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58
and of girls at each age greater than boys. There is no doubt much injury to the eyesight of school children
brought about by educational methods and especially by over pressure. It is, however, cheering to
note the heavier incidence of defect upon the older girls is less marked this year than in any former year,
and it is to be hoped that this marks an improvement in educational methods and a care for the
physical welfare of the girls which has long been due. The improvement deduced from the returns of
children referred for treatment for failing vision is shown also in the tables of visual acuity in which
the children are classified as normal, poor and bad:—
Eight.year old. Twelve.year old.
Boys. Girls. Boys. Girls.
Normal. Poor. Bad. Normal. Poor. Bad. Normal. Poor. Bad. Normal. Poor. Bad.
1918 38.2 42. 19.7 34.7 43.5 21.8 52.6 25.7 21.7 46.8 29 1 24 1
1919 39.7 40.2 20 1 35.6 42.8 21.6 51.5 26.9 21.6 47.8 29.5 22.7
From this it will be seen that the difference between the percentages of twelve.year old boys
and girls with bad eyesight, which was 2.4 in 1918, is only 1.1 in 1919.
The steady decrease in the proportion of children developing bad eyesight between the ages of
eight and twelve and the lessening of the excess of bad eyesight in girls as compared with boys at the age
of twelve, which have taken place in recent years, may be fairly claimed as a vindication of the work
of the doctor in the school. Such improvements as this and that recorded in the case of conditions of
uncleanliness are a stimulus to further effort, for they show that the forts of ignorance and ill.health are
not impregnable.
Dr. G. Chaikin's
Enquiry
into the Occurrence
of
Myopia in
School Chil
dren.
An enquiry was undertaken by Dr. G. Chaikin during the year to find out what proportion of
school children of different ages who had attended the Poplar School Treatment Centre, and in whom
refraction had been carried out under atropine by the Centre oculists showed evidence either of (a) myopia,
(b) simple myopic astigmatism, (c) mixed astigmatism, i.e., one meridian myopic. The centre records
of 603 children were examined, 270 were boys and 333 girls. The ages were from 3 to 14. Practically
all, with one or two exceptions, were uni.racial—English. Of 603 children so examined, 85 or 14.1 per
cent., were found either with myopia, or simple myopic astigmatism or mixed astigmatism in one or
both eyes. The girls showed 48 out of a total of 333, i.e. 14'4 per cent.; the boys were slightly lower,
37 out of 270, i.e., 13.7 per cent. Dr. Chaikin found—as other observers have shown—that the percentage
of myopes increased with age. At the age of five the percentage was 2 0 per cent. It then
increased gradually to 13 per cent. at the age of 11, and 23.63 per cent. at the age of 13—14, i.e., the
leaving age. Another feature was the preponderance of astigmatism over simple myopia. The ratio
was roughly for each eye, both in boys and girls, as two of astigmatism to one of myopia

In conclusion Dr. Chaikin emphasises the following points:—
(1) Considerable numbers of children suffer from myopia in one form or other.
(2) The majority show it with astigmatism, either with another myopic meridian or a
hypermetropic meridian or with an emmetropic meridian.
(3) That, as is well known, myopia increases with age.
(4) That the causes may be many, but school work cannot be entirely passed over and the
lighting and attitude must be carefully watched.
(5) The great prevalence of astigmatism, is important. There are many causes; but no
doubt a new contributory cause is found in the flickerings and bad light of picture palaces
whither multitudes of children flock, and which endanger the eyes of the young.
(6) The great care required in retinoscopy in order to obtain the best result as a consequence
of this prevalent astigmatism.
(7) This also affects the results which are often seen at re.inspections at schools when the
children do not obtain full correction—a condition not unlikely in astigmatism.
(8) The importance of well.fitting and correctly centred glasses cannot be emphasised sufficiently
in view of the frequency of astigmatism.
(9) Incidentally, the cost of glasses is affected—astigmatic lenses being more expensive.