William Horatio Bates

“ In spite of the repeated failure of preventive measures based upon the limitation of near work and the regulation of lighting, desks, types, etc., the use of the eyes at the nearpoint under unfavorable conditions is still admitted by most exponents of the heredity theory as probably, if not certainly, a secondary cause of myopia. Sidler-Huguenin, however, whose startling conclusions as to the hopelessness of controlling shortsight were quoted earlier, has observed so little benefit from such precautions that he believes a myope may become an engineer just as well as a farmer, or a forester ”

“ If Nature has attempted to adapt the eye to civilized conditions by an elongation of the globe, she has done it in a very clumsy manner. It is true that many authorities assume the existence of two kinds of myopia, one physiological, or at least harmless, and the other pathological ”

“ The prevalence of myopia, the unsatisfactoriness of all explanations of its origin, and the futility of all methods of prevention, have led some writers of repute to the conclusion that the elongated eyeball is a natural physiological adaptation to the needs of civilization. ”

“ Numerous answers to this question have been proposed, but no one has yet succeeded in finding a satisfactory one.1 In the case of children it has been assumed by many authorities that, since the coats of the eye are softer in youth than in later years, they are unable to withstand a supposed intraocular tension produced by near work. When other errors of refraction, such as hypermetropia and astigmatism, believed to be congenital, were present, it has been supposed that the accommodative struggle for distinct vision produced irritation and strain which encouraged the production of short sight. ”

“ When the condition developed in adults, the explanations had to be modified to fit the case, and the fact that a considerable number of cases were observed among peasants and others who did not use their eyes for near work led some authorities to divide the anomaly into two classes, one caused by near work and one unrelated to it, the latter being conveniently attributed to hereditary tendencies. ”

“ There are many differences between the conditions to which the children of primitive man were subjected, and those under which the offspring of civilized races spend their developing years, besides the mere fact that the latter learn things out of books and write things on paper, and the former did not. In the process of education civilized children are shut up for hours every day within four walls, in the charge of teachers who are too often nervous and irritable. ”

“ Owing to the difficulty of reconciling these facts on the basis of the earlier theories, there is now a growing disposition to attribute myopia to hereditary tendencies;6 but no satisfactory evidence on this point has been brought forward, and the fact that primitive peoples who have always had good eyesight become myopic just as quickly as any others when subjected to the conditions of civilized life, like the Indian pupils at Carlisle,7 seems to be conclusive evidence against it. ”

“ It has also been found that there is just as much myopia in schools where little near work is done as in those in which the demand upon the accommodative power of the eye is greater.5 It is only a minority of children, moreover, that become myopic ”