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be found that the child holds print nearer than normal to the eye.
Myopia is due to stretching of the globe, which may very often
be detected by the prominence of the eyes, or the great extent of
sclera exposed on looking sideways.
In high degrees of myopia there is nearly always bulging of
the sclera at the posterior pole, i.e. just outside and around the
optic disc. This bulging is accompanied by atrophy of the choroid
covering it, and with the ophthalmoscope a whitish crescent,
circle or large irregular patch will be seen; the crescent is usually,
to be seen at the outer side of the disc. The term "Posterior
Staphyloma" is applied to the bulging. The choroid is generally
thinned and its veins more obvious than usual, and in some cases
patches of choroidal atrophy are present in the yellow-spot region.
It is possible that the increase of myopia may be determined
by the pressure of the recto-muscles upon the globe during excessive
convergence required by the short focus of these eyes; for
that reason glasses to reduce convergence are a necessity. The
increase as a rule does not occur after about '25 years.
Any severe illness, especially congestion of the eyes brought
about by excessive strain in near vision, and stooping
over books, etc., favours its progress.
In high mvopia there is a tendencv to several complications,
all seriously damaging to the sight.
The rate of increase of myopia varies much amongst its subjects.
Most commonly myopia commences in childhood and
steadily increases ; the eyes are frequently weak and irritable, and
such complications as blepharitis and chronic conjunctivitis are
not infrequent.
Perhaps the most frequent determining cause of an increase
of myopia is excessive convergence. We may prevent this by
giving glasses that correct the myopia, and therefore push the ncar
po'nt of vision further from the eyes. To-day most Ophthalmic
Surgeons agree in prescribing glasses that provide a "Full Correction"
of the myopia. This is a good rule with certain limitations.
The importance of the systematic examination of the eyes of
myopic children cannot be over estimated.
Most of the myopic children are returned to the elementary
schools, with correction satisfactory, as capable of receiving the
regular education with certain restrictions.
Very high myopes are drafted to special schools for the Blind
or Partially Blind, under the definition given in the list providing
for these schools.
The Blind and Partially Blind School is a most serious matter
for children of the working classes, the child leaves school with
the stigma of the Blind School upon it; and in these days of the
Employers' Liability Acts, that is no light matter when the child
leaves school and applies for work, as it is the usual thing for the
employer to ask what school and standard passed. The mention
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