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201
Report cf the County Medical Officer—Education.
unnaturally susceptible to injury. To give the teachers guidance in this matter lists are kept of the
average and the special cases, according to the directions of the ophthalmologist; those on the special
list are limited in their games and drill to the mildest and least risky performances, and during school
hours they do not play with the normal children.
The following tables show graphically the character of the cases now on the list of the myopes,
only those cases are included of whose condition there are full notes, most have been examined on two
or three occasions.
In dealing with the myope cases proper it has been necessary to arrive at some simple means
of tabulating the degree of myopia found in any given case so as to make all the cases fairly comparable.
To arrive at this, the measures of the myopia of the two meridians of each eye have been
added together, this figure divided by four gives the average myopia for the eyes of that particular
child. The method allows the cases to be compared, but it does not bring out the particular seriousness
of those cases where the astigmatism is high and the vision proportionately defective.
For example:- Meridians in Meridians in Average myopia,
right eye. left eye.
Cases (a) —2 and —6 —2.5 and —7.5 —4.5
(b) —7 —7 —7
(c) —8 and —9 —9 and —16 —10.5
Cases entered on the roll of myopes up to the end of 1912:—
Cause of defective vision. Boys. Girls. Total.
Superficial keratitis 16 34 50
Interstitial keratitis 7 17 24
Disseminated choroiditis 2 6 8
Cerebral defect 3 1 4
Albinism 2 1 3
Purulent conjunctivitis after exanthemata 1 3 4
Ophthalmia neonatorum 3 6 9
Extreme hypermetropia 2 — 2
Cataract 4 2 6
Coloboma uvese 2 1 3
Muscle defect — 1 1
Aniridia 1 —1
Buphthalmia 1— 1
Dislocated lenses 1 — 1
Myopia 93 103 196
Totals 138 175 313
In some, myopia was associated with other causes of defective vision, e.g.:—
Superficial keratitis 10
Interstitial keratitis 7
Purulent conjunctivitis 2
Albinism 1
Congenital defects 4
One of these cases of purulent conjunctivitis is of particular interest in that it illustrates the
danger to the community of allowing infants suffering from ophthalmia neonatorum to be "at large."
A girl in the myope class with badly damaged eyes caught the disease from a neighbour's baby which
she took care of, her own baby sister took it from her and this baby's eyes Were also seriously injured.
The baby from whom the contagion was taken died.
The effect of hereditary influence in the production of high myopia was suggested in eight cases
in which definite evidence that one of the parents and other children of the same parents were myopic
was obtained.
In the accompanying Diagram H, Chart I. gives a graphic representation of the distribution of the
cases of myopia (excluding defective vision resulting from any cause other than myopia) in 198 children,
as regards sex, age, and degree of myopia. It is noteworthy that in the earlier years the recorded
cases are of fairly high degree, from nine to fourteen dioptres ; the cases of five and six dioptres in the
fourth and fifth years are cases of astigmatism in which the method of averaging the myopia in the four
divi-ions ot the two eyes reduces the apparent seriousness of the cases. The lower degrees of myopit.
are not reported until the age of seven and over when the children enter the standards.
Chart II. gives the age distribution of the cases, and confirms the foregoing observation;
cases ot myopia begin to be discovered and are reported in the seventh and eighth years and onwards.
Chart III. gives the frequency of occurrence ot the different degress of myopia, the bulk
of the cases range from six to twelve dioptres. Few cases of lower degree than 6 D are reported for
special consideration, and happily there are not many extreme cases. Those that figure in the chart
with fifteen and more dioptres are in the myope classes under strict supervision ; any sign of further deterioration
of the eye3 would necessitate their transference to the schools for the blind and partially blind.
The nature of the defects of vision for which children are referred to one of the treatment
centres for treatment is a matter of importance. In the first place it is desirable to know how far the
vision tests made by the school doctors correspond with the tests made by the doctors at the centres.
Do these doctors find by their special tests that all or most of those children sent for treatment are defective
and requiring treatment ? Secondly, it is desirable to examine the records of the centres, the only
Visual defects
of children
referred for
medical
treatment.
18820 CC