The San Francisco call., 1897-05-30
ARE DEFECTIVE
EYES PREVALENT?
a Large Percentage Of
Students Seem to Be
Afflicted.
Oculists Claim, However, That
the Examinations Are I'm.
properly Made.
Say 1t Is Impossible 10 Make Proper
Tests Without the Use of
Drugs.

the public schools, it is said, have been
found to be afflicted with various affec-
tions of the eyes.
The excessive strain imposed upon the
immature nervous system" said DR.. f.
Cornwall last evening, land through this
upon the eyes, caused by the great num-
Der of months of study in the year, to-
gether with the forcing that comes
through the competitive system in our
public schools, induces such prevalence
of eye failure, with other nervous COM
plants, as to awaken public interest.
Naturally the medical man is consulted
and particularly the oculist, and lie being
the only one with any knowledge of the
subject, all is left to him. This is as it
should be, but there are elements which
enter into the proposition and which bring
forth problems the solution of which is
desirable.
"a question arises which should be
passed upon, viz: When an ocul1st is
selected IN the ordinary way, what assur-
ance have the public of his capacity or
honesty? Human selfshness is apt to ex-
EN- pity itself in this as in all human af
fai rs, and when there is q monopoly, with
no one possessed with knowledge with
which to criticize, as in this case, things
may not proceed as they should.
AN established oculist has neither
time nor inclination 10 perform this
gratuitous work. a new and presuma bly,
inexperienced man who might wish to
bring himself before the public agitates
the matter through political friend and,
influence being brought to bear in the
right direction, he gets the place. Sc
lected in this way the oculist may be
either honest, dishonest, capable or in
capable. He has a great amount of work
TO do, for which he is to receive no salary
or compensation other than being
brought within the scope OF public view.
He may have, however, percentage with
the spectacle-man who supplies the chill
dren with their glasses, and in this way
make $40 or $50 day.
ITO an ordinary. observer this may seem
all right, even the percentage part, but
when full understanding is had it may
seem to be all wrong and of no use what
ever.
"I wish to impart this knowledg ge SO that
the professional reader may under
stand. The basis of my statements are
my own case books and that of others.
Furthermore all un biased oeulists will, in
my opinion, coincide.
What is called the accommodative
function of the eye is com posed of its lens
and muscle which surrounds it, called
the ciliary muscle. By the action Of this
muscle the lens can be changed in its
curvature. This adapts the eye for the
observation of objects at different dis
tances, and the decline of which is shown
By the fact that we require the assistance
of glasses as We grow older.
I'm normal eyes this muscle acts on all
the meridians of the lens alike, but if a me-
chanical defect fanv kind exist this mus
Gle may curve the lens in one meridian
more than another. a lens whose curva-
ture is perfectly spherical may be rem
dered unequal lspherico cylindrical). or
the reverse may be the case. Eyes, like
all individual things IN creation, are sell
dom perfect, and only exist in ideals.
This ideal eye is one that focuses light
rays. emanating from distant objects, on
its retina.
Sometimes the imperfection consists in
foresight (hyperopia), a condition in
which the eyeba is too short from front
to back for the focal length of its cornea
and lens. Another defect is nearsight
(my opia), condition in which the eyeball
is too long from front to back for the focus
OF the lens and cornea. The focus falls in
front of the part of the eye which per-
ceiyes the light (the retina). A third de-
feet is a condition in which the lens or
cornea or both are unequal in the curva-
ture of their meridians, which is called
astigmatlsm.
at would be impossible to construct
the physiological adaptation of the
natural eye or to show how muscular parts
of the in side of the eve control the curva-
ture of the lens, which changes its focal
distance and thus adapts the eye for sight
at the near as well as for the far point.
The far-sighted young overcome their de-
fects (keep the focus of parallel rays upon
the retina) by bringing into action the
functions used in the correct eye, for
seeing at the near point Thus the lens is
kept continually, with an extra curve sut.
ficient to overcome the defect. This is ac-
Companied by muscular contraction, and,
OF necessity, being constant, uses up nerve
force to maintain it. This becomes real
spasm OF the muscle, which does not re-
lax In many cases. perhaps even in Sleep
Thus reflex disturbance Of the whole ner-
vous system may ensue. which brings on
continual headache, chorea, epilepsy, etc.
This spasm of the muscle of accom- moda-
ton often becomes so great that not only
the farsight is corrected, but the eye will
actually become nearsighted.
when an attempt is made to measure
farsight with. lenses they will be re iected,
as at best only part of 1t will be revealed.
The nearsighsd young frequently accept
glasses three times as strong as the real
refraction of the eye. This is done by
spasm. The same may be said of astig-
matiSm.
attempts to correct the mechanical
defect and to get more perfect outline OF
observed objects put the nerves controlling
these functions into an irritable state and
when lenses are placed before the eve for
these tests almost any result may be ex-
pected so far as proper diagnosis is con-
cerned.
MANY persons with nearsight, farsight
or astigmatlsm, or com bination of these
may be examined every day in the week
and give. different result at each trial.
Then OF what use is an examination of
this kind, conducted as it usually is in
our public schools? 1t merely establishes
the probability of defect in the pupils
eye and approximates its kind. The
uncertainty lies in this, that farsighted
eye may measure nearsighted and an as
tlgmatic eve may overcome the defect and
not be shown during examination, or there
may appear 10 be astigmatism when the
eye Is in good condition.
"The only reliable method OF making a
diagnosis of an error of refracton is 10
instlll into the eye drug that will tempo
rarily parslyze the muscle OF accom- oda-
tion. This does no harm. but rests the
eye and prevents the muscles from accom-
modahng the eyes 10 any glass but the
right one. An optician may by repeated
fitting approximate correctness, but this
is done over period of months or years,
their only guide being that which gives
the most relief. Those who examined the
school children have but the one test, and
that is conducted in from three to five
minutes.
Modern opthalmology has taught us