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to the case. It was found in the past in some cases that when medical assistance was obtained, the medical
practitioner, after examining the infant's eyes, gave directions to the parents as to the course of treatment
and left instructions for them to seek medical help again if the inflammation did not yield to treatment,
and if there was no improvement in the condition of the child's eyes. So long as the midwife remained
in attendance, the treatment was for the most part carried out, at all events once a day; but many of
these cases had not recovered by the tenth day, the time the midwife usually ceases her attendance. It
was also found impossible for the midwife personally to attend to the infant's eyes as often as was requisite,
i.e., in some cases four or five times daily, and this duty was then left to the friends of the patient, who
were utterly ignorant of the need for using clean rags and sterile water. The Voluntary Nursing Associations
rendered very valuable assistance in connection with some 100 cases of ophthalmia.
During the year 819 notices were received from midwives, stating that medical assistance had been
advised on account of inflammation of the eyes of infants, and, in addition to these, 22 other cases came to
light in which medical help was not called by the midwife.
856 cases of ophthalmia neonatorum were notified in 1919, 464 of which were not in the practice
of midwives. There were 841 cases of inflammation of the eyes in the practice of midwives brought to
the notice of the Council, of which 392 proved to be ophthalmia neonatorum and are included in the
856 such cases referred to.
The Council's inspectors investigated the 392 cases of ophthalmia. 337 cases were reported to
be completely cured. In 13 cases there was damage to the cornea, but in 7 cases there would probably
be little impairment of vision; 16 died while still suffering from the disease, and in 26 instances the
result could not be ascertained owing to the removal of the patients, who could not be traced.
The following facts are noted relating to the cases in which impairment of vision, or any other
injury to the eyes, supervened:—
Case 1.—Mother had leucorrhoea for 2 years. Perchloride of mercury used for eyes at birth.
Onset of symptoms (stickiness) on 3rd day, "well" next day. From 4th to 10th day baby not seen except
by pupil midwife. O.P. Hospital treatment on 11th day, admitted to St. Margaret's Hospital on 12th
day—Gonococcus found. Result—Ulcer right eye, scar left.
Case 2.—No history of vaginal discharge in mother, but father (a soldier) said to have "breaking
out " on arm. Boracic lotion used for eyes a few minutes after birth. Onset of symptoms in one eye on
6th day and O.P. Hospital treatment the next day. Second eye affected on 13th day. Eye first affected
had definite ulcer of cornea present when seen on 33rd day. Bact. examination—gonococcus.—Result—
Cured, slight scar left.
Case 3.—History of vaginal discharge in mother during pregnancy. Boracic lotion used for eyes at
birth. Onset of symptoms and medical assistance on 4th day. Admitted to St. Margaret's Hospital on
6th day. Midwife severely cautioned for day's delay in notifying case to the Council. Bact. examination
gonococcus. Result.—Ulcer right, scar left.
Case 4.—History of vaginal discharge in mother during pregnancy. Boracic lotion used for eyes
at birth, but discharge from mother came over baby's face again. Onset of symptoms and medical
assistance on third day. Ulceration of cornea of one eye developed in spite of treatment. Specialist
called in. Result—Slight haze over lower half of right eye.
Case 5.—No history of vaginal discharge in mother. Boracic lotion used for eyes at birth.
Onset of symptoms and medical assistance on the eleventh day. Result—sight appears good. Very
slight occasional internal squint of right eye.
Case 6.—No history of vaginal discharge in mother. Ag NO3, 1 per cent. used for eyes at birth.
Onset of symptoms between tenth and thirteenth day. Hospital treatment on fourteenth day. Result
—sight of one eye partially destroyed.
Case 7.—No history of vaginal discharge in mother. Boracic lotion used for eyes at birth.
Onset of symptoms and medical assistance on third day. Eyes clear on fourth day. Second onset on
seventh day. Child sent to St. Margaret's Hospital on ninth day, gonococcus found. Result—
blindness of both eyes. (Baby died soon after removal from St. Margaret's.)
Case 8.—History of leucorrhoea in mother. Boracic lotion used for eyes half an hour after
birth. Onset of symptoms and medical assistance on sixth day. Result—slight injury to one eye,
not interfering with vision.
Case 9.—No history of vaginal discharge in mother. Boracic lotion used for eyes at birth.
Onset of symptoms and medical assistance (hospital) on fifth day. Result—blindness in both eyes.
Case 10.—History of vaginal discharge of mother. Boracic lotion used for eyes at birth. Onset
of symptoms on ninth day, hospital treatment on the next day. Admitted into St. Margaret's Hospital
on tenth day, gonococcus found. Result—right and left ulcers perforation. Scars only.
Case 11.—No history of vaginal discharge in mother. Boracic lotion used for eyes at birth.
Onset of symptoms and medical assistance on tenth day. Result—excision of right eye. Le ft eye
alright.
Case 12.—No history of vaginal discharge in mother. Boracic lotion and 10 per cent. drops
protargol used for eyes at birth. Onset of symptoms and medical assistance (hospital) on third day.
Admitted St. Margaret's Hospital on fifth day : gonococcus found. Result—perforating ulcer right
eye. Tiny scar only.
Case 13.—History of purulent vaginal discharge of mother. Ag NO3, 1 per cent. used for eyes at
birth. Onset of symptoms ? ante-natal, mother and infant removed at once to infirmary. Result—
blindness in both eyes.
In four of the cases where permanent impairment of vision resulted in one or both eyes there
was a history of vaginal discharge in the mother.