View report page

9
Conjunctivitis and blepharitis accounted for a large proportion of
the cases coming under the heading of external eye disease. Treatment
for blepharitis is rarely sought, and children attending the clinics for
this defect are those who have been referred there by the school medical
officers and nurses. By the time these cases have been discovered the
disease has frequently become chronic and resistant to treatment.
Admission to special institutions has been resorted to in the most
intractable cases.
I am indebted to Mr. T. W. Letchworth, M.B., F.R.C.S., Ophthalmic
Surgeon, for the following report:—
"The year 1938 was the twenty-seventh of the Ophthalmic Clinic,
work having started in January, 1912, and save for a short period in
1918 has been carried on since. 664 children were seen in 1912 and
1,482 in 1938.
"The numbers have not varied greatly of late years, the smaller
proportion of children attending the elementary schools having been
compensated by the accession of children from the secondary schools.
"Trachoma is singularly absent from Tottenham. During all these
years only a very few cases have been seen. External diseases of
nutritional origin have become much fewer. Xerosis of the conjunctiva
with night blindness, due to a diet deficient in Vitamin A, which was
prevalent before the war and of which 6 cases were seen in 1912, has
completely disappeared during the last 15 years. Phlyctenular keratitis,
which was a curse last century, causing very serious damage to the sight
of many children, is now much rarer. This has been shown by Dr.
Arnold Sorsby and others (Ophthalmological Society's Transactions,
1936) to be associated with latent tuberculosis. Cases usually respond
to treatment with Vitamins A and D and in some cases to tuberculin,
and especially to climactic treatment. We saw 16 cases in 1912 and
4 in 1938.
"Amongst refraction cases examined in elementary school children
during the year 1938 there were 279 cases of myopia, 217 of astigmatism,
88 of simple hypermetropia, and 152 of squint. In the secondary scholars
there were 102 cases of myopia to 21 cases of other defects. The explanation
is that the most common age for the development of low or moderate