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reported to the Education Authority prior to admission to school, so
that appropriate arrangements may be made for continued treatment
and special education if required.
The most important method of ascertainment during school age
is the routine medical inspections, the most important of which is
at entry. The vision of each child is assessed by the school nurse
before being examined by the School Medical Officer. They are tested
by means of the Snellen's long-distance chart illuminated toat least
ten foot candles with a child twenty feet away. The disadvantage
of this method is that a child does not always know its letters, and
special charts using animal shapes, and the letter "E" in various
sizes and positions, are employed to overcome this difficulty. Even
so, this assessment, while embracing the majority presenting defects,
will not include all, and the co-operation of teachers in this connection
is invaluable.
They refer any child who displays symptoms indicative of
defective vision, e.g. headaches; holding the book close to the eyes;
peering; obvious eye-strain; difficulty in seeing the blackboard;
stooping over the desk, or signs of mental retardation. The school
nurse who visits the school every term is also on the alert for such
defects, and often makes vision surveys. All children who are found
incapable of reading the sixth-twelfth line on the Snellen's chart
with either eye are referred for fuller ophthalmoscopic examination.
Thus the majority of children with defective vision will be picked
out; but this test, however, does miss a very few who have low
hypermetropia (long sight). Those found needing corrective glasses
are provided with these free of charge. It is important to make a
close and frequent follow-up of all cases prescribed glasses. This
is usually done regularly by the school nurse to ensure they are being
worn, and a prompt replacement is effected if found broken.
GENERAL CONSIDERATIONS.
Adequate natural illumination of all points in a class is
essential. Sky should be visible at all desk heights, and the light
should come from the left of the pupils. The lowest intensity of
artificial illumination on desks should be ten foot candles. It is also
important that the colouring of walls and ceilings be light, but
glare from any source, either from reading material or from walls,
should be avoided.