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Medical Treatment. 123
the glasses received from the makers are tested to see that
they correspond exactly with the prescription and that
they fit the child's face comfortably.
In the majority of cases the results are highly satisfactory,
and there is perhaps no department of school
medical work in which the parents appreciate more
keenly the value of what is being done for their children.
Suggestion for future development of the School Oculist's
work.—There is, however, a certain proportion of cases
in which the correction of errors of refraction does not
appear to result in any great improvement in the
visual defect. For example, a child aged 10 years on
being tested is found to have only one quarter of the
normal vision—in technical terms its vision is stated
to be 6/24 instead of 6/6. For all practical purposes
the child is three-quarters blind. On further examination
he is found to have three degrees of astigmatism—
a common error of refraction. The appropriate glasses
for the correction of this error are supplied and the child's
vision is still defective to practically the same extent.
Careful examination of the eyes fails to reveal any
other cause of defective vision.
Cases of this kind—and they are fairly common—
seem to me to point the direction in which the work
of the School Oculist must be developed in the future,
that is, in the direction of the earlier investigation
and correction of defective vision. To prevent these
cases of partial blindness there should be a systematic
examination by the method of retinoscopy of every
child's eyes when it enters school. This system is
already in use in the Glasgow schools and is giving highly
satisfactory results, and I would suggest that in Ealing