POOR sight is admitted to be one of the most fruitful causes of retardation in the schools. It is estimated1 that it may reasonably be held responsible for a quarter of the habitually "left-backs," and it is commonly assumed that all this might be prevented by suitable glasses.
There is much more involved in defective vision, however, than mere inability to see the blackboard, or to use the eyes without pain or discomfort. Defective vision is the result of an abnormal condition of the mind; and when the mind is in an abnormal condition it is obvious that none of the processes of education can be conducted with advantage. By putting glasses upon a child we may, in some cases, neutralize the effect of this condition upon the eyes, and by making the patient more comfortable may improve his mental faculties to some extent; but we do not alter fundamentally the condition of the mind, and by confirming it in a bad habit we may make it worse.
It can easily be demonstrated that among the faculties of the mind which are impaired when the vision is impaired is the memory; and as a large part of the educational process consists of storing the mind with facts, and all the other mental processes depend upon one's knowledge of facts, it is easy to see how little is accomplished by merely putting glasses on a child that has "trouble with its eyes." The extraordinary memory of primitive people has been attributed to the fact that owing to the absence of any convenient means of making written records they had to depend upon their memories, which were strengthened accordingly; but in view of the known facts about the relation of memory to eyesight it is more reasonable to suppose that the retentive memory of primitive man was due to the same cause as his keen vision, namely, a mind at rest.
The primitive memory as well as primitive keenness of vision, has been found among civilized people; and if the necessary tests had been made it would doubtless have been found that they always occur together, as they did in a case which recently came under my observation. The subject was a child of ten with such marvelous eyesight that she could see the moons of Jupiter with the naked eye, a fact which was demonstrated by her drawing a diagram of these satellites which exactly corresponded to the diagrams made by persons who had used a telescope. Her memory was equally remarkable. She could recite the whole content of a book after reading it, as Lord Macaulay is said to have done, and she learned more Latin in a few days without a teacher than her sister, who had six diopters of myopia, had been able to do in several years. She remembered five years afterward what she ate at a restaurant, she recalled the name of the waiter, the number of the building and the street in which it stood. She also remembered what she wore on this occasion and what every one else in the party wore. The same was true of every other event which had awakened her interest in any way, and it was a favorite amusement in her family to ask her what the menu had been and what people had worn on particular occasions.
When the sight of two persons is different it has been found that their memories differ in exactly the same degree. Two sisters, one of whom had only ordinary good vision, indicated by the formula 20/20, while the other had 20/10, found that the time it took them to learn eight verses of a poem varied in almost exactly the same ratio as their sight. The one whose vision was 20/10 learned eight verses of the poem in fifteen minutes, while the one whose vision was only 20/20 required thirty-one minutes to do the same thing. After palming, the one with ordinary vision learned eight more verses in twenty-one minutes, while the one with 20/10 was able to reduce her time by only two minutes, a variation clearly within the limits of error. In other words, the mind of the latter being already in a normal or nearly normal condition, she could not improve it appreciably by palming, while the former, whose mind was under a strain, was able to gain relaxation, and hence improve her memory, by this means.
Even when the difference in sight is between the two eyes of the same person it can be demonstrated, as was pointed out in the chapter on "Memory as an Aid to Vision," that there is a corresponding difference in the memory, according to whether both eyes are open, or the better eye closed.
Under the present educational system there is a constant effort to compel the children to remember. These efforts always fail. They spoil both the memory and the sight. The memory cannot be forced any more than the vision can be forced. We remember without effort, just as we see without effort, and the harder we try to remember or see the less we are able to do so.
The sort of things we remember are the things that interest us, and the reason children have difficulty in learning their lessons is because they are bored by them. For the same reason, among others, their eyesight becomes impaired, boredom being a condition of mental strain in which it is impossible for the eye to function normally.
Some of the various kinds of compulsion now employed in the educational process may have the effect of awakening interest. Betty Smith's interest in winning a prize, for instance, or in merely getting ahead of Johnny Jones, may have the effect of rousing her interest in lessons that have hitherto bored her, and this interest may develop into a genuine interest in the acquisition of knowledge; but this cannot be said of the various fear incentives still so largely employed by teachers. These, on the contrary, have the effect, usually, of completely paralyzing minds already benumbed by lack of interest, and the effect upon the vision is equally disastrous.
The fundamental reason, both for poor memory and poor eyesight in school children, in short, is our irrational and unnatural educational system. Montessori has taught us that it is only when children are interested that they can learn. It is equally true that it is only when they are interested that they can see. This fact was strikingly illustrated in the case of one of the two pairs of sisters mentioned above. Phebe, of the keen eyes, who could recite whole books if she happened to be interested in them, disliked mathematics and anatomy extremely, and not only could not learn them but became myopic when they were presented to her mind. She could read letters a quarter of an inch high at twenty feet in a poor light, but when asked to read figures one to two inches high in a good light at ten feet she miscalled half of them. When asked to tell how much 2 and 3 made, she said "4," before finally deciding on "5": and all the time she was occupied with this disagreeable subject the retinoscope showed that she was myopic. When I asked her to look into my eye with the ophthalmoscope, she could see nothing, although a much lower degree of visual acuity is required to note the details of the interior of the eye than to see the moons of Jupiter.
Shortsighted Isabel, on the contrary, had a passion for mathematics and anatomy, and excelled in those subjects. She learned to use the ophthalmoscope as easily as Phebe had learned Latin. Almost immediately she saw the optic nerve, and noted that the center was whiter than the periphery. She saw the light-colored lines, the arteries; and the darker ones, the veins; and she saw the light streaks on the blood-vessels. Some specialists never become able to do this, and no one could do it without normal vision. Isabel's vision, therefore, must have been temporarily normal when she did it. Her vision for figures, although not normal, was better than for letters.
In both these cases the ability to learn and the ability to see went hand in hand with interest. Phebe could read a photographic reduction of the Bible and recite what she had read verbatim, she could see the moons of Jupiter and draw a diagram of them afterwards, because she was interested in these things; but she could not see the interior of the eye, nor see figures even half as well as she saw letters, because these things bored her. When, however, it was suggested to her that it would be a good joke to surprise her teachers, who were always reproaching her for her backwardness in mathematics, by taking a high mark in a coming examination, her interest in the subject awakened and she contrived to learn enough to get seventy-eight per cent. In Isabel's case letters were antagonistic. She was not interested in most of the subjects with which they dealt, and, therefore, she was backward in those subjects, and had become habitually myopic. But when asked to look at objects which aroused an intense interest her vision became normal.
When one is not interested, in short, one's mind is not under control, and without mental control one can neither learn nor see. Not only the memory but all other mental faculties are improved when the eyesight becomes normal. It is a common experience with patients cured of defective sight to find that their ability to do their work has improved.
The teacher whose letter is quoted in a later chapter testified that after gaining perfect eyesight she "knew better how to get at the minds of the pupils," was "more direct, more definite, less diffused, less vague," possessed, in fact, "central fixation of the mind." In another letter she said: "The better my eyesight becomes the greater is my ambition. On the days when my sight is best have the greatest anxiety to do things."
Another teacher reported that one of her pupils used to sit doing nothing all day long, and apparently was not interested in anything. After the test card was introduced into the classroom and his sight improved, he became anxious to learn, and speedily developed into one of the best students in the class. In other words his eyes and his mind became normal together.
A bookkeeper nearly seventy years of age who had worn glasses for forty years found after he had gained perfect sight without glasses that he could work more rapidly and accurately and with less fatigue than ever in his life before. During busy seasons, or when short of help, he has worked for some weeks at a time from 7 a. m. until 11 p. m., and he insisted that he felt less tired at night after he was through than he did in the morning when he started. Previously, although he had done more work than any other man in the office, it always tired him very much. He also noticed an improvement in his temper. Having been so long in the office, and knowing so much more about the business than his fellow employees, he was frequently appealed to for advice. These interruptions, before his sight became normal, were very annoying to him, and often caused him to lose his temper. Afterward, however, they caused him no irritation whatever.
In another case, symptoms of insanity were relieved when the vision became normal. The patient was a physician who had been seen by many nerve and eye specialists before he came to me, and who consulted me at last, not because he had any faith in my methods, but because nothing else seemed to be left for him to do. He brought with him quite a collection of glasses prescribed by different men, no two of them being alike. He had worn glasses, he told me, for many months at a time without benefit, and then he had left them off and had been apparently no worse. Outdoor life had also failed to help him. On the advice of some prominent neurologists he had even given up his practice for a couple of years to spend the time upon a ranch, but the vacation had done him no good.
I examined his eyes and found no organic defects and no error of refraction. Yet his vision with each eye was only three-fourths of the normal, and he suffered from double vision and all sorts of unpleasant symptoms. He used to see people standing on their heads, and little devils dancing on the tops of the high buildings. He also had other illusions too numerous to be mentioned here. At night his sight was so bad that he had difficulty in finding his way about, and when walking along a country road he believed that he saw better when he turned his eyes far to one side and viewed the road with the side of the retina instead of with the center. At variable intervals, without warning and without loss of consciousness, he had attacks of blindness. These caused him great uneasiness, for he was a surgeon with a large and lucrative practice, and he feared that he might have an attack while operating.
His memory was very poor. He could not remember the color of the eyes of any member of his family, although he had seen them all daily for years. Neither could he recall the color of his house, the number of rooms on the different floors, or other details. The faces and names of patients and friends he recalled with difficulty, or not at all.
His treatment proved to be very difficult, chiefly because he had an infinite number of erroneous ideas about physiological optics in general and his own case in particular, and insisted that all these should be discussed; while these discussions were going on he received no benefit. Every day for hours at a time over a long period he talked and argued. His logic was wonderful, apparently unanswerable, and yet utterly wrong.
His eccentric fixation was of such high degree that when he looked at a point forty-five degrees to one side from of the big C on the Snellen test card, he saw the letter just as black as when he looked directly at it. The strain to do this was terrific, and produced much astigmatism; but the patient was unconscious of it, and could not be convinced that there was anything abnormal in the symptom. If he saw the letter at all, he argued, he must see it as black as it really was, because he was not color-blind. Finally he became able to look away from one of the smaller letters on the card and see it worse than when he looked directly at it. It took eight or nine months to accomplish this, but when it had been done the patient said that it seemed as if a great burden had been lifted his mind. He experienced a wonderful feeling of rest and relaxation throughout his whole body.
When asked to remember black with his eyes closed and covered he said he could not do so, and he saw every color but the black which one ought normally to see when the optic nerve is not subject to the stimulus of light. He had, however, been an enthusiastic football player at college, and he found at last that he could remember a black football. I asked him to imagine that this football had been thrown into the sea and that it was being carried outward by the tide, becoming constantly smaller but no less black. This he was able to do, and the strain floated with the football, until, by the time the latter had been reduced to the size of a period in a newspaper, it was entirely gone. The relief continued as long as he remembered the black spot, but as he could not remember it all the time, I suggested another method of gaining permanent relief. This was to make his sight voluntarily worse, a plan against which he protested with considerable emphasis.
"Good heavens!" he said. "Isn't my sight bad enough without making it worse?"
After a week of argument, however, he consented to try the method, and the result was extremely satisfactory. After he had learned to see two or more lights where there was only one, by straining to see a point above the light while still trying to see the light as well as when looking directly at it, he became able to avoid the unconscious strain that had produced his double and multiple vision and was not troubled by these superfluous images any more. In a similar manner other illusions were prevented.
One of the last illusions to disappear was his belief that an effort was required to remember black. His logic on this point was overwhelming, but after many demonstrations he was convinced that no effort was required to let go,, and when he realized this, both his vision and his mental condition immediately improved.
He finally became able to read 20/10 or more, and although more than fifty-five years of age, he also read diamond type at from six to twenty-four inches. His night blindness was relieved, his attacks of day blindness ceased, and he told me the color of the eyes of his wife and children. One day he said to me:
"Doctor, I thank you for what you have done for my sight; but no words can express the gratitude I feel for what you have done for my mind."
Some years later he called with his heart full of gratitude, because there had been no relapse.
From all these facts it will be seen that the problems of vision are far more intimately associated with the problems of education than we had supposed, and that they can by no means be solved by putting concave, or convex, or astigmatic lenses before the eyes of the children.
1. School Health News, published by the Department of Health of Near York City, February, 1919.
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