A Preventive And Remedy for
First published in 1958 by Research Foundation for Prevention of Myopia.
Hypertext version edited by Alex Eulenberg; last revision December 14, 2008.
It was in the year 1934 that I tried to offer my services to the children's sight saving classes. I went to see Dr. E. H. Schoenling, Health Commissioner, District Board of Health, of Hamilton County, with offices in Cincinnati, Ohio, the county seat. I told him that I had done a lot of research on vision, and was able to help many cases that are supposed to be incurable. I told him that I would like to have a chance to do some research work in the sight-saving classes. He seemed to be impressed with my story, but he told me that the sight-saving classes were out of his jurisdiction.
Nearly a year afterwards, in 1935, I met him again by chance. He told me that some time previously he had been thinking about me and would have liked to see me about a special case of eye trouble. In a flash I got an idea that I could make use of his faith in my special knowledge on vision, I told him that shortly I would come to see him at his office.
When I visited him at his office, I requested him to let me accompany his nurses when they make eye examinations in the county schools. He introduced me to the head nurse who made the arrangements. There were several nurses, and I was to accompany each one on certain days. I accompanied the first four nurses, observing the technique of limited mass eye examinations. It was on my fifth trip that the nurse was to examine the children's eyes in a school at North Bend, on the outskirts of Cincinnati, Ohio.
We found that the room where the examinations were to take place was being repaired and could not be used. After some consultations, it was decided that the examinations for that day would take place inside the classrooms. We were led into a fourth grade classroom, and were told to use the far side of the room for the eye examinations. The nurse asked me to follow her to the far side. I told her that I would rather take a seat in the rear and observe the children. I was given a chair and I took a position where I was able to observe all the children.
I noticed that many of the children started their reading or writing at a distance of about ten to twelve inches or more from their eyes. But after a minute or two, many of them began to stoop forward and bring their eyes closer and closer to their books or papers. I was shocked when I saw two tall girls not far from where I sat, bend their shoulders and their heads and bring their eyes so near to the writing paper on the desk that I judged the distance to be less than two inches.
I wondered whether this extreme close-seeing took place only in this room in North Bend, or did it take place in other school rooms as well? Later, when 1 went out with the rest of the nurses, I asked them to introduce me to the teachers and get their permission to let me obseve the children in the classroom instead of watching the nurse examining their eyes.
This they did, which gave me a chance to observe other school rooms. It confirmed my suspicion that this extreme near seeing which I discovered in a fourth grade of North Bend was not an isolated case, but a national problem.
SCHOOL ROOM NEAR-VISION OBSERVATION
I decided to follow up and extend the observations on my own resources. First, I went back to the school rooms where I formerly accompanied the nurses and where the teachers already knew me. Then I received permission from the teachers in a few more schools in Hamilton County.
Lockland is a large town in Hamilton County near Cincinnati. It has a modern school with all the primary and secondary grades, and also a kindergarten. I visited the superintendent and received permission to observe all the grades, including the kindergarten. When I was through with the regular grades I went to the kindergarten classes. I acquired the good will of the teachers and also of the little tots. I attended the kindergarten for more than a week, eating their food and drinking their milk. I also danced and played with them. I had an excellent chance for observation.
In later years, I visited a nursery and kindergarten in Orlando, Florida. I visited the nursery school of the University of Cincinnati, which one of my grandchildren attended. I also visited and observed many private nursery schools. I found that in prolonged near-seeing there is a marked tendency to bring the eyes too close to the work. In the nursery schools where there is no reading, writing, or regular drawing, this tendency is plainly noticeable when the children do their finger painting.
I wondered if this extreme closeness of seeing by so many of our school children in prolonged near work was a cause for so many of them becoming nearsighted. I believed that a near vision survey would shed some light and would be of great benefit. I went to see the superintendent of schools of my home town of Cincinnati. I told him that I would like to make a near vision survey in some of the Cincinnati schools. His answer was that he would not allow the public schools to be used for private venture.
This discouraged, but did not stop me. I went to Adrian, Michigan, where one of my sisters was living. I visited the Health Board doctor. She was favorably inclined and told me that she would have no objection. I went to see the principal of McKinley School, and he gave me permission to make a near-vision survey. I found that in Adrian, Michigan also, most children used their eyes normally for the first minute or two. After that, many of them began to bend their shoulders and heads and bring their eyes closer and closer to their work.
When I returned to Cincinnati, I wrote a letter to the Society for the Prevention of Blindness and also to Boards of Education in many cities, inquiring whether a near-vision survey had ever been made in public schools. I received replies that they believed no such surveys were ever made.
COPY OF LETTER I MAILED
February 17, 1936
National Society for
Prevention of Blindness
New York City:
Kindly give me the information and reply to the following questions. What causes the majority of children in school to bring their work closer to the eyes than they should?
What causes many of them, even hyperopes (farsighted), to use their eyes at the maximum near point?
Were there any surveys made to find to what extent children in school were using their eyes at the maximum near point or at almost the maximum?
If any surveys were made, what were the findings?
COPY OF REPLY RECEIVED
National Society for the Prevention of Blindness, Inc.
50 West 50th Street, New York
February 24, 1936
Mr. J. Raphaelson
3302 Burnet Avenue
My Dear Mr. Raphaelson:
We have no knowledge of any survey having been made to discover to what extent school children tend to use their eyes at the near point. If, as you suggest, the practice is fairly common it may be due to any or all of the following:
In childhood the near point is closest to the eyes and the power of accommodation is greatest. Hence it is possible for the child to do eye work at very close range. This may be true even of hyperopes since the power of accommodation may be sufficient to overcome even high degrees of hyperopia.
The equipment (desk etc.) in the classroom may not be so to individual children as to make good posture and the selection of proper working distance easy for the child.
The child in school must be taught proper eye habits. If the teacher's whole attention is focused on subject matter and training in specific skills the child's comfort and health may suffer. Please call upon me for further help, if necessary.
C. E. K. S.
COPY OF LETTER I MAILED OUT
Cincinnati, Ohio February 17, 1936
The Board of Education
I would be pleased to have your reply to any one or all of the following questions.
What causes the majority of children to bring their eyes closer to their work than they should? What causes many of them, even hyperopes (farsighted), to use their eyes at the maximum nearpoint?
Were there any surveys made to find to what extent children, in school, were using their eyes at the maximum near point, or at almost the maximum. If any surveys were made, what were the findings?
What effect may this abnormal use of the eyes have on vision and general health? What effect may it have on the growth and development of the eyes during school years?
What could or should be done to remedy the said abnormal use of the eyes at school?
Information and suggestion will be appreciated.
COPY OF REPLY RECEIVED
March 2, 1936
Board of Education
City of __________
Mr. J. Raphaelson
3302 Burnet Avenue
My Dear Mr. Raphaelson:
In reading the questions in your letter to the Board of Education, I feel that you would get more information in consulting an oculist.
Some children bring their eyes closer to their work than they should, because of poorly formed habits, and second, because they cannot see. However, the first is probably the most usual reason.
In regard to the survey, 'I never heard of any such survey'.
I do not understand what you mean by "maximum near point".
If you mean less than twelve inches or thirteen inches, I suppose in some instances, the child would strain his eyes. He would have a stooped position, causing poor posture and he might become fatigued. As to his general health and development, it would all depend on the amount of time he did his work in this manner.
I think it is difficult to answer this question, unless I know absolutely what you mean by "abnormal use of the eyes at school". I would say, however, that if children used easel top desks, which they can pull to them and still maintain correct posture; if they were in well lighted and ventilated rooms, using proper type and equipment and having sufficient eye rests and body rests, there would be a great improvement in the general health of all school children.
LIMITED SCHOOL MYOPIA EXAMINATION
Now it dawned on me that a survey alone, without knowing what kind of eyes these reptile-seeing children have, would be of little use to me. I decided that a suitable eye examination must accompany the near vision survey.
Again I went to see Dr. Schoenling, the Hamilton County health officer. I told him about the results of my survey and of my desire to examine the eyes of the school children. He advised me to go to Clermont County, an adjacent county in Ohio, where the health board has no eye examinations. There they might accept free eye examinations in their schools.
I drove to the health office of Clermont County and met the health doctor and another health officer. I told them that Dr. Schoenling had recommended that I see them about making free eye examinations in Clermont County public schools. They told me they would have no objection, but that I should send them occasional reports. Also, that I was to get the permission of principals and teachers of the schools.
Now I had my chance to examine the reptile-seeing children's eyes and find out whether they were nearsighted, farsighted, or had other kinds of defective eyes. However, that could easily be done with individual children, but not on a school room basis. How was I to determine, in an isolated examination, the connection between the use of the eyes in the classroom and the resultant vision test? Also, how was I to give a regular eye examination to thirty children or more in a single school day?
I devised and designed an observation, examination and recording system by which I was able to identify each child and make a record as to what kind of vision each child had. The observation system was composed of an observation chart, a teacher's chart, and a near-vision classification and near-vision code. The examination system was composed of special limited far and near vision tests. The recording system was composed of a School-Myopia Examination Record Blank, a School Room Optical Record Chart, and a Continuous Optical Record. All these charts and recording blanks are reproduced in Book One, School-Myopia.
The City of Cincinnati is in Hamilton County and Clemont County is adjacent to it. The latter has no cities and only a few small towns. It is a typical rural county. It is mainly a farming community and the inhabitants are native Americans. It was a suitable place to make a near-vision survey and schoolmyopia eye examination of American school children.
Clermont County, in 1935-36, had some mixed grade, single room, country school houses. I faintly remember driving to some of these schools and observing the children in my near-vision survey, but that is all I can remember. Recently, I found some records which I had saved from this survey. These I analyzed for my present purposes and will present the result to you at this point.
I have the records of the near-vision survey and limited eye examination of more than 500 children in the towns of Batavia, Willliamsburg and Mt. Carmel. Williamsburg is 30 miles distant from Cincinnati; the others are nearer. Batavia and Williamsburg have a population of about 1500 each; Mt. Carrnel is much smaller. My records are good proof that the children of Clermont County use their eyes unnaturally in their school work. It can fairly be assumed that what I have found in Clermont County will also be found in nearly all schools in the U.S.A.
The prevailing popular opinion, including the opinion of our educators and vision specialists, is that only some if the children use their eyes unnaturally (too close to their work). Also, that those children are either near-sighted or poor-sighted. It will amaze them to find that my records reveal that about 80% of the children, in the primary grades, use their eyes at a distance of six inches and less than six inches from their work. Our educators and our vision specialists will have to admit that prolonged near-seeing so close to the eyes is unnatural use of the eyes.
CHARTS AND TABLES
From the Near-vision Survey Records
of Clermont County, Ohio
Near Vision Code
Numeral 1. 10 inches or more from the eyes, small child 12 inches or more from the eyes, large child 2. 6 to 10 or 12 inches from the eyes 3. 3 to 6 inches from the eyes 4. 3 inches or less from the eyes
NEAR VISION SURVEY TABLE 1.
Distance Distance Started with Finished with Code No. Code No. Grades Pupils 1. 2. 3. 4. 1. 2. 3. 4. Pupils Pupils 1st 15 2 9 4 00 00 1 10 4 2nd 82 31 48 3 00 00 10 53 19 3rd 104 44 58 2 00 1 15 73 15 4th 91 60 31 0 00 00 11 61 19 5th 85 55 29 1 00 00 22 53 10 6th 95 67 27 1 00 1 6 63 25 7th 20 17 3 0 00 00 6 14 00 8th 11 11 00 0 00 00 5 4 2 ---- --- --- --- --- --- --- --- --- 503 = 287+205+ 11 +00 = 2 + 76+331+ 94 SUMMARY Number of Pupils -- 503 Distance Distance Started with Finished with Code No. Pupils Code No. Pupils 1. 10 or 12 inches 287 57% 1. 2 00.2% 2. 6 to 10 inches 205 41% 2. 76 15 % 3. 3 to 6 inches 11 2% 3. 331 66 % 4. 3 or less 00 00% 4. 94 19 % ---- ---- ---- ------ 503 100% 503 100 %
NEAR-VISION SURVEY ANALYSIS
The near-vision survey charts are good proof that it is not the near-sighted and poor-sighted only who use their eyes too near to their work. It is, rather, the children who have good normal eyes and can see well at the normal reading and writing distance who are unable to maintain that distance if the near work is prolonged. It is good proof that prolonged near-seeing is not effortless but a hardship.
Out of 287 children who started their reading and writing at comparatively natural distances of from 10 to 12 inches or farther from the eyes to the paper, only two of them were able to continue at that distance. Out of 492 children who started their prolonged near tasks at a distance of more than 6 inches from their eyes, only 78 were able to maintain that distance. The other 414 children bent their bodies for closer seeing, and brought their eyes to a distance of 6 inches and less than 6 inches from the work.
Of the total of 503 children, 94 of them (19%), in prolonged near-seeing, kept bending their shoulders and heads so as to bring their eyes to a distance of 3 inches and nearer than 3 inches from their work. These children who were, seemingly, reading and writing with their noses instead of their eyes, were not nearsighted. Most of them had perfect vision and would have been able to pass all the vision tests available. But why were they doing this?
I have been pondering this question for many years. It is only lately that I came to a reasonable explanation. A veritable reason why the children take their eyes closer and closer to their work is because it is a hardship to use their eyes for prolonged near-seeing in the human-way-of-seeing which is, mainly, conial or central vision (seeing by the nerves in the shape of cones). They bring their eyes closer and closer to their work in order to make use of the reptile-way-of-seeing (seeing by the nerves in the shape of rods).
The near-vision survey also indicated that prolonged near-seeing affects our children adversely in many other ways. For, many of them not only began to bring their eyes closer and closer to the book or paper, but also began to frown and wrinkle their foreheads or turn their heads sideways. This should be proof enough to any unbiased person that prolonged near-vision is not effortless for small children but a real task.
VISION CHART TABLE 2
very poor Number of Vision Poor vision vision 20/80 Grade pupils 20/20 20/30 20/40 20/60 and less 1st 11 5 4 - - uncertain - 2 2nd 85 70 10 2 2 1 3rd 109 91 11 6 - 1 4th 100 83 12 3 1 1 5th 85 74 9 1 1 - 6th 101 84 6 7 2 2 7th 21 20 - - - 1 8th 11 11 - - -0 - -------------- ------ ----- ----- ------- ------- Total 523 = 438 + 52 + 19 + 6 + 6 + 2 Vision Summary 20/20 438 84 % | Poor vision 52+19+6=77 pupils 20/30 52 10 % | --------------- 20/40 19 3.6% | Vision improved 43 55% 20/60 6 1.2% | Vision restored 22 29% 20/80 and less 6 1.2% | --- Uncertain 2 - | Total 65 84% of 77 ----- ---- | Total 523 100% | Improvement by Grades ---------------------------------- | | Vision Vision Poor Vision Pupils | Grade Improved Restored 20/30 32 | 1st 1 2 20/40 19 | 2nd 3 6 20/60 6 | 3rd 8 4 ---- | 4th 12 4 Total 77 | 5th 7 3 --------------------------------- | 6th 12 3 Very Poor Vision ---- ----- 20/80 and less 6 1% 43 22 Vision Examination Kind of Eyes Hyper-sighted Plus 1.00 or more 307 59% 0.75 52 10% 0.50 88 17% Hyper-sighted needing plus glasses 447 86% Plus 0.25 28 5% --- --- 475 91% Border line 43 8% Myopes, (near-sighted) 5 1% ----- ---- 523 100% -------------------------------- Glasses Worn by Pupils Grade Plus Minus 1st 0 0 2nd 3 0 3rd 2 0 4th 7 1 5th 5 0 6th 6 2 7th 2 0 8th 0 0 ---- ----- Total 25 3 Grand Total 28 5% of pupils 4 Pupils had glasses, did not wear them
THE SCHOOL-MYOPIA EXAMINATIONS
The school-myopia examination system was designed for a double purpose: first, to find out whether those children who brought their eyes so close to their work had normal and good vision for distance or if they were near-sighted or had visual defects; second, to find out if toot vision could be restored or improved, with plus 1.00 glasses, to those children whose distant vision had already failed them. The examination was composed of near-vision and distant-vision tests.
The distant-vision examination was made with a regular distant test chart and a pair of plus 1.00 glasses. It was composed of 3 tests. Test 1, a vision test with the naked eyes. Test 2, a vision test with pair of plus 1.00 glasses. Test 3, a vision test with the naked eyes immediately after removing the glasses to reveal any increase in vision after the plus 1.00 glasses had been worn for a few minutes. The results of the tests were given on the record blank.
The near-vision test I have named "The Reversal Reading Test". It measures the distance, from the eyes, at which fine print can be seen. It is also composed of 3 tests. Test 1, a near-vision examination with the naked eyes to determine the farthest at which fine printed matter can be seen. Test 2, a near-vision examination, for the same purpose, with plus 1.00 glasses. Test 3, a near-vision examination immediately after removing the plus 1.00 glasses to reveal any improvement in near-vision with the naked eyes, after the plus 1.00 glasses had been worn for a few minutes. These tests are explained more fully in Book One "School-Myopia."
I had a space in my special printed records for recording the vision before examination. Also, a space for recording the vision with plus 1.00 glasses and a space for recording the vision of the naked eyes after the plus 1.00 glasses had been removed.
I have practiced vision restoration successfully, with plus glasses, on individual persons, children and adults, for more than thirty years before Clermont County. Now I had a chance to prove that it could be done on a mass scale.
SCHOOL-MYOPIA EXAMINATION ANALYSIS
The school-myopia examination gave additional proof that prolonged near-seeing is unnatural and a hardship on children's eyes. It revealed the fact that most of the children who take their eyes too close to their work have good 20/20 distant vision and have no visual defects other than the natural plus 1.00 hyper. It also revealed that,
in the primary grades, the vision of the naked eyes can be improved or restored, with plus 1.00 glasses, to those children whose vision had already failed them.
Of the 523 children examined, 438, or 84%, had 20/20 vision: only
83, or 16%, had 20/30 or less vision; 52, or 10%, had 20/30 vision; 19, or 3.6%, had 20/40 vision and only 6, or 1.2% had 20/60 vision; only 6 pupils, or 1.2%, had very poor vision which was 20/80, or less. I was unable to determine the vision of 2 children in the first grade. The vision of most of the 77 children who had poor vision was easily improved or restored with plus 1.00 glasses.
Kind of eyes: 307 children, or 59%, were hyper 1.00 or more; 52, or 10%, were hyper 0.75; 88 or 17%, were 0.50 diopter hyper; and 28, or 5% seemed to be only 0.25 hyper; 43 pupils, or 8%, were on the border line (uncertain) and only 5 children, or 1%, could be classed as real myopes; 6 of the children who had very poor vision were out of bounds (not in the sphere of this book).
Of the 523 children, 28, or 5%, wore glasses of which 25 pairs were plus and only 3 were minus glasses. Of the 25 who wore plus glasses, 6 were out of bounds (their glasses were stronger than plus 1.00). One boy was a cataract case and wearing a plus 12.00; one wore plus 5.00 with cylinders added and one wore a plus 2.50 with cylinders added. The other three had weaker spheres but strong cylinders, stronger than plus 1.00.
Of the 28 pairs of glasses, 14 pairs were spherical glasses and thc other 14 had weak or strong cylinders in the lenses. Of the 14 cylindrical lenses, 3 were more than 1.00d. and 11 pairs were 1.00 diopter or less. Of the 11 children wearing weaker cylindrical glasses, 6 of them seemed to do much better with plus 1.00 spherical glasses, for the vision of their naked eyes improved after wearing a pair of plus 1.00 glasses for a few minutes. Of the 2 children who had weak minus glasses, one wore a pair of minus 0.50 spherical and the other a pair of minus 0.50 cylinder; the naked eye vision of both children was improved after wearing a pair of plus 1.00 glasses for a few minutes.
Of the 77 children who had poor vision (20/30 or less), 43, or 55%. had their vision improved and 22, or 29%, had their vision restored to 20/20 vision. Thus, out of a total of 77 children, 65, or 84%, had their distant vision improved or restored by just wearing plus 1.00 glasses for only five or six minutes.
Now comes the big question: If a pair of plus 1.00 glasses can and does improve or restore the distant vision of young children, why could it not prevent them from losing their distant vision? An affirmative answer should be self-evident.
A TEACHER'S COMMENT
One teacher, second grade in Williamsburg, was cooperative. She returned the "Teacher's Chart" with the names of all the pupils and also with notations under the names of 17 pupils.
The notations were as follows:
Under the names of
6 pupils, she wrote "slow reader"
2   "   "   " "poor reader"
2   "   "   " "very poor reader"
1   "   "   " "frowns when reading"
1   "   "   " "book too close"
1   "   "   " "work too close"
1   "   "   " "holds writing almost upside down"
1   "   "   " "does not seem to be able to do any kind of school work"
1   "   "   " "weak eyes, wears glasses, squints"
1   "   "   " "one eye, poor reader, wears glasses"
In this same second grade I wrote added notations on my record as follows:
Under the names of
6 pupils, "frown"
2 " "wrinkle"
1 " "frowns & wrinkles" 1 " "squints"
1 " "headache"
One of my added notations was "frowns, glasses wrong in axis"
Now it is assumed that children who squint, frown or wrinkle their foreheads, or hold their books too close and those who are poor readers or very poor readers, have or may have 'poor distant vision'. It is a fanciful and harmful assumption. My records prove, in fact, that it is just the opposite.
My school-room-examination-record shows that nearly every one of the above children had good perfect distant vision (20/20 and better). Nearly all of them would pass as normal under all the existing school tests. Most of them would also pass as normal under the tests as given by nearly all vision specialists. But my examination with plus 1.00 glasses proved, beyond any doubt, that every one of the above pupils was one diopter or more hyper. Each and every one of them needed, at least, a plus 1.00 pair of glasses for any prolonged near-seeing.
There were two children, in this second grade room, who wore glasses. The teacher wrote a notation for each one. One notation was "weak eyes, wears glasses, squints"; the other was "one eye, wears glasses, very poor reader". My own comment on the one-eyed boy was that he frowned. I neutralized the glasses and found them to be as follows:
|In the first case the glasses were:||In the second case they were:|
|R.E. +1.00 with +1.00 x 90||R.E. (glass eye) piano lens|
|L.E. +0.50 with +1.00 x 90||L.E. cylinder +0.88 x 90|
Now, in both these cases, according to the teacher's notations, the glasses were not satisfactory. Why did they not give full relief? It is my candid opinion that, in both these cases, the fault was with the cylinders. Both of these children were fitted with cylinder lenses which they did not need, instead of spherical plus, or more plus, which they did need. I have no positive proof in the first case but I do have valid proof in the second case.
This one-eyed boy, aged 11, was still in the second grade. He was a very poor reader and also frowned. With his one eye he had perfect vision for distance (20/15). He also had 20/15 vision (which is better than 20/20) with plus 1.00 glasses. He was in dire need of a pair of plus 1.00 or plus 1.50 spherical glasses to help him in near-seeing. Instead, his eye specialist gave him a cylinder lens which did him no good. He gave him the wrong axis which did him harm.
The great hunt for astigmatism in the eyes of young children and the emphasis on its correction is one of the widely popular, and harmful fallacies.
FOREHEAD WRINKLES AND FROWNS
Reprinted from Book One, School-Myopia
In the "School Room Optical Record Chart" on the following page, there was reserved a notation space for wrinkles and frowns of the school children. This was done because the tendency to frown and wrinkle the forehead begins at a very early age, and also because forehead frowns and wrinkles have a positive relationship to eye strain. It could and would be well, therefore, to study the formation of forehead wrinkles and frowns of school children in combination with school-myopia.
Frowns are the vertical creases of the forehead They are to be found mostly in the middle and lower part of the forehead. They are composed mainly of one or two creases and only occasionally some extra minor vertical creases may be noticed. Frowns often develop in combination with wrinkles but sometimes, one may develop deep permanent frown creases without any tendency to wrinkle. The relationship of frowns to eye strain is less positive than wrinkles.
Wrinkles are the horizontal creases of the forehead. They are composed of a variety of numbers, shapes, sizes and depths. They may be divided into full length rows which are, in certain persons, subdivided into three sections. These sections are, the right section over the right eye, the left section over the left eye, and the center section. Occasionally, wrinkles are composed of odd shapes, disregarding the above divisions.
A person may have short wrinkles on one side of the forehead over one eye only; or he may have them over both eyes but more and deeper wrinkles on the one side of the forehead than on the other side. One may have only long wrinkles, that will extend over the full length of the forehead without subdivisions, or he may have one or more long wrinkles in combination with short wrinkles over one eye or both eyes. The center wrinkles are not very common but they may be had by themselves or in combination with long and short wrinkles.
Wrinkles appear and disappear at intervals and are seldom permanent in young persons. They appear mostly for a very short duration. They appear, mainly, in looking up and disappear in looking down.
The relationship between wrinkles and eye strain, while being real and positive, is rather indirect. For while the main cause and factor of eye strain is the use or the excessive use of accommodation (adjustment for nearer vision), wrinkles, on the contrary, are produced during the act of disaccommodation (adjustment for farther vision). In reading, writing or other close work, no matter how long it takes to do the work or under what amount of eye strain the work is performed, no wrinkles will appear. Rather, the wrinkles come in the change from near vision to farther vision.
The reason I consider the relationship between wrinkles and eye strain real and positive is because of the positive effect that ciliary eye muscle relaxation, under the influence of plus lenses, has on wrinkles. A pair of plus glasses or the addition of plus power to the glasses a person is wearing, even as little as a fourth of a diopter, will, in many cases, diminish or eliminate the wrinkles from the forehead.
Reprinted from Book One, School-Myopia
by Jacob flaphaelson, 1937
It is essential to recognize certain principles and facts of vision restoration in order to have a full understanding of the special distance and near vision tests for school-myopia. Such an understanding and recognition is also necessary in order to get the full benefits from the detection of school-myopia and the prevention of its further development. Vision restoration means the bringing back of normal vision or an improvement in vision to the naked eyes.
The difference between the third and fourth stage of schoolmyopia, both of which refer to eyes where distant vision is less than normal, is that an improvement in vision is obtained in the third stage with plus (convex) lenses and in the fourth stage with minus (concave) lenses. The third and fourth stages were divided because of the difference in the effect that plus and minus lenses have on vision restoration. The tendency of plus lenses is to restore vision. The tendency of minus lenses is to reduce the vision of the naked eyes after wearing them.
The apparent reason for these opposite qualities of convex and concave lenses is that in order to see or to attempt to see through convex lenses a relaxation or a tendency to relax the ciliary muscles of the eyes must take place. The opposite is true in seeing or attempting to see through concave lenses.
Because of this tendency and power of convex lenses to restore vision many school children who are wearing convex glasses will be found upon re-examination to have, with the naked eyes, normal vision or better than normal vision. Most of them will be found to have, with the naked eyes, better vision than they had before wearing their glasses. On the contrary, those children who are wearing concave (nearsighted) glasses will be found to have less vision, with the naked eyes, than they had before wearing their glasses.
The same tendencies are applicable to near vision. A pupil who can see fine print no further than 16 or 18 inches from the eyes will often see the same print, with the naked eyes, as far as 20 or 26 inches from the eyes after having worn a pair of convex glasses for only n few minutes.
The time required to bring about an improvement or a full restoration of vision and also, the permanency of the restoration, differs a great deal. It is a difference that may vary from a few minutes to a few years. It depends a good deal on the age of the child or the person. It depends on the amount of close work done and the nearness to the eyes at which the work was performed. The permanency of vision restoration depends also on the time the convex glasses have been worn and on the time elapsed since one has quit wearing them.
TO PREVENT AND RESTORE THE LOSS OF VISION IN SCHOOL-MYOPIA, IT IS IMPORTANT THAT WE GIVE RECOGNITION TO THE FOLLOWING:
FIRST, WE MUST RECOGNIZE THE POSSIBLITY AND DESIRABILITY OF VISION RESTORATION.
SECOND, WE MUST RECOGNIZE THAT VISION RESTORATION, IN SCHOOL-MYOPIA, IS POSSIBLE ONLY WITH PLUS (CONVEX) LENSES.
THIRD, WE MUST RECOGNIZE THAT, IN MANY CASES, VISION RESTORATION MAY BE HAD WITH PLUS LENSES, EVEN WHERE AN IMPROVEMENT IN VISION OR NORMAL VISION MAY BE OBTAINED WITH MINUS (CONCAVE) LENSES.