THE OPTICAL DEFECTS OF THE EYE. 2;5>.' 



eyelids. After some jnoments rest, he once more sees distinctly, but 

 the same phenomena are again developed more rapidly than before." 

 According to my own experience with these cases, the above descrip- 

 tion corresponds very closely with the description that most patients 

 give of their symptoms. Some give more prominence to the neural- 

 gic pains which they experience in and around the eye, and in some 

 cases extending to the back of the head. I was consulted, about a 

 year ago, by a lady from the town of Simcoe, C.W., who had all these 

 symptoms in the most aggravated form. If she attempted to read 

 even one line, it gave her so much pain in her eyes and 

 forehead that, for several years, she had scarcely dared to even raise 

 the lid of a book. She was unable to keep her eyes upon any one 

 object for more than an instant at a time, without causing her pain. 

 Others, again, do not speak of any pain or fatigue of the eye ; but 

 that, after reading a short time, the letters become indistinct, so 

 that they are obliged to stop or look away at something distant, or 

 close the eyes for a short time, when they can again proceed, the 

 same symptoms recurring. 



In regard to the prognosis in hypermitropia, Bonders thinks that 

 when it is once developed it never gives way. All the inconvenience 

 of the accompanying Asthenopia can be relieved by wearing the proper 

 glasses to relieve the hypermetropia ; but the cause, namely (in most 

 cases), a congenital flattening of the eye-ball from before, backwards, 

 will probably remain through life. 



As age advances, the " near " point recedes from the eye, as in 

 a normal eye, so that in time it becomes complicated with presbyopia. 

 Treatment. — In order to correct this optical defect, it is necessary 

 for the patieat to wear a pair of convex spectacles of sufficient strength 

 to enable him to see distant objects distinctly, without any effort of 

 the accomodation. In cases where the hypermetropia is absolute, and 

 the patients are not able to see distinctly at any distance, they can, 

 approximately, by trial, select the glasses that will remedy the low 

 degree of refraction of their eyes. But, in all other cases, it is neces- 

 sary to paralyse the accomodation, and test with lenses of different 

 strength, in order accurately to ascertain the degree of hypermetropia. 

 When we ascertain this fact, we also know the number of the glasses 

 that we must prescribe for them. The effect of the atropine usually 

 lasts about a week, after which the patient can commence wearing 

 glasses. Before, however, he use the spectacles that he is to wear 



