£09 On the Removal of Impediments to the Acquirement 



pacity and disposition of different patients, were systema- 

 tically pursued ; not only would useful vision be obtained 

 by congenital patients in a much shorter period than usual, 

 but it would fall little short of tiiat enjoyed after the re- 

 moval of the disease from persons not born bhnd. An 

 intelligent person should always be appointed to superin- 

 tend the management of those cured of congenital cataracts, 

 whose sole business should be to watch and correct as 

 much as possible those liabits which impede the acquire- 

 ment of vision, and to assist, by every expedient which in- 

 feuuity can devise, in the attainment of the desired object, 

 correct the rolling motion of the eyes, and to acquire 

 the power of keeping them steady, the patient, after being 

 fitted with spectacles, should be made to look steadfastly 

 on one object. The muscles of the eye, and the organ it- 

 self, will soon become fatigued with this exercise ; but it 

 should be daily continued at proper intervals, by which the 

 power of fixing the eyes at pleasure will rapidly increase. 

 He should be made also to pick up small objects, such as 

 grains of rice, &c. : this is also particularly useful, as it 

 will in time enable him to judo;e accurately of distances, of 

 which at first he is ignorant. — Letters of a large size should 

 be next cut out on pasteboard : as these are capable of be- 

 ing examined by the touch as well as sight, they will -begin 

 to afford him a knowledge of different forms and shapes. 

 The propensity to indolence and want of exertion in con- 

 genital patients, even in children, is often so great, that the 

 preceptor will have considerable difficulty in making them 

 apply daily for as long a time as is necessary; and I have 

 always found it regarded more as a task than a pleasure : 

 but this must not tempt him to any relaxation in the 

 system. 



" The sensibility of the retina to the impression of light 

 increases in proportion to the degree of exercise to which 

 the eye is subjected *. It is therefore obvious that the de- 



* This appears very strikingly to have happened in thr-. case of Mrv 

 Piirkis, organist of St. Clement's Church, Strand, who was born with ca- 

 taracts, and W2 3 operated on at thirty years old; before which he was only 

 capable of perceiving light and brilliant colours. In a note at the end of 

 his case Mr. Adams states : " The professional avocations of this patient, and 

 the c(<ntiinial rolling motion of his eyes, have hitherto prevented him from 

 iieaping all the btnefit to be derived from the operation. The rolling mo- 

 tion of his eyes, however, is very much corrected, and he has acquired the 

 power of iixing them at pleasure. He has learnt to read musical characters* 

 to tell the hour with the greatest accuracy on a watch-dial, or by a churcli 

 clock at a considerable distance, and his power of vision continues to im- 

 prove. Since his return from Exeter, he walks without a guide by day and 

 night, which he never ventured to do before the operation, and has now' 

 entirely laid aside the use of spectacles, except to view minute objects." 



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