William Horatio Bates

“ The truth about presbyopia is that it is not "a normal result of growing old," being both preventable and curable. It is not caused by hardening of the lens, but by a strain to see at the near-point. It has no necessary connection with age, since it occurs, in some cases, as early as ten years, while in others it never occurs at all, although the subject may live far into the so-called presbyopic age. ”

“ In from five to ten years the accommodative power of the eye is usually gone; and if from this point the patient does not go on to cataract, glaucoma, or inflammation of the retina, he may consider himself fortunate. Only occasionally do the eyes refuse to submit to the artificial conditions imposed upon them; but in such cases they may keep up an astonishing struggle against them for long periods. A woman of seventy, who had worn glasses for twenty years, was still able to read diamond type and had good vision for the distance without them. ”

“ Donders1 says that the power of accommodation diminishes little, if at all, more rapidly among people who use their eyes much at the near-point than among agriculturists, sailors and others who use them mainly for distant vision; and Roosa and others2 say the contrary. This is a fact however, that people who cannot read, no matter what their age, will manifest a failure of near vision if asked to look at printed characters, although their sight for familiar objects at the near-point may be perfect. ”

“ The retinoscope showed that when I tried to see anything at the near-point without glasses my eyes were focussed for the distance, and when I tried to see anything at the distance they were focussed for the near-point. My problem, then, was to find some way of reversing this condition and inducing my eyes to focus for the point I wished to see at the moment that I wished to see it. I consulted various eye specialists, but my language was to them like that of St. Paul to the Greeks, namely, foolishness. "Your lens is as hard as a stone," they said. "No one can do anything for you." ”

“ It has been shown that when the eyes strain to see at the near-point the focus is always pushed farther away than it was before, in one or all meridians; and by means of simultaneous retinoscopy it can always be demonstrated that when a person with presbyopia tries to read fine print and fails, the focus is always pushed farther away than it was before the attempt was made, indicating that the failure was caused by strain. ”

“ Fortunately for those who feel called upon to defend the old theories, myopia postpones the advent of presbyopia. and a decrease in the size of the pupil, which often takes place in old age, has some effect in facilitating vision at the near-point. Reported cases of persons reading without glasses when over fifty or fifty-five years of age, therefore, can be easily disposed of by assuming that the subjects must be myopic, or that their pupils are unusually small. ”

“ But once the glasses are adopted, in the great majority of cases, they produce the condition they were designed to relieve, or, if it already existed, they make it worse, sometimes very rapidly, as every ophthalmologist knows. In a couple of weeks sometimes, the patient finds, as noted in the chapter on What Glasses Do to Us, that the large print which he could read without difficulty before he got his glasses, can no longer be read without their aid. ”

“ There are also people who regain their near vision after having lost it for ten, fifteen, or more years; and there are people who, while presbyopic for some objects, have perfect sight for others. Many dressmakers, for instance, can thread a needle with the naked eye, and with the retinoscope it can be demonstrated that they accurately focus their eyes upon such objects ”

“ When people who have reached the presbyopic age experience difficulty in reading, they are very likely to resort at once to glasses, either with or without professional advice. In some cases such persons may be actually presbyopic; in others the difficulty may be something temporary, which they would have thought little about if they had been younger, and which would have passed away if Nature had been left to herself. ”

“ These extremely quick cures are rare. In nine cases out of ten progress has been much slower, and it has been necessary to resort to all the methods of obtaining relaxation found useful in the treatment of other errors of refraction. ”

“ There are many people, however, who do not fit this schedule. Many persons at forty can read fine print at four inches, although they ought, according to the table, to have lost that power shortly after twenty. Worse still, there are people who refuse to become presbyopic at all. ”

“ The fact that such persons, at the age of forty-five or fifty, cannot differentiate between printed characters is no warrant, therefore, for the conclusion that their accommodative powers are declining. ”