View report page

31
During the past two or three years, orthoptic training in the treatment of squint
has made progress. The ophthalmic surgeons take full responsibility for the treatment,
and, after examining the children to ascertain the visual acuity, the angle
of squint, the presence of fusion and its degree, and the presence of stereoscopic
vision, prescribe the exercises most suitable for the individual children. These
exercises are then undertaken under the supervision of trained orthoptists. As a
general rule, it is necessary to devote at least 20 minutes to each child twice a week.
Such training by orthoptists is undertaken at Central London Ophthalmic, Guy's
and King's College hospitals, and at the Streatham and Whitechapel centres.
During 1937, the number of squint cases treated at the various hospitals and
centres was 243. The following particulars relating to the orthoptic treatment of
squint at the Streatham centre has been received from Mr. P. M. Moffatt, M.D.,
D.P.H., D.O.M.S., the ophthalmic surgeon in charge of the work:—
The clinic was opened in April, 1936, and held two sessions a week until April, 1937, when
the number of sessions was increased to three a week. The figures in this report cover the period
from the commencement of the clinic to the end of December, 1937.
The total number of children examined was 65. If from this figure is deducted 10 on waiting
list, 16 being at present treated, 4 "apparent" cases, 3 failed to attend, and 6 unsuitable for
treatment by orthoptist, i.e., a total of 39, it will be seen that 26 children were treated to completion.
These may be analysed as follows:—12 cured by orthoptic exercises alone; 3 cured by
orthoptic exercises and operation; 3 cosmetically straight in glasses, but fusion not complete;
3 improved; 5 not improved, or so little that treatment was stopped after 12 treatments on the
ground that more suitable cases would benefit.
Ear, nose
and throat
During the year, the number of children suffering from ear, nose and throat
diseases dealt with was 13,592, for whom 9,251 operations were performed for enlarged
tonsils and adenoids, compared with 13,190 and 9,116, respectively, during
the preceding year. Of the operations, 8,004 were for both enlarged tonsils and
adenoids, 862 for enlarged tonsils only, and 381 for adenoid growth only. The remaining
4 were operations in which cauterisation was used.
There are 6 hospitals, viz., Belgrave, Royal Free, Princess Louise, St. Mary's,
South.Eastern, and Victoria hospitals, and 7 centres, viz., Cyril Henry, Hammersmith,
Highgate New Town, Poplar, Hanover Park, St. Georges dispensary and the
Wick, where operative treatment is undertaken. In all cases, the children are dealt
with as in.patients, and as a general rule they remain at the hospital or centre for
two nights after the operation. Those cases in which the operation is performed on
Friday are normally kept in for one night only, but arrangements have been made
to convev them to their homes by ambulance.
Ringworm
Although the incidence of ringworm of the scalp among school children is
now happily of rare occurrence, it has been thought desirable to retain centres
in different districts of London in order that such cases as may arise may be
speedily dealt with. One centre was, however, closed in Woolwich during the
year, as the apparatus, which had been in use for over 20 years, was worn out.
There are so few cases forthcoming in the district that it was deemed undesirable,
on the score of expense to renew the apparatus. Such cases as may arise can be dealt
with at one of the hospitals in central London without difficulty. There remain 5
hospitals and 3 centres where suitable treatment by X.rays is available. At two
hospitals (Charing Cross and the London) payment is made on a capitation basis
(25s.), at three hospitals (Princess Louise, Queen's and St. Mary's) payment for such
cases as may arise is included in the block grants, and at three centres (Fulham,
Islington and St. George's dispensary) the salaries of the surgeons are paid on a
sessional basis as required.
During the year, the number of children dealt with was 78, of whom 69 were
treated by X.rays, compared with 89 cases (80 X.rays) during the year 1936.
Minor
ailments
The nominal provision in London for the treatment of minor ailments is at
present 87,450 cases a year. The number of children actually dealt with during 1937
was 125,669, including 19,304 seen by the nurses only, compared with 122,305, including
16,548 nurses' cases, during the year 1936. In addition, a number of children suffering