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112
To the School Medical Officer,
County Borough of East Ham
Education Committee.
January, 1928.
Sir,
I have the honour to present by Fifth Annual Report.
During the past year I have examined 656 children for defective
vision—588 also remain under supervision from last year and
172 no longer require it. One finds that children with defective
sight carry out instructions more carefully if they know that they
are to be called to see the oculist again after a certain interval; the
interest also of the teachers is thereby stimulated, while the
parents feel that the defect, having been discovered, is still
engaging our attention.
Defective sight results from two main causes—errors of
measurement in the eye as an optical instrument, and the effects
of injury or disease. As to errors of refraction, the child may be
long-sighted or short-sighted. If long-sighted the defect is greatest
in infancy and improves with age, but, unless care is taken,
may give rise to squint and defective vision in the squinting eye.
Squints result from a relatively poor power of binocular vision
combined with a defective muscle balance of the two eyes. They
appear early in life—long before school age—as soon as the
child begins to use its eyes in the middle of its second year, and
are immensely favoured by the onset of infectious diseases in childhood.
(At my special request Dr. Bendix allows children admitted
to the Isolation Hospital to wear their glasses.) Hence the
importance of the Ophthalmic Surgeon in the Maternity and Child
Welfare Centres which will be referred to later. The treatment
of squint consists in improving the power of binocular vision with
glasses (and in a few cases by exercises) or by correcting the
muscle balance defects by operation. The latter should never be
resorted to until the former has been given a fair trial. If a
squint is allowed to persist without treatment for any length of
time—six months—the visual centres upon the two sides of the
brain develop unequally and the chances of successful treatment
by glasses is rapidly reduced to vanishing point. As the eyes