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

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fbeuelapmenl' af 'Uiftian New Haven, Conn.-A ten-year project at Yale University reveals for the first time the detailed development ol vision in infants and children. The project, which is headed by Dr. Arnold Gesell, prominent authority in the field of child behavior, has produced findings that established a new approach to the prob- lems of child vision. These findings show that the child is never a miniature adult even in his visual equipment, according to the report. It should not be necessary to wait until belated adolescent years to determine the efficiency of his visual functions. The results of the investigations are re- ported in a new book, Vision, Its Develop- ment in Infant and Child, published by Paul Hoeber. Inc., the medical book depart- ment of Harper and Brothers. The authors are Dr. Gesell, Dr. Frances L. Ilg, and Glen- na E. Bullis. Their research was supported by a grant from the American Optical Com- pany of Southbridge, Mass. Their information was collected through clinical examinations carried on during the past ten years. The normal visual functions in their relation to the total action system of the child were studied at a score of ad- vancing age levels from early infancy to the tenth year. In general, about 50 children were investigated at each age level. The authors used a variety of tests and observation procedures in recording infor- mation about children. Included among these were regular clinical examinations. the graded tests of visual skills. optometric meas- urements, and the retinoscope. As in their past work with child behavior. Dr. Gesell and his associates have recorded the development of behavior patterns. and these findings have been analyzed and com- pared from age to age and from child to child to define growth trends in vision. Their findings demonstrate that vision is profoundly integrated with the total action system of the child-his posture, his manual skills and motor attitudes, his intelligence, and even personality make-up. The child sees not with his eyes but with his whole be- ing. fhe Yale report points out that during the fetal period of the infant, important develop- ments in the organization of eyes and brains are taking place in anticipation of the act of seeing, and fetal eyes move beneath sealed lids several months prior to birth. Birth marks the arrival but not the be- ginning of the individual, the authors write. Although the newborn infant stares vaguely into far away space, his structural visual world begins in the near vicinity of his eyes. It is a plastic domain which he manipu- lates in terms of the nascent powers of his growing action system. The supine infant. the run-about infant, the sedentary school child, each has his own space-world with a distinctive set of planes to regard. The Yale researchers have established a new approach to problems of child vision and they give it the name development optics. This new approach is concerned both in the- ory and application with the growth and or- ganization of visual functions of the child in relation to the total action system of the hu- man body. The authors believe that this emphasis on the development of the visual functions of the child will broaden the scope and goal of visual hygiene. A'The conservation of vision has become a problem of vast social dimensions and calls for a better understanding of child vision on the part of teachers and pediatricians, Dr. Gesell states. HOur culture is making un- reasonable demands upon many young chil- dren. Our whole technology and education place a relentless premium upon an alert. accurate, and swift vision. lVe are in a look- QPleasc turn to page 12D PAGE NINE

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Prescribe a contact lens with the cor- CCNTACT LENSES FUD SUBLUXATIO The correction of subluxation has always presented a problem. This is due to the fact that inasmuch as the crystalline lens is partially displaced. the patient sees double. This diplopia is obviously due to the two foci received on the macula as a result of the lens being off center. One image is re- ceived through the pupil where the crystal- line lens is absent and the other image through that section of the pupil where the lens is located. Ol course the creation of the monocular diplopia is dependent upon the refractive error of the eye. It is also conceivable that single vision will be re- tained despite the displaced lens, depending on the amount of the error of refraction. Use of Regular Spectacles Regular spectacles do not answer the purpose for these patients who have monoc- ular diplopia as a result of subluxation. The only time that spectacles help the patient is when one of the two lfoci can be properly corrected. leaving the other focus so diffused that it will not stimulate vision. This can be accomplished by either correcting that section of the eye in which light rays will pass through the pupil without the lens be- ing there. or else. ignoring this element, we correct the eye so that light rays passing through the crystalline lens will come to a focus on the retina. lt has been the practice to proceed with the correction according to judgment in the direction where better vision can be obtain- ed. or greater comfort achieved. ln either case single monocular vision is to be sought. Hle can encounter some of these cases where monocular diplopia cannot be avoided under any circumstances. One of the solu- tions has been to occlude the eye so as to re- tain single vision with the other eye. lRejJri2zlw1 from Ojllical AI0'lll'lZdl-R6Z!i6Zll, August l, 1948. PAGE EIGHT l by L. Lester- Bm-lm-, on., F.A.A.o Having presented the possibilities of treat- ment of subluxation in the past, the theory is now advanced, as born out by logic and experience, that a contact lens can solve the problem without difliculty. There are three ways in which a contact lens can bring about single monocular vision, where otherwise diplopia was a deiinite re- sult: l. Prepare a contact lens which will have two foci, one for the section without the lens and the other for the section where the lens is present. This is not practical. 2. rection for that part of the eye where the lens is absent. That section of the cornea which is symmetric with the location of lens can be made all black, to resemble the pupil and at the same time shut out all light from that section of the eye. 3. Reverse the situation as expressed in the second case, wherein the contact lens cor- neal section can correct the eye according to the optics through the crystalline lens and black out the other portion of the corneal segment. Thus another new use for contact lenses has here been illustrated. just as in kerato- conus, high myopia, aphakia, binocular dis- turbances, here too our primary considera- tion is to help the patient with his visual problem. Removal of Crystallirzc Lens YVe are not unmindful of the fact that the removal of the crystalline lens would elim- inate all these problems, but we must recon- cile ourselves to the realization that surgery is not practical unless the crystalline lens will become hardened as in the formation of a cataract. The procedure here described requires skill of judgment in prescribing and accu- rately marking the area on the semi-finished Contact lens for the purpose of occlusion.

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R OPTICAL CO., INC. GENEVA. N. Y. Since 1864 ll lCIlIIflIg'III.lIl11l- fncluwr of Slylrd Eyvzuear, Qualify Beyond Question Lenses and Lens Proccssin EQllf1Jl'H.6'IIf for Hu' Optical L,IlbOTlIlO7'lV