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Dr. A. C. Williams has made an analysis of the medical findings in 100 applicants
for training under the Blind Persons Act, 1920. Under this Act training is provided
in certain circumstances for those who are both blind within the definition and
capable of making use of the training. In London, candidates are examined by the
Consulting Ophthalmologist who certifies blindness according to the standard laid
down by the Ministry of Health. There is also an examination of the general bodily
and mental condition to determine whether good use can be made of the training, or
whether such severe disabilities are present which would render training useless.
An analysis of 100 recent cases shows that the causes of blindness were :—
Optic Atrophy, 15; Choroido-Retinitis, 9; Retinitis-Pigmentosa, 3; InterstitialKeratitis,
12; Irido-Cyclitis, 5; Ophthalmia-Neonatorum, 11; Lenticular Affections
(mainly Cataract), 10; Affections of the Cornea other than I.K., 8; Congenital
Malformation, 9 ; Miscellaneous, 18.
The last group includes results of accidents and extreme refractive errors. Many
of those found to be not certifiably blind belong to this group. The total number
accepted as " blind " by the Ministry of Health was 89, four of these only after special
consideration. Eleven candidates had too much vision to come within the provisions
of the Act.
At the general medical examination the number of persons having physical or
mental defects in addition to the blindness was strikingly large—32 per cent., or
nearly 1 in 3. Physical defects and general disabilities are particularly common
in those whose vision in itself does not make them "too blind" to perform work for
which eyesight is essential, and some candidates have evidently hoped that the
presence of combined defect would cause them to be accepted for training, although
they had a visual acuity above the certifiable standard. Circulars 681 and 780 of
the Ministry of Health, however, emphasise the rule that only the visual condition
should be taken into account, and other mental or bodily infirmities should be
disregarded so far as action under the Blind Persons Act is concerned. Often more
than one defect was found in one person, so that the total number of defects was 43.
The physical defects were :—
Serious diseases of the nervous system, 2; Surgical defects, 6; Anaemia, 2;
Weak heart, 1; Debility, 1; Rhinitis, 1; Prurigo, 1; Haemophilia, 1; Bronchitis, 1;
Pyorrhœa (severe), 4; Rheumatism, 1; Gastritis (severe), 1. There were in addition
6 cases of marked deafness.
Also noted were 15 cases of mild mental abnormalities (dullness, neurosis and
mental instability). Mental dullness and inertia occurred especially in candidates
who came from poor law institutions, though not of a type that would be a permanent
or insuperable bar to training.
Careful watch was kept for cases of mental deficiency and several detailed
examinations were made for this purpose. Although no certifiable cases were found
among those given here, one or two defectives had been found on other occasions
and handed over to the care of the mental deficiency authority. Two cases of paralysis
and one of severe gastritis were rejected on medical grounds.
Eight cases passed as fit for training had disabilities needing special consideration,
such as old dislocation of forearm necessitating light work ; rheumatism needing
avoidance of damp in training ; chronic bronchitis for which work had to be chosen
where there would not be much dust. In several instances of remediable delect
treatment was advised and obtained.
Miss Jones, Secretary of the Metropolitan and Adjacent Counties' Association
for the Blind, has kindly supplied a detailed list of the results in the 86 cases who
were sent on as certifiably blind and physically fit for training. Of these 71 are
doing well, or at least promising, two are under treatment recommended, and 13 are
failures. Of the unsuccessful cases, seven failed on social or temperamental ground,
e.g., "parents opposed training," "man refused to continue training." Six failed
15435 D
Analysis cf
condition
found at
examination.