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wherever it seems necessary endeavours to secure its transfer to St. Margaret's
Hospital, Leighton Road, which has been rendered available for opthhalmic cases
under the arrangements between the Council and the Metropolitan Asylums Board
which manages that institution. During 1925, 1,349 cases of inflammation of the
eyes in infants attended by midwives were dealt with, of which 422 proved to be
ophthalmia neonatorum. Of these cases 398 were completely cured, 14 died,
impairment of the vision in both eyes occurred in one case, and of one eye in 3 cases,
while in 6 the patients removed and the after results could not be traced. 65 cases
received in-patient treatment at St. Margaret's Hospital. The Council's consulting
ophthalmologist has pointed out the value of the methods introduced in recent years,
for whereas in his first survey of the causes of blindness amongst the children
attending the Council's schools for the blind the proportion ascribable to ophthalmia
neonatorum exceeded 36 per cent., in his last survey the figure had fallen to 19
per cent.
Purulent conjunctivitis of later years is due to a great variety of conditions,
but for the most part cases follow attacks of the exanthemata, especially measles.
The prevention of the conjunctivitis is therefore bound up with the prevention of
the exanthemata themselves. Measles is no longer a notifiable disease, except in
10 metropolitan boroughs, but the arrangements made by the Council for the forwarding
of information as to absences from school, due to this cause, to the medical
officer of health of the borough and to the school medical officer have contributed to
the control of this disease and its after effects.
In periods of epidemic prevalence a limited number of beds are available at
the fever hospitals of the Metropolitan Asylums Board, while there are schemes
whereby in each borough nursing assistance may be available in the homes of the
children where needed. Apart from cases occurring during the acute and infectious
stages of the exanthemata the Council's scheme for medical inspection and
treatment secures that any children attending school who have discharging eyes
can be at once referred for treatment at treatment centres or hospitals.
Phlyctenular conjunctivitis and blepharitis do not lend themselves to active
preventive measures other than those which tend to raise the general standard of
nutrition and cleanliness. Once the conditions have arisen children are referred for
treatment at clinics, hospitals or minor ailment centres. There are arrangements
whereby special cases are seen by the Council's ophthalmic consultant. By arrangement
with the Metropolitan Asylums Board children in need of longer residential
care are sent on the certificate of the Council's medical officer to Swanley, where
they remain until relieved. In certain cases this may involve residence for prolonged
periods. If necessary, a child may be sent more than once. This arrangement is.
most effective and is being increasingly utilised by the hospital authorities of London.
These disorders lead more often to impaired vision than to actual blindness.
With regard to the cases treated at minor ailment centres to which allusion is
made in the preceding paragraphs, it may be added that of the 88,000 cases dealt
with at these centres during 1925, a large proportion were slight ailments of the eyes
such as blepharitis, etc.
Trachoma, an acute infection of the eye, conveyed by contagion, is one of the
chief causes of blindness in some countries, but has in this country now become
relatively rare, though it occurs in little epidemics after importation from without
London, usually, it is believed, from the Continent. Children suffering therefrom
are promptly admitted on the certificate of the Council's medical officer to the
Metropolitan Asylums Board's institution at Swanley. Cases are usually detected!
through the school inspection and treatment centres. Greater difficulties arise
in the case of adults who may not seek treatment for some time, although they
may be in an infectious state, of which the sufferer is probably unaware. Between
1903 and 1920 the proportion of trachoma cases among poor law children admitted
14172 k 2