View report page

of case we wish to see. A small number do not require immediate active
treatment but are still welcome, as they may require observation.
The majority require treatment and receive it at the clinic. Some again
require operative treatment. This year there were eight, and of these,
seven have been admitted to the Orthopaedic Unit at Highlands General
Hospital. The parents of the remaining one are unfortunately unable to
make up their minds. This is unusual, as the parents and children are
usually most co-operative in carrying out the treatment suggested".
Ophthalmic Clinic, Hornsey
I am indebted to Dr. R. Welch, M.D., for the following report:—
"During 1958 I have been in charge of the eye clinics at Hornsey Treatment
Centre and during this period they have been exceptionally busy.
The cases seen are for the most part referred after routine school medical
examinations, generally because of defective vision in one or both eyes.
Others have symptoms suggestive of eye-strain such as headaches and
blurred vision especially after close work. A smaller group of cases are
those who have developed an obvious or suspected squint and as these
are serious they are given priority in arranging appointments. Another
class of cases examined at the clinic are those sent by doctors in charge of
welfare clinics. The importance of the latter I shall show later.
Where indications are present for doing a refraction, Atropine is used
as a cycloplegic for very young children. For older children Gutt. Hyoscine
or Gutt. Homatropine and Cocaine are used as a mydriatic so as not to
interfere with their school work and progress. In many cases refractions
are done without a mydriatic. Where necessary, glasses are prescribed and
the child is kept under supervision and examined at appropriate intervals
of about one year. This re-examination at intervals is necessary as during
years of growth refractions often change, especially in cases of myopia.
Supervision is also necessary to ensure that glasses are worn as prescribed
and are in good repair and also to determine when glasses are no
longer necessary. Incidentally I deprecate the practice of prescribing
glasses for all and sundry errors of refraction as a routine practice. Only
when specific indications for their need are present should glasses be
prescribed.
Attention is specially directed to those cases who are found to have a
unilateral amblyopia—often unsuspected—whether it is associated with a
manifest or latent squint or anisometropia. After correcting the error
of refraction with the appropriate glasses, occlusion is immediately begun
and the visual acuity, especially in the amblyopic eye, is reviewed weekly.
Very close supervision of these cases is kept by the orthoptist to ensure
that the occlusion is efficient and not tampered with. Full explanations are
given to parents as to the necessity and importance of this treatment and
to secure their co-operation which is usually forthcoming. In this way,
results obtained have been most satisfactory and visual acuity in the
92