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unsuitable for operative treatment this boy has been recommended admission to a special school
for the partially sighted. Another, a case of nystagmus, occurred in an infant of eight months
old and could therefore not be described as a congenital defect. A provisional diagnosis made
in this case was a typical spasmus nutans although there was no sign of head nodding. Lastly
a case of a girl of 14 years of age, recently arrived from Ghana, was found to have a complicated
cataract in the right eye, and the left eye presented a picture of retinitis proliferans. Further
investigations into the aetiology arc being made by serological tests, not yet available, but her
condition was considered to be the sequelae of Eale's disease.
Tottenham
The visiting consultant, Mr. T.G. Kletz, reports;-
"As in previous years the cases attending the clinic ranged in age from young infants to
school leavers of 18 years.
Whilst the majority of cases seen are refractive including squints andmuscle imbalances, a
number of cases requiring ophthalmic treatment both medical and surgical were seen including two
cases requiring surgery following trauma:- a retinal detachment and a perforating injury.
Although more cases of strabismus and suspected strabismus are being seen in very young
children, there are still too many cases of we thought he (she) would' grow out of it". The
opportunity is taken of impressing the need to get these children investigated and treated at the
first sign or suspicion of a squint, no matter how young they are - even under six months old
if there is a strong family history of squint. Apart from the suspected or manifest squints there
were about 28 cases including the higher age groups or school leavers referred as having strabismus
or "lazy eye" and who had neither visual defect, muscle defect or appreciable refractive error.
The congenital defects included muscle paresis, ptosis, nystagmus and cataracts."

Child Guidance Clinic in Tottenham
The visiting psychiatrist, Dr. W.H. Craike, commenced duties on the 5th May 1959 for two
sessions per week. Dr. Craike reports that the problems were difficult behaviour at home and
school, nocturnal enuresis and other psychosomatic symptoms, three cases of multiple tics and
three children with physical defects as well as emotional disturbances.
They all came from working class backgrounds, some of the homes were materially good and
some poor. There were eleven children of average intelligence, nine were of superior intelligence,
and six were of below average intelligence.
Four parents refused treatment at the outset, or broke off treatment after one session. There
were four cases in which it was doubtful whether the parents would accept treatment, they are
being kept under occasional observation, the patents being seen by the psychiatric social workers
and the children by the Psychiatrist.