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RECUPERATIVE HOLIDAY HOMES
During the year the following recommendations were forwarded to the county health department
for placing in suitable recuperative holiday homes:—
Adults 122
Children 16
138
SCHOOL HEALTH SERVICE
Tuberculin Testing.
In January, 1955, tuberculin testing by the Heaf-gun method on school leavers was given a trial in
the Stonebridge area, and was found to be more reliable than the Patch Test and equivalent to the Mantoux
Test. At the commencement of the summer term, Heaf-gun testing was extended to all leavers.
Orthoptics.
Investigation and classification of the cases.
Every new patient undergoes a detailed examination; a history is taken and tests are carried out
to determine the presence or degree of binocular vision and the type of squint, so that an accurate
diagnosis and prognosis can be made. The cases can be classified as follows:—
(a) Children who can be cured by orthoptic treatment alone include :
(1) those whose eyes are straight with glasses (or without glasses) at least part of the time;
(2) children with very recent onset of squint (within the last few months), and
(3) those with late onset of squint, 3½ years or more ago.
(b) Children who need operation, cannot straighten their eyes at any time. They are often given some
pre-operative exercises to improve their binocular vision.
Methods of Treatment.
48 of the 67 cases referred required treatment (Table 1). Orthoptic treatment comprises:—
(1) restoring good visual acuity, by occluding the eye with the better vision;
(2) improving and developing binocular vision with the synoptophore, where the patient is trained to
superimpose two dissimilar pictures, such as the lion and the cage, fuse two similar pictures (the child
is taught to see one picture while adduction up to about +25° and about -5° are taught), and to fuse
slightly dissimilar pictures, using stereoscopic vision.
The child's accommodation is relaxed while using the synoptophore and he is trained for binocular
vision for distance. However, a large number of children squint mostly for close work, and therefore it
is very important to teach them to use binocular vision for near work. Picture books and reading exercises
are used to achieve this.
The close co-operation of' the ophthalmic surgeon and orthoptist is essential in achieving good
results, more particularly so in cases that need operation.
Results of Treatment.
The 18 orthoptic cures were functional cures; single binocular vision has been restored with and
without glasses for all distances and directions of gaze. The 7 cosmetic cures were very satisfactory in
appearance; the children have acquired equal (or as nearly as possible equal) visual acuity and have been
taught to alternate, so that their visual acuity does not deteriorate (table 2).
The 10 observation cases were cures which are being watched closely before they are recorded
as discharges.