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103
on the quantities and qualities of served meals, random samples were analysed from
time to time by the Council's Chemist-in-Chief (see page 37).
Vision
All school pupils, other than entrant infants, have their distant visual acuity tested by
the school nurse by means of Snellen test charts, those pupils who have them wearing
their spectacles for the test. The test is carried out at the time of the routine age group
general medical inspection, and in cases of sub-normal vision the result of the test is
checked by the school doctor.
In testing, the ability to recognise certain letters 9 millimetres square from a distance
of twenty feet, is the standard vision. This is termed V=6/6; vision of two thirds that
acuity is called V=6/9; vision which only recognises symbols double the normal size
is 6/12, and so on. Since vision testing is not objective, the results obtained depend
upon the child's response, which involves, inter alia, its knowledge of the types of
lettering used on the test chart. The charts now used by the Council are double sided,
having lower case script lettering on one side, and plain block capitals, without serifs,
on the other; it having been found that children have less difficulty with such types of
letters than with the classical Snellen types.

The constancy of the proportion of pupils recorded with normal visual acuity,
about 80 per cent. of those tested, has been noted for many years. In fact the earliest
report available, that of the medical officer to the late School Board for London,
analysing the results of the testing of the visual acuity of 28,057 pupils in 1902, stated
'The general result is that, while 80 per cent. of the children are found to have normal
vision and 10 per cent. have fair vision, the sight of 10 per cent. is bad'. (The 1902
report made it quite clear that the standard of normality then adopted was the same as
today, i.e. Snellen 6/6).
The above table also shows the proportion of pupils referred to ophthalmologists
for specialist examination, and this percentage has also been fairly constant for many
years. The table shows that the higher proportion of children referred for treatment at
the older ages was mainly due to the need for the adjustment of their glasses with the
passage of time.
The problem of ensuring that treatment is obtained for pupils with defective vision
now that this specialist work is the function of the Hospital Eye service, is discussed on
pages 109-110.
Personal hygiene inspections and the cleansing scheme
For the purpose of assisting at medical inspections, each school nurse is allocated to
a group of schools. Each school in the group is also visited by the school nursing sister
in accordance with a rota, in order that she can carry out the inspection of the personal
hygiene of the children. Each school is visited at least once a term, so that each child
is seen at least three times a year.