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79
should never be asked to cover one eye with the hand while the other
is being tested. A card or a folded paper should always be used.
" A small number of children counterfeit visual defect because
they wish, for purposes of adornment or other reasons, to wear
glasses. Such counterfeiting can be detected without much
difficulty when a mydriatic is used, a fact which might usefully
be brought to the notice of those parents who allow a child's
myopia to progress untreated because they believe that his complaints
are only due to a desire to wear glasses. It cannot be too
strongly stressed that the slightest complaint of blurred or failing
vision on the part of a child is an urgent reason for the seeking
of medical advice.
" The other eye complaints which brought children to the
Health Centres were conjunctivitis, blepharitis, and styes. An
acute attack of any of these three conditions would receive local
treatment, but recurrences or the existence of an inflammation
of long standing should always be regarded as a sufficient indication
for refraction. Sixteen children with chronic lid affections (stye
or blepharitis) were tested by refraction and were all found to have
refractive errors. In every case seen again the prescription of
glasses was found to be followed by a marked improvement in the
inflammation. Of six children with conjunctivitis, five had refractive
errors and had their condition improved by the wearing of
glasses.
" It must be emphasised that recurrent inflammation of the
eyes, in the same way as headache, is an early sign of defective
vision which is to be regarded as one of nature's warnings which
must not be neglected.
" On the whole the year has been a highly satisfactory one,
in which the routine of eye treatment at present carried out in
Ealing has completely justified itself. There is however one
criticism and suggestion which might usefully be made.
" It is the practice at School Medical Inspection to refer for
refraction only those children in whom the visual acuity of one or
both eyes is A or less. As was pointed out at the beginning of
this report, moderate hypermetropia and slight myopia may and
frequently do cause a smaller degree of disability, while yet being
severe enough to justify full investigation. While it is impracticable
and undesirable to refract fully all children who read S in one or