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At a Squint Clinic Orthoptic training with special apparatus would develop binocular and
stereoscopic vision, with their attendant advantages, and by so doing would improve and cure many
cases that would otherwise give poor results.
Group I.—Cases suitable for Orthoptic training :—
(1) Visual acuity in squinting eye 6/12 or over.
(2) With Normal retinal correspondence.
(3) Angle of squint less than 20°.
(4) Response to fusion training after five lessons.
Group II.—Cases unsuitable for Orthoptic training :—
(1) Visual acuity in squinting eye less than 6/12.
(2) With abnormal retinal correspondence.
(3) Angle of squint greater than 20°.
(4) No response to fusion training after five lessons.
All cases in Group I. may be expected to benefit from Orthoptic training, while many cases in
Group II. will pass into Group I. after active treatment on the present system, and also after training
with apparatus for increasing the visual acuity of the squinting eye, which could be incorporated
in the Clinic.
The advantages of a Squint Clinic are thus evident. The difficulties are due directly to the time
involved in training, and the necessity for co-operation on the part of the parents during this period.
Twenty-minute lessons once or preferably twice a week would be required, and fifteen to
twenty attendances.
If such a Clinic was developed, I would suggest, that two sessions should be held each week,
and that the Ophthalmic surgeon should attend at one session to investigate the suitability of new
cases for treatment, direct the course of treatment, and supervise old cases. A nurse trained by him
could attend at the same session and carry on the treatment at the second session.
APPENDIX F.
REPORT ON THE WORK OF THE ORTHOPEDIC CENTRE FOR THE YEAR ENDED
31st December, 1935.
H. J. SEDDON, F.R.C.S., Orthopaedic Surgeon to the Council.
No outstanding features mark the work carried out at the Orthopaedic Clinic during the past
year, apart from a great increase in the number of cases sent for examination. It is most gratifying
to see patients with only slight degrees of deformity, and one has the impression that the School
Medical and Maternity and Child Welfare Officers are determined that no case of actual or potential
deformity shall excape observation. One difficulty that has arisen as a result of this increase in work is
that as many as 75 patients have been examined in the course of one afternoon. Under such conditions
thorough work is difficult and I have sometimes had the feeling that important physical signs may
possibly have been missed in the cases examined towards the end of such a long session. The greatest
number of cases that can be dealt with efficiently at one session has been found to be between 40
and 45.
I should like to take this opportunity of discussing two conditions, one relatively common—
the other rare. Although I have said (1934 report) that rickets in Willesden "can hardly be considered
a crippling disease," it still exists; and unfortunately four cases have required admission to
hospital during 1935, whereas none were admitted during 1934. Operative correction of deformity
was required in three of the cases, the degree of deformity in one being very considerable.
The various aspects of rickets have been studied with such remarkable thoroughness and success
(see the article by Park & Eliot in Diseases of Infancy and Childhood. Edited by L. G. Parsons
& Seymour Barling. Oxford Med. Publ. 1933. Vol. 1. p. 216), and prevention is so relatively simple
and inexpensive, that this disease should be the first to disappear from those that now commonly
afflict the child population. Yet even in easily accessible districts the disease persists, though in a
mild form. One possible explanation that occurs to me is the still widespread belief that breast-fed