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143
In 1036 a fully equipped squint training department will be instituted.
Preliminary to the actual training, all eases of squint and of defective vision in one
eye must first be carefully prepared. Various measures are adopted to restore
the vision of the "lazy eye." These consist in the administration of drops to the
second eye which make the child use the squinting eye while reading and doing
other close work. If this is insufficient an occluder is worn. Detailed instructions
are given to the parents and the child is seen once a month at the Clinic when its
progress is recorded.
The other type of visual defect is short sight and here the danger lies in the
rapid increase of this condition rendering the wearing of powerful glasses permanent.
Much may be done to mitigate this risk by special attention being given to the child
at school. In all such cases a letter advising easy treatment is sent to the parents
and teachers. This "easy treatment" naturally varies with the individual case.
Our aim is to do everything possible to retard the increase in the short sight while
not interfering too much with normal education. It is only in severe cases that all
reading, etc., is stopped. Children suffering from short sight are examined at least
every twelve months and in some cases as often as every term.
It may be asked to what extent the visual defects found in school children are
inevitable and does environment play any part in their production. Of those
defects which can be classed as inevitable, squint and short sight must both be
included. Of course, many parents tell you that the squint was only noticed after
some illness, e.g., Measles, and while this illness may, from its weakening effect
generally, have caused the squint to develop, the underlying factors were already
present. Thus, during the past year, I have seen at Barking Hospital two cases of
squint following Diphtheria. Both patients were cured by simple treatment in
the course of some 12-14 days, because no factor other than Diphtheria was present.
The factors producing the common type of squint are either an excessive degree of
long sight or some hereditary predisposition. Such cases of squint require long
and patient treatment if the vision of both eyes is to become normal. As regards
short sight this often runs in families. It is the aim of all our treatment to limit
the degree of short sight, for in the lesser degrees it hardly forms any disability.
Children with a tendency to short sight often get worse from an environment which
they themselves create. Instead of playing games they are always reading. This
constant use of the eyes for near vision is to be deprecated.
It will be seen that much may be done in an Ophthalmic Clinic to prevent
disability which, after all, is the aim of all work in public health.