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32
ORTHOPTIC CLINIC.
Orthoptics now hold a valuable and clearly defined position
in modern ophthalmic practice. For many years attempts
have been made to obtain a functional cure in cases of squint,
and the aim of orthoptic treatment is to develop perfect
binocular vision. In each case this possibility must be
explored at the outset.
In the main there are roughly three groups. Some
respond to orthoptic treatment only, some will require operation
as well, and others for whom a cosmetic result, either with
or without operation, is the only hope.
One of the most important points in dealing with squint
in children is that of occlusion. It cannot be too clearly
stressed to the parents, and to general practitioners, that
occlusion must be started as early as possible. Where the
vision is less than 6/18 the good eye should be totally occluded,
and it has been found that either adhesive tape or isinglass
plaster on the face is the most effective form of occlusion,
provided the patch is changed occasionally. Partial occlusion
is obtained by means of paper patches on the spectacles, or by
atropin until the vision is equal in both eyes. Actually
atropin is especially valuable in cases of very young children,
even before the age of twelve months, as it can be put into
the fixing eye as soon as the squint is noticed, and may obviate
more drastic patching at a later age.
During the year 81 new cases were referred to the
Orthoptic Clinic. 21 of these were M. & C.W. cases; 61 cases
were given treatment, 37 being discharged.
428 other cases mainly for visual tests attended during
the year in addition to those on regular treatment. 23 cases
for squint were operated on by the Ophthalmic Surgeon.
Good results were obtained in 21 cases, but further operation
may be required in the remaining 2.
DENTAL SERVICES.
This scheme requires a particular note as it is now one of
the most comprehensive of its kind in the country and is being