Victorian child eye test lecture

Heather Stewart

Faculty: Science and Engineering
School: Vision and Hearing Sciences
Course: BOptom (Hons) Optometry
Category: Vision and hearing sciences

27 April 2015

Students dressed as Victorians

Below is my part of a group presentation we recently gave as part of our communications module, slightly longer than the one I actually gave due to time constraints. It outlines what not to do in an eye test with children – told from the perspective of a rather prickly Victorian!

Victorian child eye test lecture

Victorian dress (Heather)Good morning student opticians, I am Professor Canal von Schlemm, and I will be giving your lecture today.

The practice of optometry in recent years has become less of a last resort for those whose sight is deteriorating beyond the ability of quiet disguise, and more of a form of art in its own right. Is vision not the most salient of all our special senses? How can our favourite patient, the artist, produce the masterpiece, or the sailor tack for shore, or the lover look into the eyes of his companion, without the aid of sight?

Perhaps in no other branch of science has such progress been made, so much valuable relief to suffering humanity been furnished as in this science of ophthalmology. And indeed, no age of personage is exempt from the use of glasses. They are placed on a child that is little more than able to talk, as well as on the aged patriarch who finds them indispensable to his happiness and comfort. However, the field of fitting the aged with spectacles is a churned-over mire of well-trodden ground, and many reputable manuals are already available for the perusal of the applied student. Here, we will focus on the treatment of the youth, those unfortunate enough to bear the burden of weak eyes, while their peers gad gaily about the town.

How then, does one go about determining whether a child truly has impaired vision, or is simply too indolent to put his mind to his learning? It is an unequivocal certainty that the practising optometrist should suffer the expostulations of the aggrieved mother, asking them why their child has not yet learned their letters, is it some as yet undiagnosed and even undiscovered disease of the eyeball that is preventing them? Or some uncorrected refractive error? And when the vision is tested and no impairment is found, and the child is discovered to be idle, invariably it is the optician that receives the blame, and the pandering mother scurries away to find a second opinion. Blunt honesty, then, is the key. Head off the opportunity for long-winded complaints with a stern offence. The accompanying parent must be told that the child is inept because of a free and fancy will, and not due to ocular pathology, and a course of severe discipline should be administered to rein them in. Caning usually does the trick.

With time-wasters and lolly-gaggers filtered out, how then does one treat the genuinely afflicted child? Many children are afraid of receiving physical examinations by any health professional, with the optician being placed in the same band as the ham-fisted dentists and general practitioners. The child may have already received treatment from one of these peddling quacks and gained prejudice against opticians without ever having set foot in an ophthalmological establishment. This must stop. As soon as the child is determined to be a potential genuine customer, they must be communicated with formally, as one would with a fully formed adult, and not be obsequiously grovelled to, like a nanny to a squalling babe. The child will know that we are a practice of qualified individuals, ready to treat them as a miniature version of their parent, and not dance about their problems like goats around a maypole.

On establishing authority, the child may also be introduced to the equipment we use, in order to dispel any magic or mystery in their minds about the tests and procedures about to take place. Some smaller children find the outfit we use to be intimidating, even terrifying, therefore, forcing them to confront their anxieties head-on will not only help the child master their infantile ways, but will save time in coaxing the nervous youngster to cooperate, although on occasion restraints may be required, thereby freeing up more of the optician’s valuable time for senior appointments during the rest of the day. I must stress the base importance of the child’s accompanying adult not being present during the examination, they will not only impede the precipitancy of the optometrist’s routine by peppering him with questions about what is going on at every given second, but the child won’t look to them for amelioration and encouragement – things which should be obstructed in both parent and child, and could lead to dangerous consequences.

How then, when all is said and done with, do we ensure that the child will actually wear the correction prescribed to them and not toss them in with the rest of their toys as soon as they are back in the nursery? There is little more distressing to the practising optician than to have a parent come in a few weeks, even days after their appointment with their offspring bearing a pair of broken glasses, frame bent, lenses, obliterated beneath the rollers of a wooden horse, or the savage and ignorant sole of a boot. It is, of course, a situation most apprentices are trained to accept, though incidents of justly irate eye professionals throwing these barbarians from their practice is not an unheard of occurrence.

One must persuade the given child that refractive correction is not merely an irreplaceable aid to their own wellbeing and prosperity, but that they are an aid to fashion, and the wearing of glasses proves one to be a step above so-called emmetropes, who muddle around as they do. You may wish to tell the child in question to confront any peers that mock his spectacles thusly: ‘It is a mistake to judge those wearing eye-glasses as having impaired vision, in fact, by wearing these spectacles I most likely have clearer sight than you do, and it is high time that all prejudice against their use should be done away with’. If the child survives the confrontation, they are sure to continue to wear their glasses gladly, and cherish them as much or more than their favourite wooden soldier or model train set.

And there we must conclude, any questions, please direct them towards my learned colleagues, who I believe have further information to impart.



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