William Horatio Bates

“ The center of sight goes blind first, partially or completely, according to the degree of the strain, and if the strain is great enough the whole or the greater part of the retina may be involved. When the vision of the center of sight has been suppressed, partially or completely, the patient can no longer see the point which he is looking at best, but sees objects not regarded directly as well, or better, because the sensitiveness of the retina has now become approximately equal in every part, or is even better in the outer part than in the center. ”

“ One part of an object is seen best only when the mind is content to see the greater part of it indistinctly and as the degree of relaxation increases the area of the part seen worse increases, until that seen best becomes merely a point.
The limits of vision depend upon the degree of central fixation. A person may be able to read a sign half a mile away when he sees the letters all alike, but when taught to see one letter best he will be able to read smaller letters that he didn't know were there. ”

“ On the principle that a burnt child dreads the fire, some patients are benefited by consciously making their sight worse. When they learn, by actual demonstration of the facts, just how their visual defects are produced, they unconsciously avoid the unconscious strain which causes them. ”

“ When a patient has consciously lowered his vision and produced discomfort and even pain by trying to see the big C, or a whole line of letters, equally well at one time, he becomes better able to correct the unconscious effort of the eye to see all parts of a smaller area equally well at one time... ”

“ Eccentric fixation is a symptom of strain, and is relieved by any method that relieves strain; but in some cases the patient is cured just as soon as he is able to demonstrate the facts of central fixation. ”

“ When he comes to realize, through actual demonstration of the fact, that he does not see best where he is looking, and that when he looks a sufficient distance away from a point he can see it worse than when he looks directly at it, he becomes able, in some way, to reduce the distance to which he has to look in order to see worse, until he can look directly at the top of a small letter and see the bottom worse, or look at the bottom and see the top worse. ”

“ The highest degrees of eccentric fixation occur in the high degrees of myopia, and in these cases, since the sight is best at the near-point, the patient is benefited by practicing seeing worse at this point. ”

“ This strain, when it is habitual, leads to all sorts of abnormal conditions and is, in fact, at the bottom of most eye troubles, both functional and organic. The discomfort and pain may be absent, however, in the chronic condition, and it is an encouraging symptom when the patient begins to experience them.
When the eye possesses central fixation it not only possesses perfect sight, but it is perfectly at rest and can be used indefinitely without fatigue. It is open and quiet; no nervous movements are observable ”

“ In most cases of eccentric fixation, on the contrary, the eye quickly tires, and its appearance, with that of the face, is expressive of effort or strain. The ophthalmoscope1 reveals that the eyeball moves at irregular intervals, from side to side, vertically or in other directions. ”

“ These movements are often so extensive as to be manifest by ordinary inspection, and are sometimes sufficiently marked to resemble nystagmus.2 Nervous movements of the eyelids may also be noted, either by ordinary inspection, or by lightly touching the lid of one eye while the other regards an object either at the near-point or the distance. The visual axes are never parallel, and the deviation from the normal may become so marked as to constitute the condition of squint. ”

“ The textbooks state that muscular insufficiencies occur in eyes having normal sight, but I have never seen such a case. The muscles of the face and of the whole body are also at rest, and when the condition is habitual there are no wrinkles or dark circles around the eyes. ”