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Subjective Testing with a + 1.0D Sphere. -It will be recalled that this scheme, in the form
in which it was proposed by the Board of Education, was abandoned last year, and that a modified
scheme was adopted. This consisted in making a record, at routine school medical inspections, of
all children who, with 6/6 unaided vision, show a diminution in acuity of three or more Snellen
lines when a +1.0D sphere is placed before the eye. These children were then to be specially
noted at the next medical inspection, and were to be referred to me if the diminution of acuity at
the second examination was greater than at the first.
The extremely significant result emerges that, in the fifteen months concerned, not one such
case was referred. The only deduction one can draw from this is, that the leakage in the discovery
of progressive myopes, which obtains in the ordinary methods of subjective testing, is nil. This
is actually less to be wondered at when it is remembered that it was found last year that the leakage
in the case of even stationary myopes was exceedingly small -in 52 unselected cases, sent up under
the " +1-0D scheme," only one myope was discovered.
Medicinal Treatment of Progressive Myopia. -This investigation is not yet complete ; a
sufficient number of patients have been put under treatment for conclusions to be drawn when the
time comes. From a cursory inspection of results it would appear that the measure is of definite
benefit in the treatment of progressive myopia.
APPENDIX F.
REPORT ON THE WORK OF THE ORTHOPEDIC CENTRE FOR THE YEAR ENDED
31 st DECEMBER, 1933.
by
H. J. SEDDON, F. R. C. S., Orthopaedic Surgeon to the Council.
The most striking feature of the work at the Stone bridge Health Centre is the rarity of
severe deformity or serious bone and joint disease among the children who attend.
This is, I think, to be attributed to two factors. In the first place, as Willesden is not far
from several large general and special hospitals there is a tendency among the parents of children
with serious deformity to attend one of these hospitals on their own initiative, and it is only when
the hospital wishes out-patient treatment to be continued at a Clinic that we see these patients.
Secondly, the routine examination of infants and school children is undoubtedly reducing the incidence
of severe deformity ; it is now possible to correct almost every early case of club-foot by manipulative
treatment at the Clinic, and similarly most cases of knock-knee yield readily to splint treatment
and operative correction is rarely called for.
The organisation of the orthopaedic clinic leaves nothing to be desired. The case cards never
leave one in doubt as to the reason for the child's attendance at the Clinic, and the collateral
information about previous illnesses and non-orthopaedic defects is most helpful.
The Masseuse is to be congratulated on her enthusiasm and careful attention to the details
of treatment ordered.
The follow-up work on cases that have ceased to require treatment, but are in need of observation,
is excellent, and one cannot recall any case of importance that has not been faithfully ''rounded
up'' for re-examination at the time specified.