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past year bear witness to their value to the
borough. Parents are realising not only the
importance of the elucidation of refractive errors,
but also the early investigation of strabismus. The
attendance of pre-school children at the clinics
has certainly increased.
'To provide the full diagnosis and treatment of
squints an orthoptic service is essential and it has
been an excellent idea to make the services of
Mrs Cynthia Butterworth, the orthoptist, available
at the ophthalmic clinics at Feltham and Hounslow
whilst the eye clinics are in session.
'There is an excellent rapport between Ashford
Hospital and the West Middlesex Hospital for
those requiring surgery, but the availability of the
orthoptic services in the borough makes it
economical both in time and financial cost to the
parents of these children.
'There are still small numbers in the Chiswick
and Brentford areas where frequent attendances
for orthoptic treatment present difficulties, due to
the cost of travel and domestic problems of
smaller children.
'An eleven-year-old girl presented herself at the
Brentford Clinic with a long-standing uniocular
cyclitis. There were also four cases of virus
keratitis which were presented for routine
examination and which I referred to hospital.
A ten-year-old girl was registered as partially
sighted and as a result was admitted to a special
school for the partially sighted.
'Finally, I should like to stress the importance
of screening children between the ages of ten and
sixteen years to detect simple myopia, as this often
retards school work and affects personality if
it remains undiagnosed. A very high percentage
of those over the ten year age group are myopes.'
Orthopaedic Clinics
These clinics are staffed jointly by the Regional
Hospital Board who provide the orthopaedic
surgeons and the local authority who employ the
physiotherapists. Two clinics are held in the
borough, one at Brentford Health Centre where
Mr J A Cholmeley attends fortnightly and the
other at Hounslow Health Centre where
Mr F Godsalve Ward attends monthly.
Mr Cholmeley is associated with the Royal
National Orthopaedic Hospital and Mr Ward with
Ashford and Hounslow Hospitals.
Although 388 children are on the orthopaedic
clinic registers, only 357 needed to see a surgeon
during the year and 114 children required
treatment by physiotherapists at Council clinics.
In addition to attendances made at the Brentford
and Hounslow clinics, a physiotherapist attends
Busch House School daily to provide treatment
for 43 children suffering from asthma, bronchitis,
cystic fibrosis and other conditions. Cystic fibrosis
is becoming an increasing problem because of the
larger number of children who now survive and
require special school placement.
The attendance of a physiotherapist was also
arranged twice weekly at the Marjory Kinnon
school for educationally subnormal pupils because
of the increasing number of children with
additional physical disabilities who are admitted
to this school.
I am indebted to Mr Ward for the following
report on his work at the Hounslow clinic during
the year:—
'Attendances have been satisfactory with very
few defectors—about 30 cases are seen in each
monthly clinic, a third being new cases referred,
with very few exceptions, from the school medical
officers and infant welfare clinics.
'Many cases are trivial but these are accepted
for fear of missing the occasional important case.
'The co-operation of the records officer at
Hounslow Hospital in arranging for appliances
and clinical photography has been much
appreciated. The direct pedestrian access to
Hospital Road will be a great convenience to
parents and children when the new health centre
is completed.
'It is always a pleasure to attend this monthly
session with Mrs Morgan, the physiotherapist.'
Orthopaedic Clinics
In 1967 a staff of four full-time and one sessional
speech therapists was deployed among the clinics
and centres listed in the tables which follow. It
will be seen that there is a shortage of staff, but it
is hoped that the position will be relieved in 1968
with the appointment of an additional full-time
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