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"It follows, therefore, that a considerable number of hypermetropic
children will, sooner or later, become emmetropic and
cease to need glasses, a fact which accounts for all except one of the
thirty-eight children in lines 1 and 2 of Table II. Moreover,
any improvement in methods of examination which permits of
children being examined more frequently will produce an increase
in this class of case until the ideal of annual tests is finally achieved.
"A further important result of this is that in a child exhibiting
a small degree of hypermetropia, spontaneous cure of the condition
is almost certain to occur. It is, therefore, my practice to refrain
from prescribing spectacles when the hypermetropia amounts to
0.5 D. or less and is not associated with noteworthy discomfort or
diminution of visual acuity, and the results seem amply to justify
this course of action. This accounts for many of the children
classed as emmetropic in Table III (lines 1, 2 and 5).
"Taking the various items in Table III in order, it must be
remembered that, for various reasons, malingering is occasionally
responsible for apparent visual defect. In the case noted (a) in
line 2, the visual acuity was only 6/24 with both eyes and the child
was referred to the Western Ophthalmic Hospital, where the
diagnosis of malingering was confirmed. On the whole, however,
malingering rarely takes so extreme a form and a child reads up
to 6/12 or 6/9 without lenses. In such cases, a combination of
plus and minus lenses, having the effect of a plane lens, produces
subjective improvement up to approximately 6/6.
"Three other classes of children fall into these groups. The
first comprises those who, usually after a slight squint which has
disappeared with the passage of time, are left with partial amblyopia
in one eye. Of 39 children, 6 fall into this class. The second class
comprises a number of children, under eight years of age who,
either from unfamiliaiity with letters or because of some physiological
reason, are unable to see 6/6 and yet have apparently normal
eyes. As a rule the vision of these children becomes normal with
increasing age. The third class, a much smaller one, confined in
the present year to a single instance, comprises those whose vision
is impaired by some such condition as a scarred cornea, generally
following an inflammatory condition.