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65
school medical inspection. Also examination of all children under
5 years of age should include refraction.
Whether such a procedure is practicable on many grounds is
questionable, but a more searching and thorough test at the routine
medical inspection is suggested, and arrangements made whereby
the younger children could have their vision tested at an earlier
age than it is now done and at frequent intervals."
(Sd.) G. BANHAM.
Dr. Banham's report requires very serious consideration
and she has kindly promised to report further upon any modification
which may be necessary in our procedure, more particularly
in the initial examination during routine inspections. Her vast
experience, not only in Hospital and private work, but also in school
work makes her advice particularly valuable. She is intimately aware
of the limitations which are imposed upon us and how far we are
from the ideal, but she also appreciates the difficulties with which
we are met.
Reference has already been made to the Report of the Committee
appointed by the Board of Education, and 3 main points
emerged upon which stress was laid.
(1) The comparative rarity of normal vision at any age,
the condition being observed in only 2-3% of children at the age of
admission to school. Though its incidence increases with age,
it does not exceed 10% among children about to leave school.
(2) The rarity of myopia or short-sightendess under 5 years
of age, and the gradual increase in incidence as age advances.
(3) The great preponderance of cases of hypermetropia
or long-sightendess at all ages, though the incidence diminishes
as age advances.
Group 111 includes the figures of treatment of Defects of
the Nose and Throat. There is a slight decrease in the number of
children who were operated on at the Acton Hospital under the
terms of the Authority's scheme. In view of recent work which
has been carried out on the results of operative treatment on Tonsils
and Adenoids, it is possible that this decrease may have been a
blessing. Formerly, our difficulty was the opposition of the parents
to the removal of Tonsils and Adenoids. We still come across
cases where the tonsils are obviously diseased, the boy or girl is
a mouth breather, snores at night, suffers from frequent colds, and