Alternating periods of rest and work must be insisted upon also at home, and the eager reading of story books and novels, usually very poorly printed, should be forbidden. The reading of music notes, and the production of fine needlework are exceedingly harmful for the eyes of a child. If, in spite of all these precautions, a visual weakness is suspected by the way in which the work is brought up close to the eyes, or by a lack of endurance, no time should be lost in providing for a careful examination by the physician. If deemed necessary, spectacles may be prescribed, so that the child may not he backward in school because of visual defects which can be remedied.
A child who complains of twitching of the eyeball generally suffers from a congenital weakness, and allowances must be made for children thus affected.
The beneficial effects which outdoor exercise, gymnastics, swimming, and other sports exert on the organism, are of course extended also to the organ of sight. But at the very beginning it is essential that any over indulgence in such sports be carefully avoided. Diving after objects is harmful, because inflammatory disturbances may arise from keeping the eyes open under water for a prolonged time.
The play of children should be under the supervision of either teachers or parents. Knives and other cutting instruments should not be permitted, and this restriction should be extended to weapons of all kinds, including the apparently harmless pop-guns and pea-shooters. Especial attention is here directed to the toy pistol ; the explosion of the caps which are used in it often cause severe and incurable injuries to the eves.
The choice of an occupation should largely depend upon the condition of sight, and it is advisable to have this ascertained by a medical examina tion. "Where there is present a tendency to near-sightedness, no occupation should be chosen which requires distant vision as an essential. Those afflicted with far-sightedness will, on the other hand, find it extremely incon venient to follow a calling which requires the continued application of their sight to objects near at hand. If repeated inflammatory disturbances have brought about an irritable condition of the eves, occupations must be avoided which necessitate exposure to external irritation, such as dust, smoke, strong light, or heat. The Army, the Navy, and the railway companies have established certain minimum visual requirements which must he fulfilled by applicants for positions in their service.
The care of the eyes should not be neglected even by adults, who should always endeavour to alternate periods of work with rest, especially when doing work near at hand. When the time has arrived, usually about the forty-fifth year, when near vision becomes somewhat impaired, the individual should not hesitate to wear proper glasses in order to assist the eyes, instead of giving way to the popular delusion that such a course weakens the visual organs. The choice of glasses should not be left to the optician. Although apparently simple, this is a difficult task which requires exact study of each individual case, and the application of specialised medical knowledge. Reading while in the recumbent posture strains the eyes, and
sewing at dusk or with insufficient light is also harmful and should he avoided. As a general rule, it is well to avoid sudden changes of light and darkness, as well as a glaring light. The latter may be lessened by pro tective spectacles or by white window-curtains. If the artificial light is too strong, some form of lamp-shade, or the protective eye-shade already referred to, should be employed. The blinding which results from gazing into an open fire or into the sun is likewise harmful, and such exposure ought to be avoided. Fa the same reason, smoked glasses should be worn to overcome the blinding effects of sunlight on the snow, or when sojourning at the seashore. These glasses not only serve to protect weak, irritable eves, but are of service also in protecting normal eyes which are exposed to various external irritants, such as bad air, and the entrance of foreign bodies. In case the latter accident has taken place, medical aid should be sum moned. This applies particularly to cases where caustic substances, acids or alkalies, have penetrated the eve. Among foreign bodies must also be included the larva: of certain animals, which have entered the organism in contaminated food, and have then been taken up by the circulation and settled in the interior of the eve. Fortunately such cases are extremely rare. They constitute a serious condition, and can he eliminated only by operative procedures.
The effects of various poisons may be very deleterious to the eve. The excessive use of stimulants, such as alcohol and tobacco, may cause symptoms of visual disturbances ; and poisons which enter the system in consequence of the individual's occupation may likewise cause great harm. The latter condition is found among workers in bisulphide of carbon, many dyes, lead, etc. The best and, in fact, the only efficient treatment consists in the removal of the offending toxic material, and, where indicated, a change of occupation.
The indiscriminate use of the various eye-washes commonly exploited calls for particular warning. They arc either useless or harmful. Very often they are the means of postponing a timely consultation with the proper medical adviser. There arc no drugs or salves which can strengthen the eyes. The treatment of such a delicate organ by household remedies, secret concoctions, or by a quack, usually meets with the reward which it deserves. Self-treatment with milk, raw meat, frog's spawn, freshly passed urine, etc., can only be productive of harm to a diseased eye. Rut caution must not be limited to such disagreeable and disgusting remedies ; it must be extended also to apparently harmless remedies, including cold applica tions of water, camomile, and lead-water. In any given case the choice of the remedy should be left to the discretion of the physician, who also will decide whether cold, warm, or hot applications are to he employed. It is well to remember that in every case of disturbance which involves the eves, the physician's counsel had best be sought, for in no other organ of the body is it more difficult to compensate for the sins of omission.