may be considered together, and are seen to run parallel till school work
has become the chief thing in the child's life, when they diverge, myopia increasing steadily and astigmatism
decreasing pari passu. The child with bad vision due to astigmatism attempts to facilitate the