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Title: A record and analysis, with conclusions, upon the examination of 1041 school children attending the Bradford Eye and Ear Hospital from April 1902 to November 1905
Author: Eames, C. W.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1906
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With regard to the Hypermetropíc eye becoming Myopic, I fail to find sufficient evidence as to whether the cause is due to the strain pure and simple, or to a diseased condition of the Choroid etc: Personally I think it is due to a combination of both of these conditions, although the: strain certainly plays a very important part. In comparing the different groups it is a noticeable fact that girls are greater sufferers than boys, and I would emphasize the fact that it is in children between the ages of 7 and 11 years that the strain upon the eyesight appears to be the greatest. aThe absolute necessity for school children having both eyes examined separately for visual acuity upon admission to the school. I have tabulated a series of cases (see appendix) showing that undoubtedly children may have fairly good, or very good vision in one eye, whilst the vision of the other eye is moderate, or even bad. Several of these cases which have been tabulated were not-sent-by the school authorities but, brought by the parent, these children having passed the tests employed. It certainly appears to me to be a distinct advantage for children to have the combined use of.both eyes. If they are allowed to go on using one eye only, the other eye eventually becomes Amblyopic, thus they are handicapped during their school life, and also in after ' life. aSpasm of Accommodation is a condition which is frequently met with in our children, and it is on this account that I strongly condemn the practice which is very much in . vogue, of parents, and even school authorities sending children to so -.called "Opticians "; for it is impossible for anyone to fully estimate the degree of error of refraction in any child unless its "accommodation" is properly paralysed; a fact which has been well illustrated in numerous instances in my paper. In many of the children who had Homatropine dropped into their eyes, their retinoscopy taken, yet obtained no improvement with glasses, I find that when Atropine was given for a week, and retinoscopy again taken, there was found to be a great difference'between the first and second examination, showing the fact that "Spasm of " Accommodation" may lead one into error. Although the visual acuity may be bad in some cases, upon examination by retinoscopy the eye is proved to be Emmetropic. Of the 110 cases of Spasm of Accommodation: 91 were Hypermetropes, 12 were Myopes, 3 were Mixed Astig: 1 was Hyper: c Myopia, 4 were Normal. This shows, that the condition occurs most frequently in Hypermetropes. From the complications which occurred in the various groups I think we can safely deduct that it is absolutely necessary to have the eyes of every child examined as soon as there is any inflammatory condition of the mechanism of the eye; for although the defect in refraction may not be the actual cause, yet, it does aggravate the trouble, and if the proper correcting glasses are given, this prevents a recurrence. It is suggested that very many of these complications are produced and aggravated by the child rubbing its tired eye. Here again I consider we have a very strong argument against unqualified men being, partially trained as so- called "Opticians" when they would be quite unable to diagnose any of these diseased conditions. aChildren should not be admitted to any school before the age of six, and even at that age the work should be light. It. should be forcibly impressed upon parents that schools are not nurseriesè The early training of all children should be in the hands of the mothers, and they alone are responsible for the care and training of their children. It would certainly be interesting to compare the eyesight of children who have attended school from the age-of three and upwards with those who have not been sent to school before the age of five or six years. I consider that a wise course has been adopted by the authorities during the past. twelve months in stopping the grant for children under five years. of age. I am convinced that the authorities are taking precautions in all directions save that of compelling-parents to have the eyes of their children properly examined by an Ophthalmologist. What might be done with advantage would be to point out to'the parents by a "printed letter" the absolute necessity of their children having the full and combined use of both eyes, and the folly of not allowing them to wear glasses simply for the sake of appearance; and also to point out that from the disuse of one eye, the child may eventually lose the sight of this eye, and thus be considerably handicapped in his after life. I am fully aware of the fact that no action could be taken if the parent refused to have his child attended to, yet I feel certain that if compulsory education is enforced, then it is not sufficient for the authorities to simply give one, two, or three notices, and then take no further action, but they must,in the interest of the child, and thus, of the community, refuse to allow children t take advantage of free education; for undoubtedly drastic measures are necessary, otherwise, through lack of thoughts or through ignorance, our children may become useless citizens. Another alternative is to provide a properly trained Ophthalmologist and have children attending all schools thoroughly examined, ignoring- the'parent. Upon this point I will make same observations later. aHome lessons for children. under nine or ten years old, should be strongly discouraged, and even at this age it should depend upon the child's capabilities as to the amount given. It should be impressed upon the parent the importance of seeing that the child when doing home lessons, should be in a properly lighted room, and that the desk, form or chair, and paper, be in proper relationship. Children who have defective eyesight or are otherwise weakly, should have a modified curriculum. There should be a period of rest between all lessons, also constant change from reading or writing to black board, or object lessons etc. Teachers should be instructed as to the elementary facts of the relationship of school work and strain to the eyesight. I find that upon this point very many teachers are extremely ignorant, and I would enforce a special class of instruction upon this subject. That there is an advantage of having the eyesight of school children properly examined and their error of refraction corrected, I think no one will doubt, but I think the following-tables. which give the visual acuity of the right and left eye of 683 cases upon their first "visit, and the visual acuity of 407 of these cases upon their last visit to the Hospital, will give an indication of the advantages which are obtained by treatment.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available