The morning call., 1893-06-15
AN INTERESTING LECTURE.
Delivered by Frank Cornwall, Md, Before
the Pupils Of the State Normal
School at San Jose.
SUBJECT, SPASM OF ACCOMMODATION.
Concerning the Uses Of Eyes and the Fit
ting Of Opticians and
0CuliStS.
SUBJECT, SPASM OF ACCOMMODATION.

In recent lecture delivered at San Jose
before the pupils of the State Normal
School by Dr. Frank Cornwall, that learned
gentleman selected for his discourse a
practical subject, concerning the uses Of
eyes in those who attend school. There
were 600 pupils present at the lecture,
which was replete with interest from be-
ginning TO end. 1t required one hour for
the doctor to elucidate his subject, so that
many would have an understanding of 1t.
but it is thought that it may lead to a fur
ther investigation where the disrresses
that come from this condition of the eyes
affllct themselves or others with whom
they have to do. The doctor first eX-
planned what was meant by 'spasm of ac-
comm modation." 1t is known that an eye
that is correctly focused makes no effort
for distant sight. but when near objects
are seen distinctly the crystalline lens in
creases its curvature so as to keep the focus
on the retna. This is called "accommoda-
tion," because 1t is through this function
of the eye that it can accommodate itself
to different distances Nearsighted eyes
do not see we'll at q distance, but in pro-
portion as they are nearslghteG they do
not need to accommodate for the near
point. Farslghted eyes see we'll at a dis
CORRECTLY
sighted, but they have 10 use the accom-
modation that should only be used for the
near point for distance, and then when at
the near point they have TO add the effort
that is needed Tor distance to that required
Tor the near point, thus doubling this ac-
mmodatiOn effort. This is what pro-
duceS fatigue ana reflex SYMPTOMS of other
kinds in favsighted people. This c0ntinu-
Gus effort that Is necessary for fars GIFTED
people to see distinctly at a distance is
called 'spasm Of accommodation" The
reason why it is called ''spasm" is that
there is muscle Called the ciliary muScle)
which contracts when the lens has its
curvature increased, and when this in
creased curvature is kept up all the time il
constitutes spasm This so uses up the
energy Of this muscle for distant vision
that when near work Is done for a great
length Of time it sometimes entirely fail
ana then vision is said 10 blur. At other
times this blurring is not a noticeable
eature OF the case, but headache or gen.
eral nervousness Is prod iced. In the young
there commonly is an indlSpoSitiOn to read
for long time, as 1t causes some kind of
iil-tefned unpleasant feeling about the
head and eyes COnvergent strabiSmuS is
commonly caused by this condition, and
when spasm exists there is always a teu-
dency for the visual lines to converge. This
tendency gives rise TO pain, because the
eyeball is not in its place of rest when
both are fixed on the same point. l am of
the opinion that the magnitude of the
prevalence in America OF hypermetropia
Qarsightedness) is not fully appreciated
by the profes sSion-not even by the oculists
In the first place the most of our textbooks
on Optha lmology are written by Europeans,
either in Europe or by those who were
born and educated in that country; and in
the second place, that drugs. such as afro
pine, have not been used universally in
making diagnoses OF these errors of re-
fraction. For two years l have used a
combination Of homatropine and cocaine,
which acts in half an hour. i'll every case
where the patients were under the age of
40 and not pronounced myOpes. | have
found spasm existing in so many cases
wherein 1 could not from my former OBJ
servation have suspected it, that it has
ceased to be surprise. | have been led
to use this drug i'll every instance because
of headaches, neuralgia, vertigo, inability
to maintain vision long at the near point
(asthenOpia), or such symptom existed, and
In almost every case the results have bGen
most gratifying. In the light of my sx-
perience of the last few years, the fitting
of opticians and oculists who do not make
use of mydriatics universally is extremely
unsatisfactory. The time required for a
correct diagnosis without paralyZing ac-
comm odation is often three or four years,
and in that time thousand headaches
might have been averted. 1t is the inten-
tion of DR.. Cornwall to deliver several
more lectures on this subject, all of which
promise to prove even more interesting
than this ones