Better Eyesight, August 1919
A MONTHLY MAGAZINE DEVOTED TO THE PREVENTION AND CURE OF IMPERFECT SIGHT WITHOUT GLASSES
HOW TO USE THE SNELLEN TEST CARD for the Prevention and Cure of Imperfect Sight in Children The Snellen Test Card is placed permanently upon the wall of the classroom, and every day the children silently read the smallest letters they can see from their seats with each eye separately, the other being covered with the palm of the hand in such a way as to avoid pressure on the eyeball. This takes no appreciable amount of time, and is sufficient to improve the sight of all children in one week and to cure all errors of refraction after some months, a year, or longer.
Children with markedly defective vision should be encouraged to read the card more frequently.
Records may be kept as follows:
John Smith, 10, Sept. 15, 1918. R. V. (vision of the right eye) 20/40. L. V. (vision of the left eye) 20/20.
John Smith, 11, Jan. 1, 1919. R. V. 20/30. L. V. 20/15.
The numerator of the fraction indicates the distance of the test card from the pupil; the denominator denotes the line read, as designated by the figures printed above the middle of each line of the Snellen Test Card.
A certain amount of supervision is absolutely necessary. At least once a year some one who understands the method should visit each classroom for the purpose of answering questions, encouraging the teachers to continue the use of the method, and making a report to the proper authorities.
It is not necessary that either the inspector, the teachers, or the children, should understand anything about the physiology of the eye.
A HOUSE BUILT ON SAND
That the results of the present method of treating defects of vision are far from satisfactory is something which no one would attempt to deny. It is well known that many patients wander from one specialist to another, seeking vainly for relief, while others give up in despair and either bear their visual ills as best they may without assistance, or else resort to Christian Science, mental science, osteopathy, physical culture, or some of the other healing cults to which the incompetence of orthodox medicine has given birth. The specialists themselves, having daily to handle each other's failures, are scarcely better satisfied. Privately they criticize each other with great asperity and freedom, and publicly they indulge in much speculation as to the underlying causes of this deplorable state of affairs.
At the recent meeting of the Ophthalmological Section of the American Medical Association, Dr. E. J. Gardiner, of Chicago, in a paper on The Present Status of Refraction Work, finds that ignorance is responsible for the largest quota of failure to get satisfactory results from what he calls the "rich heritage" of ophthalmic science, but that a considerable percentage must be attributed to other causes. Among these causes he enumerates a too great dependence on measuring devices, the delegation of refraction work to assistants, and the tendency to eliminate cycloplegics, in deference to the prejudices of patients who have a natural objection to being incapacitated by "drops."
On the same occasion, Dr. Samuel Theobald, of Johns Hopkins University, noted a tendency to "minimize the importance of muscular anomalies" as an important cause of many failures to give relief to eye patients. Among cases that have come into his hands after glasses had been prescribed by other ophthalmologists he has often found that "though great pains had been taken to correct even minor faults of refraction, grave muscular errors had been entirely overlooked.” From this fact and from the small number of latent muscular defects noted in the hospital reports which he has examined, the conclusion seems to him inevitable that such faults are in large measure ignored.
Dr. Walter Pyle, of Philadelphia, laid stress on "necessary but often neglected refinements in examination of ocular refraction.” "Long practice, infinite care and attention to finer details," he said, "are imperative requisites, since a slight fault in the correction of a refractive error aggravates rather than relieves the accompanying asthenopic symptoms.” This care, he says, must be exercised not only by the oculist but by the optician, and to the end that the latter may be inspired to do his part, he suggests that the oculist provide himself with the means for keeping tabs on him in the form of a mechanical lens measure, axis finder and centering machine.