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95
The reason for the large number of Hypermetropes who are eliminated in this scheme is that,
except in cases with very high errors, the vast majority of young Hypermetropes have no Manifest
Hypermetropia. If the latent hypermetropia which they possess causes no symptoms they are thus
in my opinion excluded from the necessity for correction. The statement on page 53 of the report
referred to, then, that "under this condition (with a +1.0 D. sphere) if the child is hypermetropic
he will still read 6/6 "is, in my opinion, incorrect as a generalisation. Again, an Emmetrope with
a +1.0 D. sphere before the eye is given an artificial far point at 1 metre distance, and naturally
fails thus to read 6/6; but I consider the "correction" of static emmetropes to be in every way
undesirable. The same rule applies with appropriate modifications to Astigmatic cases in the region
of Emmetropia; if there is no discomfort and no diminution in acuity from their Astigmatism alone
they should not, in my opinion, be compelled to wear glasses.
The argument from the administrative side is given in my quoted reports ; the above is a
short outline, from the academic side, of my argument for the condemnation of the suggested scheme.
I have intentionally omitted any reference to the low proportion of progressive to non-progressive
myopes, for it is, of course, essential in discussing cases in bulk to take care not to belittle the importance
of the individual case ; I have also omitted to refer at all to the highly controversial point
as to the efficacy or otherwise of the action of glasses in preventing or diminishing progress in refractive
errors ; these matters, though of first importance, are in strict fairness excluded from my argument.
Of considerable interest and importance is the modification of the "+1.0D. scheme" which
emerged from this question, which modified scheme is now in operation in the area. This consists in
keeping a record of all children who, at the subjective test, while reading 6/6 unaided, show a diminution
of visual acuity to the extent of 3 or more Snellen's lines; at the subsequent tests these children
in this group who show an increased diminution in acuity are to be referred to me for refraction.
It is thought that, by this scheme, progressive increase in refractive error will be detected early,
and definite good would thus be done by its utilisation, with which I fully agree; in addition, far
less school time would be wasted than by the original scheme. The result of the trial of this modified
method will be awaited with interest.