Three Cases of Squint

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Stories from the Clinic

9: Three Cases of Squint

By Emily C. Lierman

One day as I entered the clinic I saw two mothers standing side by
side, each holding a little boy by the hand. The children were both
about the same age, five years, and both were cross-eyed; but there
the resemblance ceased. One seemed happy and contented, and it was
quite evident that he was much loved and well cared for. Although
cheap and plain, the clothes of both mother and child were clean and
neat, and often the boy would look at the mother for a smile, which
was always there. The other boy was plainly unhappy and neglected. I
could read the mind of the mother, who was anything but clean, as she
stood there grasping his hand a little too tightly, and even without
her frequent whispered threats of dire things to happen if the child
did not keep still, I would have known that she considered him a
nuisance, and not a precious possession as boy No. 1 plainly was to
his mother.

I was at a loss to know which child to treat first, but decided upon
Nathan, the clean one, and tried to keep the other interested while he
waited. Nathan had beautiful black curls, and should have been pretty,
but for the convergent squint of his right eye, which gave him a very
peculiar appearance. His vision was very poor. With both eyes together
he could read at ten feet only the fifty line of the test card, and
with the squinting eye he read only the seventy line. I showed him how
to palm, and while he was doing so I had time to talk to his mother.
She said that his right eye had turned in since he was two years old
and that all the doctors she had taken him to had prescribed glasses.
These, however, had not helped him. I now asked Nathan to read the
card again, and was delighted to find that the vision of the bad eye
had become equal to that of the good one, namely 10/50. I had
difficulty in keeping his head straight while I was testing him, for
like most children with squint, he tried to improve his sight by
looking at the object of vision from all sorts of angles. After he had
palmed for a sufficient length of time, however, he became able to
correct this habit. The extraordinary sympathy which existed between
mother and child came out again during the treatment, for no matter
what I said or did, the child would not smile until the mother did.

Nathan came to the clinic very regularly for a year, and for the first
six months he always wore a black patch over his better eye, the left,
while atropine was also used in this eye to prevent its use in case
the patch was not worn constantly. Nathan did not like the patch, and
his mother had to promise all sorts of things to keep it on. After it
was removed the atropine was continued. Dr. Bates had told me what to
expect when the patch was removed, and so I was not shocked to see the
eye turn in. I knew the condition was temporary, and that in time both
eyes would be straight. Treatment was continued for six months, and
now the boy reads at times 10/15 with both eyes, and always with a
smile.

The dirty little boy, to whom we must now go back, was called George,
and his condition was worse than that of Nathan, for he had squint in
both eyes. At ten feet he read the fifty line, but complained that he
saw double. I showed him how to palm, and while he was doing so his
mother told me how very bad he was, adding that I was to spank him if
he did not mind me.
"I think he gets enough of that already," I said, but I was careful
to say it with a smile, fearing that she might lose her temper and say
more than I would like.

George had now been palming five minutes, and I asked him to uncover
his eyes and look at the card. He was very much surprised to find that
he could read the forty line without seeing the letters double. I
asked his mother very quietly to be a little patient with him and help
him at home, and I gave her a test card for him to practice with.
"Madam," she replied, "I am the mother of six, and I haven't time
to fuss with him."
"No wonder the kiddy is cross-eyed," I thought, and seeing I could
get no help in that quarter, I appealed to George.
When I revealed to him the possibility of a Christmas present if he
came to the clinic regularly and did what I told him he became
interested. I did not know how much could be done for his eyes in the
eight weeks that remained before the holidays, but I felt sure that
with his co-operation we could at least make a good start. This he
gave me in full measure. Never did I have a more enthusiastic patient.
He came to the clinic regularly three days a week, and often when I
came late I would find him waiting for me on the hospital steps and
yelling:
"Here she is. I saw her first."
After he had been practicing faithfully for two weeks—palming six
times a day, and perhaps more, according to his own report—he was able
to keep his eyes straight while he read the test card at twelve feet.

After he had done this I asked him to spell a word with four letters,
and instantly his eyes turned. I had him palm again, and then I asked
him to count up to twenty. His eyes remained straight, because he
could do this without strain.

Two days before Christmas I brought my bundle of presents for the
children. George was there bright and early, and with him had come
three of his brothers, to get their share too, "if there was any," as
George explained. Fortunately a little fairy had prepared me for this,
and I had gifts for everyone. That day George was able to keep his
eyes straight both before and after his treatment, and to read 15/10
with each eye separately. I have never seen him since, and can only
hope that he kept up the treatment until permanently cured.

When little Ruth, aged three, first came to us Dr. Bates suggested to
her mother, who was nearsighted, that she should have her own eyes
cured, because her condition had a bad effect on the child. She
consented, and now has nearly normal vision. Ruth had squint and was
so tiny that I had to put her on a table to treat her. As she could
not, of course, read the letters on the test card, I held before her a
card covered with E's of various sizes turned in different directions.
Her mother was quite positive that she couldn't understand what I
wanted her to do, but Ruth, as often happens in such cases, had more
intelligence than her mother gave her credit for. I asked her to tell
me whether a certain E pointed upward, or to the right or left, by
merely indicating the direction with her finger, and it did not take
an instant for her to show Mother how bright she was. I showed her how
to palm, and in a little while she indicated correctly the direction
of the letters on several lines. When the letters became indistinct,
as I moved the card further away, she became excited and wanted to
cry, and her left eye turned in markedly. She palmed again and while
she was doing so, I asked her all about her dolly, whether her eyes
were blue, or some other color, what kind of clothes she wore, and so
on. When she removed her hands from her eyes both were straight. Her
mother was instructed to practice with her many times a day at short
intervals, so that she would not tire of it, and in three months her
eyes were straight every time I tested her sight. I was much
interested to learn from her mother that if Ruth's daddy raised his
voice in the slightest degree when he spoke to her, her eyes were sure
to turn in. This merely confirmed my own experience that it is
necessary to treat children who have defects of vision with the utmost
gentleness if one wants to cure them. Ruth is not cured yet, but she
hopes to be before Christmas, because Santa Claus is sure to visit
Room 6, Harlem Hospital Clinic, and he does not like to see children
squinting.
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Squint Number
Better Eyesight
A monthly magazine devoted to the prevention and cure of imperfect
sight without glasses
Copyright, 1920, by the Central Fixation Publishing Company
Editor—W. H. Bates, M.D.
Publisher—Central Fixation Publishing Co.
$2.00 per year, 20 cents per copy
342 West 42nd Street, New York, N. Y.
Vol. III - November, 1920 - No. 5
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