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84
Medical Officer by the School Nurse. A certain number were
sent to the department by their teachers on suspicion of
having defective eyesight. Others, again, were brought by
their parents for advice on the matter.
A few words may be said as to the method of examination
employed. In all children under eight years of age
atropine ointment is used to dilate the pupils and paralyse
the muscles of accommodation.
In children over eight atropine is not used unless there
is any special indication for it, but homatropine and cocaine
drops are instilled into the eye at the time of examination.
In certain of the older children no mydriatic is required.
There is need for some insistence on the fact that the
examination of the eyes of children necessitates the use of
poisonous drugs, the use of which must be carefully regulated.
Many sight-testing opticians claim to be able to test
correctly children's eyesight without the use of a mydriatic
drug. This claim is confuted by the unanimous opinion of
the leading ophthalmic surgeons that such a drug is almost
always necessary, and should only be administered under
medical supervision.
Arrangements have been made to keep all cases treated
in the department under supervision until they leave school.
Most of the children will be examined in two years' time and
a change of glasses ordered if necessary. Unlike the adult
eye, the eye of the child is in a state of growth, and hence
the strength of lens necessary to correct the refractive error
may vary from time to time. Certain children are found to
require more constant supervision, and attend the department
at shorter intervals of time.
438 children attended at the public health offices for
examination subsequent to the primary examination. Many
of these visits were simply for the purpose of having the
spectacles supplied by the optician examined and approved.