New England College of Optometry - Scope Yearbook (Boston, MA)

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Projecto-Chart, in the same refracting room under good conditions. A ltzrzjferf R6'f1'rIt'fjOl1 f6fj.ffrI1IC6 Q .' O. D. -1.75 Sphere 20f20 O. S. -1.75 Sphere 20f20 A 0.25 cylinder has been dropped to facili- tate the discussion. Retinoscopy gave a good reflex, and indicated more mirzzrr which is an opposite reaction. A binocular add of +0.50 was accepted for distance over the subjective, vision remaining zofzog that is the patient read an easy 20f20 with an O. U. Rx. of -1.25 spheres. Pbo1'it1.s' .' Well within normal limits, at all times, for both distance and near, This is also true during cycloplegic and post-cycloplegic ex- aminations. Exfez'm1l.r nm! Fz11m'i.' Normal and negative. Media clear. Pupils not small. H0l1lr1f1'0lf?ill6 Rej'1'rrfti01z.' Q22-5 drops, 12 minutes apart O. UQ Naked vision funder cycloplegicj: O. D. 20f500!! O. S. 2o!50o!! We tried to coax more naked vision under cycloplegic, we asked the patient to squint or use any other means known to him to improve his vision, all without successg the bert possible vision was 20f300. The patient also reported a severe drop in vision while under cycloplegic, very similar to that re- ported by hyperopes while under cyclopegia. It was at this point that we hrst considered Negative Accommodation. Did the homatro- pine inhibit this Negative Accommodation as it does Positive Accommodation in a hy- perope? l Refraction under cyclopegic: O. D. -5.00 Sphere Port-Cycloplegic Refmftiorz flvlrznifertj : Once again, 20f20 vision was obtainable easily with an Rx. of -2.00 spheres O. U. This indicates that some accommodative function is supplying at least one diopter of mizzur power, over the so-called position of rest inducted on the ciliary by the homatropine. ADDITIONAL NOTES: If the cycloplegic inhibited all the ciliary action, then the patient is about a three diopter myope, with the ability to negatively accomodate for at least one diopter. When this Negative Accommodation was inhibited by cycloplegia, the patient re- mained a three diopter myope, with a cor- rerlpozzdizzg decrease in vision to 20f300. Slit lamp examination of the media failed to reveal any irregularities which might have created marginal aberrations due to the en- larged pupil. While at times a flight de- crease in vision under the cycloplegia can be explained by these marginal aberrations, it was felt that the drop from 20f60 to 2Of300 was considerably out of proportion and therefore not consistent with this ex- planation. CONCLUSION: All of the refractionists present at the time, both optometric and medical, sincerely felt that the patient had developed an unusual accommodative function, which enabled him to manifest a lesser degree of myopia than he actually had. This function reacted in the exact manner that Positive Accommoda- tion reacts in a hyperope, except that it was okpporite in function. It was therefore felt that the patient could manifest for distance at least one diopter of Negative Accommo- dationf' The writer would appreciate receiving any O. S. -3.00 Sphere other comments or explanations that might be Retinoscopy Definite offered for this type of reaction. Page lfozzr

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eqalliae fqccammacf Much has been said and written concerning Negative Accommodation. Unfortunately the majority of statements brought to the writer's attention appear to be too didactic to be ac- cepted in full. It is claimed alternately that this function either does or does not exist. Some of our Optometric colleagues claim that their respective schools have taught that this function can not and does not exist. Further- more they are supported by many of our lead- ing authors in their texts concerning refraction. Again some practitioners will claim, on the basis of a few odd reactions noted in an oc- casional patient, that Negative Accommoda- tion is tzr 71111513 11 fznzclimz as Positive Accom- modation itself. These same men, however, who will argue either pro or con in this question, will readily admit the variability that exists in other functions of the body. They accept without question the fact that the func- tion of circulation may be carried on under moderately different degrees of pressure for different patients. We all know that a blood pressure, considered normal for one individual, may be considered high for another. Again, and more pertinent to our field, we occasionally find a patient, who can rfofznznzrily nzeznifert some degree of divergence for infinity. fThe writer recalls a fellow Optometric student with this ability. He was definitely not a strab case -his other binocular functions being well within the normal rangej. If these variations can and do exist in other functions, why then is it not logical to assume that they may, and at times do exist in the accommodative function of some individuals, giving rise to Negative Accommodation, or something that acts very much like it. Many of us in practice today have served as Optometrists with the armed forces, and 4' Reprinted from The Rhode Island Optometric journal' . 4' By Willifzflz D. Corrente, O.D. '41 M P1'0z'ia'e12ce. R. I. were at times called upon to refract with a cycloplegic, which in most cases followed the manifest refraction, and was used as an addi- tional check-test. In cases where the manifest and cycloplegic differed moderately, a post- cyclopegic refraction was made. It naturally was usual to find less minus under cyclopegia. There was, in most cases of myopia, a corres- ponding ifzrreare in uncorrected vision, due to the lowered degree of myopia found under the cyclopegic. Occasionally, however, the cyclo- plegia seemed to produce a reverse reaction and a marked defreme in uncorrected vision was noted in myopes. It seemed as if the homa- tropine had inhibited the patient's increased vision. One of the most marked cases of this type was recorded by the writer, and is pre- sented below with additional comments. Un- fortunately the equipment available for this refraction prevented a complete analysis, but the findings presented are accurate and have been verified by other examiners present at the time. When it was noted that the patient presented this unusual reaction, additional care was taken with the patient to ascertain his reactions-hence the comments following the various tests. PATIENT: Age 18, .....,...... highly intelligent and reli- able, former student at a northern college, never wore glasses, referred to Eye Clinic for blurred vision at times. Naked Virionz O. D. 2Of50-1 O. S. 20f5O-2 From the manner in which the patient called the letters, it was thought he was squinting - some letters seemed alternately clear and blurred, as in a hyperope, who is accornmo- dating. All testing done at 20 feet, with a May 1947 by permission. Page Three

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M. S. O. Graduates Nineteen at June Commencement Exercises In the first formal commencement exercises held by the Massachusetts School of Optometry since 1943, 19 members of the Class of '47 were awarded diplomas on -Sunday afternoon, june 8th, at the New England Mutual Hall. Before an audience of 500 relatives and guests, Dean Ralph H. Green gave high praise to the 1947 graduates, who had attained the highest scholastic average in the recent history of the school. Of the 19 new optometrists, twelve were graduated with honors, a record that is not likely to be equalled for some time. In his address, Dr. Green pointed out that fourteen of the class were ex-servicemen, many of whom had been forced to interrupt their studies at the beginning of the war and re- turned years later to complete their profes- sional education. As a parting message to the graduating class, Dr. Green said, The Massachusetts School of Optometry has rendered an educational service to you young men by providing you with a basic formula for studying, analyzing, and thinking problems through to their logical conclusions. You have been given a thorough and carefully planned course of instruction in optometry. Our obligation to you, however, does not end with your graduation. Rather, we feel a sense of responsibility for your ulti- mate success in the practice of the science and art of optometry . Dr. Bradly is guest speaker Dr. G. Edward Bradley, optometrist of Somerville, Mass., a member of the Board of Trustees of the school, was the guest speaker of the afternoon. Dr. Bradley stressed the re- lationship that exists between the art and the science of optometry. The young graduate, he declared, has received a thorough foundation in the Jciezzce. but development of the arf of optometry can come only with the experience of actual practice. One of the highlights of the exercises was the presentation of awards. This was presided over by Dr. Frederick E. Farnum, chairman of the Faculty Committee on Awards. The awards were made as follows: Faculty Award-for the highest average for the course, to DAVID YORRA. fofepb Scanlon Memorial Azz'ara'-pre- sented by the Omega Epsilon Phi Fraternity on the basis of scholarship, clinical proficiency, and school service, to BERNARD POTVIN. Leiter Epiteiu Memorial Aulara' -pre- sented by the Pi Omicron Sigma Fraternity for scholastic achievement in Theoretic and Ap- plied Optometry, to ARTHUR CowAN. The following men received diplomas: Sumnza Czmz Laude David I. Yorra ..,........ ....... M attapan, Mass. Magna Cum Lazzde Arthur Cowan ............... ........ M attapan, Mass. Hyman R. Kamens ......... ..... C helsea, Mass. Anthony B. Pezzulo .................... Cranston, R. I. Cum Laude J. M. Arsenault .......... South Dartmouth, Mass. Harold Bond .............................. Roxbury, Mass. A. F. Buonfiglio .......................... Revere, Mass. james McCarty, jr ................. Cambridge, Mass. james Newman ........ ............ R oxbury, Mass. Lew Parker ........................ ,New London, Conn. Bernard S. Potvin .................... Worcester, Mass. Irving Sternberg ............................ Revere, Mass. Benjamin Hamilton ..... ....... P awtucket, R. I. Kenneth C. Landry .................. Methuen, Mass. Salvatore Lazzaro .......... ....... W akefield, Mass. David D. Rubin ........................ Brighton, Mass. Nelson F. Waldman .,.......... Cambridge, Mass. J. Edward Whelan ................ Biddeford, Maine Page Fire