BOWMAN LECTURE. CLVII 



screen, he always looked considerably above the object, i. e., he used the 

 retina a little above the Y.S. He was then tested in the garden in 

 brilliant moonlight, and the following notes made : he could not see a 

 white handkerchief on the grass only a foot from him, although it was 

 visible to all of us at many yards off ; he could not see the white cuff of 

 his own shirt when his coat sleeve was drawn up ; he was qiiite unable to 

 see a number of flowers that were easily visible to the rest of us ; finally 

 he was quite unable to find his way about the lawn (a flat one) without 

 a guide, and on turning to the house said that the lighted window was 

 the only thing by which he could at all guide himself ; and it was obvious 

 that if there had been any pit or obstacle on the ground he woiild have 

 walked into it unless guided. The whole result was very striking, 

 and certainly not to be explained merely by the uncorrected myopia. 

 Married eight years, one child, get. 8 years (VI, 1), seen and found to 

 have H. 2 D, with normal fundus, perfect sight, and no night-blindness. 



V, 4 began glasses at four years old, and was first seen by Mr. W. J. 

 Cant in 1889, viz., when from five to six years of age, and found to be using 

 - 9 D. spectacles ; Mr. Cant gave him - 6 D. In April, 1904 (set. about 

 10 years) the E. was found to be divergent and somewhat amblyopic, V. 

 Avith correction being only - against yV with the L., and he had difficulty 

 in maintaining fixation with R. ; it was probably then that his present 

 full correction was ordered. There is no further record until the early 

 part of 1908 (set. 14 years), when Mr. E. C. Clements and Mr. Cant made 

 a careful examination, with the following results : R. 10 D. ^ ; L. 

 9 D. sph. with 1'5 D. cyl. partly; is already wearing glasses of 

 this strength. When the illumination is reduced to half light, V. with 

 correction equals only ^, and with one quarter illumination only % and 

 with the window-blind drawn still further down he was unable to see a 

 piece of white paper 10 in. (25 cm.) square at 6 ft., even when it was 

 moved about. Fields for white ; L. normal in full light, much 

 reduced in the same half and quarter light ; when the blind was 

 drawn more than three quarters down the fixation object was invisible 

 to him even when 1 in. square ; R. (amblyopic eye) smaller for full light 

 than L., and shows similar further contraction in lowered light. Fundus 

 perfectly healthy in appearance in every detail, except for ordinary 

 sharply defined crescents from one quarter to one third the width of 

 O.D. ; especially, retinal vessels of full size and no trace of retinal pig- 

 mentation. 



His mother noticed that his sight was not right before he was a year 

 old, and that when between two and three he could not see his toys if 

 the light was at all bad, but had to grope for them. 



When Mr. C. H. Usher and I saw him (October 3rd, 1908) we found 

 him a tall, narrow-chested boy, 5 ft. 6 in. high, of between 14 and 15 

 years, with, as already noted, perfectly normal fundi ; by estimation the 

 myopia was much less at the periphery than at posterior pole of globe ; 

 choroids rather fair. Various comparative qualitative tests applied whilst 

 wearing his correction, such as a square of white paper several inches in 

 the side viewed tinder different degrees of illumination, showed repeatedly 



