Oculopathy: Disproves the orthodox and theoretical bases upon which glasses are so freely prescribed, and puts forward natural remedial methods of treatment for what are sometimes termed incurable visual defects
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About this ebook
Diagrams are included which explain to those who prescribe glasses the irregular activity of the intracranial processes of vision primarily responsible for the 'external' refractive error - a field of knowledge hitherto mainly disregarded and unexplored. Remedial methods of treatment, other than glasses, are also indicated. The eyes can be trained scientifically to work in accordance with nature's design of the visual mechanism - this is of great importance to children and young adults, while the need for glasses can be postponed for the middle-aged. Good sight is to be cherished, and everyone has a vested interest, far surpassing other considerations, in his or her own eyes.
It is the hope of the author of this book that increasing efforts will be made in schools, clinics and private practice to bring to as many as possible the joy of unaided normal vision.
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Oculopathy - R. Brooks Simpkins
England.
CHAPTER ONE - OCULOPATHY
As described in the introduction to my book 'New Light on the Eyes" many years of research in the mechanics of human vision have proved to me beyond question that the conjugating tractile tensions of the external muscles of the eyes are primarily responsible for accommodation while the crystalline lens provides finesse of the focus of vision for all ranges. These mechanical and involuntary processes produce in the normal eye variable degrees of 'natural shortsight' relative to proximity of near objects and reading matter, enable automatic return to normal unaided distance vision and also allow accommodation for extreme distance vision. Accordingly a longsighted eye, or moderately shortsighted eye, is one that does not involuntarily exercise its mechanical ability to readjust its focus for normal distance vision.
Of course, I am well aware that these finding of mine are opposed to the century-old Helmholtz theory of accommodation that incessant changes in curvature of the crystalline lens inside the eye are solely responsible for adjustment of focus of the vision for all purposes. My findings also contradict the universally accepted theory that a longsighted eye is short, a myopic eye elongated or too long, that astigmatism is mainly congenital in origin, that the external muscles of the eyes do not play any part in producing these conditions, and that accordingly nothing can be done except prescribe the glasses which in most cases have to be periodically increased in strength.
In this belief mydriatics are clinically employed, and to assess the refractive condition (hypermetropic, myopic, astigmatical) of the eyes a method called indirect retinoscopy is used. Since mydriatics relatively paralyse the ciliary processes, embodying the crystalline lens, the patient subsequently is expected to become accustomed to the glasses prescribed, irrespective of adjustments made subjectively with the distance test charts.
It is perhaps not an under-statement that the strength of either organ or limb cannot be accurately assessed when certain relative nerve-centres are affected by drugs. The dilatation of the pupil under mydriasis inhibits the contraction of the pupil by the sphincter pupillae which are served by fibres from the third cranial nerve on the same side. We know that the third cranial nerves also supply some of the external muscles of both eyes by crossed connections and connections on the same side. So it is not improbable that mydriasis extends in some degree beyond inhibiting pupillary contraction, and particularly so in relation to refraction tests.
Having tested the refractive condition of a patient's eyes and made a note of the strength and construction of the glasses in use for distance and reading, I check up on the amplitude of accommodation for reading (particularly when possible with very small type such as J1) both unaided and with reading glasses. I have found that recession of the amplitude is approximately related to recession of the power of binocular convergence — a mechanical relationship which indicates the part played by the external muscles in adjusting the focus, or more broadly the focal-length of the eye.
In a mechanical sense, since the diverging muscles of the eyes rotate the eyes outwards (in the lateral plane, outwards upwards, and outwards downwards), their contractile tension must relax to enable the converging muscles to rotate the eyes inwards towards each other so as to enable maximal amplitude of binocular convergence (17 degrees monocularly and 34 degrees binocularly) in order to bring the two visual axes to bear on the letters of a line of print approximately 31 or 4 inches or 10 centimetres from the eyes. A normal eye with unaided vision can read small print at this close range, and also at a distance of 50 centimetres or in some cases a little further away.
There is no doubt that the superior and inferior oblique muscles play an active and primary part in producing both longsight and shortsight. The former gives the ability to accommodate for extreme distance vision, and the latter to accommodate for near vision. The mechanical disposition of the six external muscles of each eye clearly indicates that unless the superior and inferior oblique muscles relaxed their tension, or expanded, it would be mechanically impossible for the converging muscles to rotate the eyes inwards toward each other. In the same way the converging muscles must relax in order to allow the diverging muscles to rotate the eyes outwards out of binocular convergence to restore parallel disposition of the visual axes for distance vision.
The mechanics of binocular convergence and parallel disposition of the eyes are entirely different processes which conceivably would be impossible if the two oblique muscles were not inserted in posterior temporal quadrants of the eyeball and 'fixedly' attached anteriorly to the nasal wall of the socket; the tendon of the superior oblique muscle passes through its trochlear above the eye, and the tendon of the inferior oblique passes below the eye.
Mechanically for contraction and expansion these muscles are disposed at an angle of 35 degrees relative to the rotary centre of the eye, while the superior and inferior rectus muscles, inserted rspcctively above and below the eye a few millimetres posterior to the corneal margin, and fixedly attached at their other ends to the bony rim of the optic foramen in the back of the socket, are at an angle of 70 degrees to the rotary centre of the eye.
Diagram I shows these mechanical dispositions. We see that the traction of the two oblique muscles is from behind forwards in direction A, while the traction of all four rectus muscles is from in front backwards in the direction C. These diagonally opposed tractions generate pressure (by traction backwards) on the front of the eye by the four rectus muscles, and pressure on the back of the eye by the two oblique muscles (by traction forwards).
We also note (refer also to Diagram 3) that the two oblique muscles constitute a sling 'embracing' the back of the eyeball in the plane of their insertion. In this sling the eye can be rotated in all directions while requisite inter-orbital-muscular tension is maintained relative to what we will term normally shaped eyes for normal distance vision, flattened or shortened eyes for extreme distance vision, and lengthened or elongated eyes for near vision.
It is apparent that subnormal or relaxed tension between the directly opposed tractions of the diverging and converging muscles enables the pliable eyeball to expand or lengthen. This is confirmed by the conical corneae of some high myopes, and in many such cases the bulging and eventual collapse of the back of the eyeball in the plane of the posterior embrace of the two oblique muscles. Clearly, too. abnormal or involuntarily increased tension between the directly opposed tractions of the diverging and converging muscles will pull forward the back of the eyeball and flatten its front, thus causing a shortened or a longsighted eye.
As we know, the six external muscles constitute three pairs of opposed muscles. Thus, as the inferior oblique muscle rotates the eye upwards and outwards the superior oblique must conjugate or cornpensatingly expand if the shape of the embraced eyeball is not to be affected. In a similar manner the inferior oblique has to compensate when its opposite number, the superior oblique, rotates the eye downwards and outwards.
At the same time opposing directional traction of the converging muscles has to conjugate in too complicated a manner to explain in this short book, but it is important to realise that the contractile and compensating tensions between the superior and inferior rectus muscles, and the external and internal rectus muscles are reflected by the cornea in the plane of their insertions behind the corneal margin. Thus, if the opposing traction between the superior and inferior rectus muscles is abnormal or excessive the curvature of the corneal surface is