This article was originally written by By John L. Moore, Atlanta, Ga., and read at Alabama Optical Society’s Convention in Montgomery, May 12, 1908, which is believed to now be public domain.
THREE great divisions of optical science are geometrical, physical and physiological optics. A lifetime may be spent in the study of optics without exhausting or mastering the subject, but this does not discourage the ophthalmologist. He selects a portion of geometrical and of physical optics, and applies his mind to a close examination of physiological optics. Moreover, the study of each of these main divisions is not kept separate and distinct from that of the others.
The investigations in each of the three branches blend together as may best serve the purpose of the ophthalmologist, and may properly be classed under the technical term, Ophthalmic Optics. We derive the term from the Greek word for eye. Hence, we select from the three main divisions of optics as much as appertains to the visual apparatus and the sight function, and call this grouping Ophthalmic Optics. This is a comparatively late classification, and during the time that this term has been in use the greatest advance in the knowledge and correction of refractive errors has been made.
Some time in the sixties, a friend of the writer was suffering from a high degree of compound myopic astigmatism and went to the elder Spencer in New York City for relief from his eyestrain. Spencer was an optician and optical instrument maker of unusual ability and very considerable scientific attainment. On testing my friend’s eyes, Mr. Spencer found that sphero-cylindrical lenses were required for the correction of the trouble, and he made an attempt to grind the cylinders. At that early period, he had no disks for grinding cylindrical lenses. In fact, this was his first attempt to make such a lens. He fashioned his own cylindrical disks and ground the lenses by holding the glass in his hand and rubbing it back and forth on the disks, using emery and continuing the rubbing until the desired curvature was obtained. He then polished the lenses by the same hand process with rouge. Of course, this was a long, laborious process, but he succeeded in making a fairly good correction of my friend’s eye trouble.
I think we may consider this as the beginning of cylindrical lens grinding in the United States, for while it is probable that Gerson, in 1810, was the first to point out the existence of corneal astigmatism, yet it was as late as 1846 when Senf made the first measurements of the cornea, and it was not till 1855 that Helmholtz published his ophthalmometrical measurements of the cornea. Donders did not publish his first paper on this asymnetry till 1860, but a short time before Spencer ground his first cylinders.
Indeed, as late as 1880 the ordinary dealer in glasses did not know that there was such a thing as a cylindrical lens used in spectacles. In that year, the writer, then a young man living in a small town in Nebraska, went first to one and then to the other of the two jewelers located there, who were the only dealers in glasses. He tried all the spectacles that both dealers had that he could use at all, but none of them were at all satisfactory. After struggling along with faulty eyes for some time, he went to a celebrated oculist in Omaha, who discovered that he had astigmatism, and who made the proper test, sending the prescription to St. Louis to have the glasses ground.
When the writer received his spectacles, he showed them to one of the local jewelers, telling him the oculist called them cylindrical lenses. The jeweler laughed at the idea of such a lens, saying, “Don’t you know that a cylinder is a round hollow object, and if this were a cylindrical lens it would be hollow in the center?”
Again in 1883, the writer, partly because his eye trouble suggested it, applied to a wholesale optician for a traveling position, and was accepted. At that time, many of the small towns in the Southern States had no jewelers; some of them had watchmakers who did repairing only and carried no stock, so I sold bills of spectacles and eyeglasses to druggists as well as to jewelers. In fact, I obtained more customers among druggists than among the jewelers, because the former were the more numerous class. I carried a trunk full of goods with me and delivered goods as I sold them. My usual method of sale was to place assortments, as I called them, consisting of a certain number of several different kinds of spectacles and eye glasses with frames already fitted with lenses. It was a very rare thing to sell lenses and frames separately.
At that time there were very few oculists in the South, and no prescription work was done by the small dealers.
Now the count of the oculists in the city of Atlanta, for instance, runs up nearly to the twenties. In 1883, there were only two oculists in Atlanta and there was no optical house in Atlanta or in the South which did surface grinding. There were then no exclusive opticians except in a very few of the larger cities.
These reminiscences are only interesting as showing at what a low state the common optical knowledge was at that period, and also as revealing to us the great progress that has been made in optics in the last quarter of a century.
Consider, for instance, our common refractive error, hypermetropia or hyperopia, and it will show this progress in ophthalmic optics.
The condition of hypermetropia remained almost entirely unobserved till recent years. In the year 1811 Wells wrote of a case of this kind—his own eyes. His was a case of hypermetropia acquisita at the age of 55 years, but he did not know of that name, of course, and that classification came much later. MacKenzie’s work, “A Practical Treatise on the Diseases of the Eye,” published in London, England, in 1830, mentions this condition.
Nov. 19, 1812, James Ware, in a paper read before the Royal Society, spoke of the condition of sight mentioned by Wells and MacKenzie, and added: “There are also instances of young persons, who have so disproportionate a convexity of the cornea, or crystalline lens, or of both, to the distance of these parts from the retina, that a glass of considerable convexity is required to enable them to see distinctly not only near objects, but also those that are distant, and it is remarkable that the same glass will enable many such persons to see both near and distant objects, thus proving that the defect in their sight is occasioned solely by too small a convexity of the parts above mentioned.”
Nothing of importance was added to the knowledge of this subject by later writers till 1853. In that year, the condition was described in a scientific manual (Reute. “Lehrbuch du Opthalmologie für Aerzte und Studireude”).
The name used in this manual for this condition of sight was Uebersichtigkeit (oversightedness). At a meeting in Heidelburg in 1859, Prof. Donders first showed that presbyopia, and what had been called hyperpresbyopia, were entirely different conditions of sight; that the latter condition was the opposite of myopia. He then contended that hyperpresbyopia was not the proper name for this condition of sight. Helmholtz at once proposed the term hyperopia. As this agreed with the word Üebersichtig-keit (oversightedness), first used by Ruete in 1853, it found acceptance with a number of persons. It is in use at the present day, but I think Donders is more correct in using the term hypermetropia, for it agrees in formation with the words ametropia and emmetropia, which he had previously employed, and which have come into general use.
Up to this time and until about 1887 or 1888, the optician was dependent upon publications intended for the physician, for his reading on ophthalmological subjects. About the year 1887, Bohne’s “Hand Book for Opticians” was published, and in the same year a wholesale optical house in Michigan began the publication of a series of lessons for the optician which were called “Eye Studies” and which appeared monthly.
These and other publications stimulated a desire for scientific knowledge of ophthalmic optics among the ordinary dealers in spectacles and eye glasses, and many began a systematic course of reading. The optical schools put in an appearance and began to bid for students, offering short courses of study of a month or six weeks at a moderate cost for tuition.
These efforts at optical education, crude as they were, served a fine purpose in awakening the spectacle dealers’ interest in securing a better knowledge of their calling. These efforts have begotten a germ or nucleus of an optical profession, which has passed through much the same experience as the members of the dental profession passed through before they attained their present state of high efficiency and public usefulness.
With a thorough campaign of education, I see no reason why the optometrist shall not come into as full and complete public recognition in due course of time as the dental profession has already achieved.
Perhaps the writer, because he is not practicing optometry, can speak to you in a more unprejudiced way than could one of your own number, so he will try to emphasize a few points that, during a long experience in the optical business have seemed to him to be important.
In the first place, do not bring on a fight with or antagonize men of any other profession. You will have enough to do in attending to your own legitimate duties. Moreover, the public is not interested in any man’s personal affairs. They want him in a professional capacity.
Try to get the best optical education that you can secure, but remember that it is for your use, not for mere show. The real scientist is modest, is simple and direct in his statements, while the sciolist flaunts his smattering of knowledge, and is effusive in his use of technical terms.
Remember that the greatest hinderance to full public recognition of the optical profession is the imperfectly educated optician. For that reason, work in season and out of season, to raise the general standard of optical education. In our boyhood days the courses of study in medical colleges were of three years’ duration. Now the better class of medical schools give a four years’ course. The dental colleges now commonly have three years’ courses.
Formerly the law schools gave a course of one year. The Georgia Bar Association, in common with the bar association of other states, recommended longer courses of study. The committee from the Georgia Bar Association says: “The tendency in states becoming more thickly populated and growing in wealth is to impose more stringent requirements for entrance to the bar. The necessity for doing this naturally is greater as the number of lawyers increases, the rewards to be gained become larger, competition becomes stronger, and novel difficulties, novel situations arise from a more complex civilization. We owe the duty to the public and to ourselves to see to it, so far as we are able, that only the qualified shall have opportunity to offer themselves as worthy to be trusted with the preservation of property, liberty, life or reputation.”
With a few changes, this recommendation of the Georgia lawyers applies fully as well to the optician as to the lawyer.
It is time for the schools with courses of study of “one month” or “six weeks” to go. I see that a school of optics in New York City is now advertising, “Three months’ attendance required.” A Boston school has 12 weeks’ course.
These are steps in advance of the one month’s course, but even that is not enough. The duration of the course should be lengthened almost immediately to one year, after a time to two years, with a possible three or four years’ course as a hope for the future.
The applicant, on entering a college of optics, should be required to stand an examination, and should show at least a good common school education. We occasionally find men who hold diplomas as graduate opticians, who cannot write three consecutive English sentences correctly. Such men could not enter a college of medicine or of dentistry and, before being admitted to an optical college they should be required to study the common English branches in an ordinary school or academy until they can pass an examination in ordinary English composition with a fair standing.
I hear some one ask: What is the optician to study during a term of two or three years? I answer that he should acquire as thorough a knowledge of anatomy as the graduate of a dental college is obliged to have. He should pay more attention to neurology than the dental profession needs to give to it.
Ophthalmologists sometimes think that when, with the aid of their ministration, the function of vision is perfectly performed, they may rest in the belief that the eye is perfect. Not so by any means. Think of the excessive amount of nerve impulse required by some eyes to sustain that perfection of vision.
It is an academic question among ophthalmologists how far excessive abnormal innervation of the eye muscles depletes the nerve centers, and gives rise to brain irritation of varying degrees. It is claimed that “All alterations of function are primarily central in the nervous system,” and that many serious disturbances arise from what are called reflex causes. We know that great relief has followed the correction of local disturbances of the nasal passages, of the rectum and of female organs, all of which are abnormal innervations, so we should expect as full or even greater relief from the correction of abnormal innervation through the visual centers.
From this we see that the really scientific optometrist must be a skilled neurologist and must thoroughly understand the correction of muscular anomalies. There is no part of the work which the optometrist undertakes that is so generally performed skilfully as the use of prisms in attempting to correct muscular insufficiency.
The optometrist should study more thoroughly physical and mechanical optics. He should have an expert knowledge of the ophthalmoscope, not for use in correcting refractive errors, but in order to recognize diseased conditions of the reflective media, so as to know whether a given case is for the oculist or the optician to relieve.
A period of two to three years would not be too long for a faithful study of these subjects. Your state societies, and your national organization should recommend and urge better schools, and a broader education.
You must keep in touch with the spirit of this scientific age. A great mind like that of Herbert Spencer can write a system of philosophy that is aesthetic, comprehensive, embracing the principles of all knowledge, but the large majority of minds have no such comprehensive grasp of things and ideas. Hence they should specialize. One takes up the study of biology, another ethics, yet another medicine, and so on through the range of man’s activities.
You should specialize on optics. This is an ambitious programme, but when the time comes that optometrists generally are fully prepared by training and education for the highest duties of their calling they will find public recognition of a dignified optical profession, and legislation in their interest will come naturally.