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Eye defects.
The numbers dealt with in the eye departments of the centres and hospitals
during the year was 39,570, compared with 39,450 during the year 1935. There
are 38 centres where refraction is undertaken by specialists appointed by the local
committees responsible for the centres in addition to special school children's departments
at 11 voluntary hospitals in various districts of London. The following
are the hospitals where these arrangements are in operation: Belgrave, Central
London Ophthalmic, King's College, London, Metropolitan, Princess Louise Hospital
for Children, Royal Eye, Royal London Ophthalmic, St. Mary's, South Eastern,
and Western Ophthalmic.
Of the total number dealt with (39,570) about 2,000 were suffering from diseases
of the eye. Spectacles were prescribed in 27,744 cases.
Increased attention has been given to the treatment of children suffering from
squint. Special sessions are devoted to this work at the Belgrave, Central London
Ophthalmic, Lewisham, Royal Eye, and St. Mary's hospitals, and at the Paddington,
Streatham and Whitechapel centres. During the year an experiment has been
in operation at the Streatham centre under which the services of an orthoptist
are employed for training the children under the supervision of the eye surgeon
in charge of the department. Orthoptists are specially trained for this work and
hold diplomas issued by a body recognised by the British Medical Association.
Their duties, under the direction of an eye surgeon, are confined to the training of
patients suffering from squint, to obtain single binocular vision with stereoscopic
fusion by means of exercises with suitable apparatus. This training is a long and
tedious process calling for personal attention at frequent short intervals for varying
periods of time. The employment of orthoptists to undertake this particular task
not only enables considerably more attention to be devoted to each particular
patient with the consequent encouragement of persistent endeavour on the part
of the child, but effects an economy in expenditure compared with the employment
of ophthalmologists to undertake the work. The rate of payment of orthoptists is
about 10s. a session, compared with £1 16s. 4d. a session for eye surgeons. The
work at the Streatham centre is under the direction of Mr. P. M. Moffatt, M.D.,
D.P.H., D.O.M.S., who attends the centre for one session a week to see the children
and to deal with ordinary refraction patients. The orthoptist attends on two
sessions a week to carry out the training. Great care is necessary in the selection
of cases for training, as good results can only be obtained if the visual acuity is capable
of being brought up to a certain standard, which is regarded as better than 6/12
in the worse eye. The initial examination of the child consists of determining:—
(1) Visual acuity with and without glasses.
(2) The angle of the squint on the synoptophore.
(3) The presence of fusion and degree.
(4) The presence of stereoscopic vision.
It is necessary for the orthoptist to devote to each child a minimum of 20 minutes
at least twice a week. The more regular the visits, the quicker a permanent cure
can be obtained, as the effect of the training at the previous attendance does not
then wear off. The arrangement was only put into operation on 1st April, 1936,
so that it is not yet possible to draw any definite conclusions as to the value of the
work, but there is no doubt that the parents are most appreciative of the efforts
being made on behalf of their children, and no difficulty is experienced in obtaining