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83
"There are two forms of myopia to be considered:—
(a) A simple form which shows itself for the first time
at 6 to 7 years and increases slowly up to 18 years or so. The
defect does not usually exceed 3.50 dioptres.
(b) A malignant form which appears a little earlier,
progresses rapidly to middle life and may result in total
blindness.
"It is most important therefore to recognise the malignant
form as early as possible, and to adopt the measures that will
tend to check its advance. This may be effected to some extent
by avoidance of near work such as reading, writing and sewing so
that a child with malignant myopia cannot take full advantage of
the educational facilities in the ordinary school without risk of
permanent injury to its sight. It has been recommended that such
children should spend a third of their time at the ordinary school
—for oral teaching—and the remainder at a special school with
educational methods specially suited to preserve their sight. The
special school should be under a teacher who fully appreciates the
object in view.
"In order roughly to estimate the number of children attending
elementary schools in Ealing who would be eligible for special
teaching a review was made of the vision cards. These give the
results of examinations at the Health Centre of children with
defective vision. In deciding which of the cases of myopia were
likely to be of the malignant or rapidly progressive type two points
were taken into consideration ; first, the amount of advance in the
condition as revealed at successive examinations, and second, the
amount of myopia in relation to the age of the child.
"The treatment recommended was of three kinds depending
on the extent of the defect and its rate of advance.
"(1) Observation: This was advised for children suffering from
mild degrees of myopia. The child continues his work at the
ordinary school, wears suitable correcting glasses, and submits to
re-examination at stated intervals, usually half-yearly. If on
subsequent examination the condition shows an unusually rapid
advance, treatment under (2) or (3) is advised.