[Report 1938] / School Medical Officer of Health, Salford.

  • Salford (England). Council.
Date:
1938
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1938] / School Medical Officer of Health, Salford. Source: Wellcome Collection.

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    The clinic deals with a large variety of cases. Patients of ages ranging from 2-12 years attend, from small infants with suppression to older children with Heteropharia. Since the clinic opened, over 700 cases have been examined. The children are referred to the orthoptic clinic from the ophthalmic clinic on their first visit before being given mydriatic drops. If they are found to be amblyopic, occlusion of the sound eye, with plaster patches, is advised, and the patients attend on an average of once a month for a test. A great deal of importance is attached to this stage and careful co-operation with patient and parent is required. The majority of parents are enthusiastic and attendances at the occlusion clinics held twice weekly are extremeb/ good and regular. When the vision of the two eyes is equal, the squint favourable to a cure by treatment alone, and the patient of an age to co-operate satisfactorily, fusion training is commenced. Twice weekly treatments of 25-30 minutes each period are given, 6 children attending each session. The number of treatments per child required to produce a satisfactory cure varies from 20-40 or 10-15 hours intensive training. This, in consideration of the fact that the patient has squinted since infancy, is a remarkably short time in which to effect a permanent cure. There are over 250 children waiting for fusion training to be commenced. This number increases weekly as visual acuity is equalised by occlusion. Approximately 50 per cent, have an angle too large for curative treatment without operative help. This is one of the great drawbacks of the clinic at present, and requires due consideration if the percentage of cures is to be increased. While the results of the clinic are encouraging, it is imperative that arrangements should be made for surgical assistance, if the best results which are being aimed at are to be obtained. It is for this reason that children over the age of 12 years—and there are many in the schools—-have not been examined, and have not had that treatment which their condition merits. ]\Iost of these cases will have reached school leaving age before it has been possible to obtain beneficial results. It therefore cannot be stressed too strongly that early arrangements for surgical assistance, such as are in operation in all up to date clinics, should be completed. There are a number of children who, for such reasons as intractable amblyopia, lack of the fusion faculty or paralysis of muscle, require an operation for a cosmetic result only. These cannot be dealt with owing to lack of facilities. In addition to manifest squints there are a number of chilren who suffer from Heterophoria, and convergence insufficiency, causing headaches and diplopia. These cases respond well to fu.sion training, the aim being not so much a scientific cure as a removal of asthenopic symptoms. Children of pre-school age react favourably to treatment, which, at this early age must be occlusion, total or partial, of the sound eye. With patience they can be taught the illiterate “E” test and have their vision recorded. It