The Prevention of Myopia: Methods That Failed - Better Eyesight, W.H. Bates, M.D.

Discussion in 'Optometry Archives' started by Zetsu, Jun 28, 2009.

  1. Zetsu

    Zetsu Guest


    The publication in 1867 by Professor Hermann Cohn of Breslau of a
    study of the eyes of ten thousand school children first called general
    attention to the fact that while myopia is seldom found in the pre-
    school age, the defect increases steadily both in percentage of cases
    and in degree during the educational period. Professor Cohn's
    investigations were repeated in all the advanced countries, and his
    observations, with some difference in percentages, were everywhere
    confirmed. The conditions were unanimously attributed to the excessive
    use of the eyes for near work, and as it was impossible to abandon the
    educational system, attempts were made to minimize the supposed evil
    effects of reading, writing and other near work which it demanded.
    Careful and detailed rules were laid down by various authorities as to
    the size of type to be used in school books, the length of the lines,
    their distance apart, the distance at which the book should be held,
    the amount and arrangement of the light, the construction of the
    desks, the length of time the eyes might be used without a change of
    focus, etc. Face rests were even devised to hold the eyes at the
    prescribed distance from the desk and to prevent stopping, which was
    supposed to cause congestion of the eyeball and thus to encourage
    elongation. The Germans, with characteristic thoroughness, actually
    used these instruments of torture, Cohn never allowing his children to
    write without one, "even at the best possible desk." [1]

    The results of these preventive measures were disappointing. Some
    observers reported a slight decrease in the percentage of myopia in
    schools in which the prescribed reforms had been made; but on the
    whole, as Risley has observed in his discussion of the subject in
    Norris and Oliver's System of Diseases of the Eye, "the injurious
    effects of the educational process were not noticeably arrested."

    "It is a significant, though discouraging fact," he continues, "that
    the increase, as found by Cohn, both in the percentage and in the
    degree of myopia, had taken place in those schools where he had
    especially exerted himself to secure the introduction of hygienic
    reforms, and the same is true of the observations of Just, who had
    examined the eyes of twelve hundred and twenty-nine of the pupils of
    the two High Schools of Zittau, in both of which the hygienic
    conditions were all that could be desired. He found, nevertheless,
    that the excellent arrangements had not in any degree lessened the
    percentage of increase in myopia. It became necessary, therefore, to
    look beyond faulty hygienic environments for the cause of the
    pathological states represented by myopia." [2]

    With the passage of time further evidence to the same effect has
    steadily accumulated. In an investigation in London, for instance, in
    which the schools were carefully selected to reveal any difference
    that might arise from the various influences, hygienic, social and
    racial, to which the children were subjected, the proportion of myopia
    in the best lighted and ventilated school of the group was actually
    found to be higher than in the one where these conditions were worst.
    [3] It has also been found that there is just as much myopia in
    schools where little near work is done as in those in which the
    demands upon the accommodative power of the eye are greater, while in
    any case it is only a minority of the children in any school who
    become myopic, although all may be exposed to practically the same eye
    conditions. Dr. Adolf Steiger, in his recent book on Spherical
    Refraction, bears witness, after a comprehensive survey of the whole
    question, to the "absolutely negative results of school hygiene," [4]
    and Dr. Sidler-Huguenin reports [5] that in the thousands of cases
    that have come under his care he has observed no appreciable benefit
    from any method of treatment at his command.

    Facts of this sort have led to a modification of the myopia theory,
    but have produced no change in methods of myopia prevention. An
    hereditary tendency toward the development of the defect is now
    assumed by most authorities; but although no one has ever been able to
    offer even a plausible explanation for its supposed injuriousness, and
    though its restriction has been proven over and over again to be
    useless, near work is still generally held to be a contributing cause
    and ophthalmologists still go on in the same old way, trying to limit
    the use of the eyes at the near-point and encourage vision at the
    distance. It is incomprehensible that men calling themselves
    scientific, and having had at least a scientific training, can be so
    foollish. One might excuse a layman for such irrational conduct, but
    how men of scientific repute who are supposed to write authoritative
    textbooks can go on year after year copying each other's mistakes and
    ignoring all facts which are in conflict with them is a thing which
    reasonable people can hardly be expected to understand.

    In 1912, [6] and a good many times since, I published the observation
    that myopia is always lessened when the subject strains to see at the
    near point, and always produced in the normal eye when the subject
    strains to see a the distance. These observations are of the greatest
    practical importance, for if they are correct, they prove our present
    methods of preventing myopia to be a monumental blunder. Yet no one,
    so far as I have heard, has taken the trouble to test their accuracy.
    I challenged the medical profession to produce a single exception to
    the statements I made in the 1912 publication, and that challenge has
    stood for seven years, although every member of the Ophthalmological
    Section of the American Medical Association must have had an
    opportunity to see it, and anyone who knows how to use a retinoscope
    could have made the necessary tests in a few minutes. If any did this,
    they failed to publish the results of their observations, and are,
    therefore, responsible for the effects of their silence. If they found
    that I was right and neglected to say so, they are responsible for the
    fact that the benefits that must ultimately result from this discovery
    have been delayed. If they found that I was wrong, they are
    responsible for any harm that may have resulted from their

    [1] The Hygiene of the Eye in Schools, English translation, edited by
    Turnbull, p. 127.

    [2] System of Diseases of the Eye, 1897, Vol. II, p. 361.

    [3] Brit. Med. Jour., June 18, 1898.

    [4] Die Entstehung der sphärischen Refraktionen des menschlichen
    Auges, Berlin, 1913, p. 540.

    [5] Archiv f. Augenhlk., Vol. LXXIX, 1915, translated in Archives of
    Ophthalmology, Vol. XLV, No. 6, November, 1916.

    [6] Bates: The Cause of Myopia, N. Y. Med. Jour., March 16, 1912.


    A monthly magazine devoted to the prevention and cure of imperfect
    sight without glasses
    Copyright, 1919, 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
    39-45 East 42nd Street, New York, N. Y.
    Vol. I - August, 1919 - No. 2

    Zetsu, Jun 28, 2009
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