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48
In 110 less than 127 cases no defect was discovered or a defect so
small as not to require correction. This was in some cases due to
children being sent on account of headaches not caused by ocular
defects, and in others to the difficulty of distinguishing a real squint
from what was only an apparent one. In many young children
there are conditions which cause an appearance of a squint, notably
epicanthal folds, when the eyes are really straight.
One can recognise a true convergent squint by getting the child
to fix and then cover the good eye. The squinting eye will then turn
inwards.
In a child too young to co-operate one can only go by the light
reflex on the cornea as seen through the retinoscopy mirror. In the
squinting eye the position of this reflex will be displaced to the temporal
side.
One must again remember that many squints start as being
only occasional.
Therefore it is better that all children, in whom there is only a
suspicion of a squint, should be seen. Cases suitable for orthoptic
treatment are referred to the Prince of Wales's Hospital.
Of the children seen 1,069 had errors of refraction. In 796
glasses were ordered and in 791 obtained. In the other cases glasses
previously ordered were still satisfactory.

I saw no phlyctenular ulcers of the cornea which in 1912 caused so
much damage to eyes and sight. No trachoma. Nor have I seen a
case of xerosis of the conjunctiva with night blindness for about
twenty-five years. All this testifies to the better nutrition of the
children!