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day, during which they may be read to by teachers or other pupils or given other approved
occupations. Myopes who are not allowed to read and who are not systematically read to by
others are seriously handicapped in comparison with other pupils. If suitable books with large
and clear type were available, the special preparation periods might for pupils with lesser
degrees of myopia be limited, but it is understood that in present circumstances the cost of such
books is prohibitive. Appropriate subject matter types on a Bulletin machine could be studied
by most of the myopes in preparation periods or during lessons.
The practice of allowing pupils to take text-books home in order that members of their
families may read to them oilers strong temptation to pupils to transgress the rule about reading
at home, and cannot be followed without serious risk except in cases where family co-operation
has been enlisted and can be depended upon. School books, therefore, should not be taken home
by myopic pupils except on the specific direction of the head acting in consultation with
the ophthalmologist.
The word " homework " in the sight-saving instructions should be taken to mean any work
or study at home involving any use of the eyes.
In the case of some myopes the question may arise as to whether a secondary school course
is, for medical reasons, the best available course. It might, for example, be desirable, in certain
cases to consider the practicability of a transfer at a suitable age to a trade school. Machinery
exists whereby such a transfer can be made where the myopic pupil holds a special place, but the
difficulties of finding a suitable trade and of persuading the parents to agree to the transfer are
considerable.
After-school occupations should continue to receive much attention. Although the degree
of myopia tends to remain almost stationary after 20 years of age, complications with serious
visual defects frequently ensue in later years. Close work and that involving strenuous exercise
and the lifting of weights are to be avoided, and it is only in a few exceptional cases of nonprogressive
myopia without fundus changes that medical sanction has been given for occupations
such as teaching. The higher education of myopes should be regarded as an opportunity to guide
pupils of intelligence in their careers and thus to prevent blindness.
Broadly speaking, it would appear that from the medical and the educational points of
view the experiment of providing a special type of secondary education for myopic pupils is
justifying itself and should be continued, with certain modifications suggested above, and that
the possibility of extending the provision to one or two additional schools should be explored.
Defects.
The children in secondary schools are, as far as scholarship cases are concerned,
selected children, and no child is admitted who is deemed incapable by reason of illhealth
of benefiting from the education provided. Cases of heart disease, defects
of nose and throat, and ear disease are rarer than in elementary schools, where there
is no selection beyond that of drafting to special schools. Yet in the secondary schools
there are more cases of postural defects such as curvature of the spine, again showing
the effect of more intensive study, and in these cases also the incidence is higher at
the age of 15 than at the age of 12.
Nutrition in
a secondary
school for
boys.
Dr. Simpson supplemented his inquiries into nutrition in elementary schools,
by an examination of boys in a selected secondary school.
The school is housed in a modern building, with large grounds, in a newly developed
residential district on the borders of London.
There are 435 children on the roll at present, most of whose parents are reported to be " in
comfortable circumstances." About 60 per cent. of them have been in elementary schools,
either in London or elsewhere, and a third of these have scholarships. Rather more than half
of the children live locally, and 25 per cent. outside the county of London.
A hundred boys have been examined—that is to say, about a quarter of the school. These
boys have not been selected in any particular way—they are merely the next 100 due for
inspection. They had been seen by the school doctor in 1932, so that it is possible to compare
their present condition with that of a year ago.

The type of school at which they received their earlier education gives a rough idea of their
home circumstances. The number who have previously been to Council schools is 57 (about
the same proportion as in the whole school) and 25 have scholarships.