Astigmatism

[ClarkNight]

By W. H. BATES, M.D.

MANY people who have astigmatism often talk about it in a boastful way as though it were a mark of distinction. This is not so strange, considering the fact that so many eye doctors claim that astigmatism does more harm to the eyes and nerves than any other condition. They tell their patients that in order to prevent serious eye diseases, glasses should be worn constantly. Such patients, accordingly, become much worried and are in constant fear of serious eye trouble developing, and probable blindness resulting. It is true that the glasses prescribed may give temporary relief; but no patient under my observation was ever cured or benefited very much by glasses.

Definitions

The normal eye is spherical in shape and all the meridians are of the same curvature. The curvature of the cornea is like that of a segment of a sphere; but when astigmatism is present, it is said to be lop-sided; that is, one principal meridian of the curvature is more convex than the meridian at right angles to it. With an instrument called the ophthalmometer, it is possible to measure all the meridians of the curvature of the cornea.
Astigmatism may be simple hypermetropic, simple myopic, compound hypermetropic, compound myopic, mixed or irregular.

In Simple Hypermetropic Astigmatism, one principal meridian of the cornea has a normal curvature, while the meridian at right angles to it is flatter than all the other meridians.
In Simple Myopic Astigmatism one principal meridian of the cornea has a normal curvature, while the meridian at right angles to it is more convex than all the other meridians.
In Compound Hypermetropic Astigmatism, the two principal meridians are flatter than the meridians of the normal eye, one being flatter than the other.
In Compound Myopic Astigmatism, the two principal meridians are more convex than a normal meridian, one being more convex than the other.
In Mixed Astigmatism, one of the principal meridians is flatter than a meridian of the normal eye, while the other principal meridian is more convex than a meridian of the normal eye.
In Irregular Astigmatism, the meridians of the curvature of the cornea are so malformed that no glasses can correct the astigmatism.


Occurrence

Astigmatism is the most common defect of the human eye. Most people with astigmatism have had it since birth. In some cases, it may increase, while in other cases it may become less or entirely disappear.
Nine-tenths of the cases of astigmatism are due to imperfect curvature of two or more meridians of the cornea. The other cases of astigmatism are due to imperfect curvature of the lens, or less frequently to a malformation of the eyeball.

Symptoms

When a high degree of astigmatism is present, the vision is appreciably lowered. Usually when vertical lines are regarded, they may appear more distinct than horizontal lines, or the reverse may be true. It was found that so many patients with astigmatism failed to see vertical lines as well as horizontal lines, or had trouble in seeing oblique lines, that a card, called the clock-faced card, was designed with lines at various angles. At one time it was believed that astigmatism could be diagnosed when the patient was able to see horizontal lines on this card better than the vertical lines or vice versa. Some patients with astigmatism could see distinctly the line pointing to five o'clock, while the line at right angles to it could not be seen so well. With increased experience, however, it was found that some patients with astigmatism could see horizontal and vertical lines equally well. On the other hand, patients with normal vision have complained that they did not always see vertical or horizontal lines equally well.
A man, sixty years of age, was found to have unusually good vision without any symptoms of astigmatism; but when he regarded a number of vertical, horizontal, and oblique lines, his vision immediately became very imperfect with a production of six diopters of astigmatism. When he closed his eyes and rested them, his vision soon became normal and the astigmatism disappeared.

The standard, old clock face card (astigmatism wheel) is not an effective test for astigmatism and often results in unnecessary eyeglass prescriptions with astigmatism correction. This occurs because the eye doctor tells the patient to use incorrect eye function to see the clock: The patient is told to keep the eyes immobile, looking at only the dot in the center of the clock while at the same time, also trying to see all the lines around the clock in the peripheral field perfectly clear. This prevents central fixation and shifting, two major normal eye functions necessary for clear vision. It also causes temporary strain, blur and astigmatism during the test. Other conditions of the standard card astigmatism test also produce incorrect results.
The resulting unnecessary astigmatism eyeglass prescription causes, increases astigmatism resulting in more vision impairment.
A Natural Eyesight Improvement astigmatism wheel allows the person to look directly at and shift on the lines, one at a time to test for and remove astigmatism. The standard old card is also seen clear when it is used correct with shifting and central fixation.

Astigmatism can appear and disappear in the normal eye without discomfort, notice. Doctors state that the eye/cornea can change shape temporarily due to temporary occasional eye muscle tension, stress, neck tension, sinus congestion, diet resulting in slight astigmatism.

Cause

The cause of astigmatism is always associated with an effort or a strain. In all cases the stare can be demonstrated. An imperfect memory requires an effort or a strain and always produces astigmatism. An imperfect imagination also requires an effort or strain and always produces astigmatism. A mental strain of any kind always causes astigmatism. In the normal eye, astigmatism can be produced with a very slight amount of strain or effort to see. In those cases, however, where a great effort is made for a length of time, the astigmatism becomes very much increased, and may be more or less permanent. Irregular astigmatism is caused by the contraction of scar tissue, either from ulcerations of the cornea or from an incised wound.

Treatment

Some years ago, I published an article in the Archives of Ophthalmology with the title, "A New Operation for the Cure of Astigmatism—A Preliminary Report." In this article, I described an operation in which the more convex meridian of the cornea was incised at right angles to its curvature, but not penetrating into the anterior chamber. The scar produced by the cut of the knife usually healed very promptly, and the traction of the scar tissue flattened the curvature of this principal meridian. A number of cases were reported with good results. It was not very long, however, before I had some unsuccessful experiences in which, for some reason or other, the operation failed. The theory was so good that I expected the facts to verify it. I became disappointed with my operation and did not investigate the facts any further after the first six months. A year or two later, my operation was performed by some one in England, and a report of some interesting cases that were apparently cured was published in an English Medical journal. Other articles were published in medical journals, confirming my earlier claims and giving me due credit.
I no longer believe that an operation of any kind should be performed, because all forms of astigmatism can be demonstrated to be always temporary. Astigmatism is not organic; it is always functional, even when scar tissue is associated with it.

Scar Tissue

It is very interesting to observe cases of astigmatism in which scar tissue of the cornea is a complication. Scar tissue, as is well known, is composed largely of new connective tissue. With the aid of the memory and the imagination, this connective tissue sometimes disappears in a very short time. When the memory is perfect for some letter, color, or object, the scar tissue disappears. When the imagination is perfect for a letter or other object, the scar tissue disappears. Imagination or memory of perfect sight is a cure for astigmatism.


Conical Cornea

The most serious effect of astigmatism is to produce conical cornea. In this disease, the front part of the eyeball becomes more conical in shape, and after some years the apex of the cone becomes ulcerated: This ulcer becomes steadily worse with an increase of the astigmatism. Not only is the vision progressively lowered, but the patient may also suffer from severe pain. There is no operation which has been generally accepted which is satisfactory in correcting conical cornea, nor has any treatment heretofore practiced been curative or even beneficial.
The treatment in my experience which has yielded the best results is the practice of the variable swing. The patient holds the forefinger of one hand about six inches in front and to one side of the eyes. When he moves his head a short distance from side to side, the finger appears to move in the direction opposite to the movement of the head and eyes.
While practicing the variable swing, the patient is directed to regard one known letter of the Snellen test card at ten or fifteen feet, and imagine it as well as he can with his eyes open for a few seconds. The eyes are quickly closed while the patient remembers the same letter more perfectly than it was seen. He then opens his eyes and imagines the known letter on the card, as well as he can for a few seconds. The patient alternately remembers the known letter perfectly with the eyes closed and imagines it with the eyes open for a few seconds, until he becomes able to imagine he sees the known letter nearly as well with his eyes open as he can remember it with his eyes closed. By this method, the patient can improve his vision for each known or unknown letter of the Snellen test card. It is remarkable how promptly the conical cornea subsides when the variable swing is practiced in this way. Some patients have obtained normal vision in a much shorter time than one would expect.

Case Reports

Recently a man, aged sixty years, was treated by me for the relief of eye troubles, caused by one-quarter of a diopter of astigmatism. He suffered intensely from strong light and complained of floating specks. He was not able to read fine print with or without glasses for any length of time without pain and fatigue. It seemed very strange that he should suffer so much from so low a degree of astigmatism. His distant vision was almost normal, while his ability to read was only slightly impaired by the pain. When his astigmatism was corrected by treatment, his vision, with each eye, for distance improved until it became normal, and the floating specks disappeared. After practicing the swing and improving his vision for the Snellen test card, the fatigue which he had felt when working and reading was also lessened. He no longer suffered from discomfort in the strong light of the sun, after he had received the sun treatment with the sun-glass.

Hypermetropic Astigmatism

About a month ago, a fourteen year old girl came to me for treatment. She had about three diopters of hypermetropic astigmatism in each eye. The vision of each eye was one-half of the normal. After practicing rest and the short away of her body for an hour or longer, her vision became almost normal without glasses.
Without any treatment, she read the fine print imperfectly at twelve inches. She was directed to close her eyes and to imagine the spaces between the lines to be as white as snow, white starch, whitewash or a white handkerchief. With her eyes open and moving her head a short distance from side to side, she became able to imagine the white spaces between the lines to be more perfectly white. By alternating, her imagination of the white spaces increased, until she became able to read diamond type at six inches or less, without any fatigue or discomfort. Her ability to read had been improved by her imagination. When her symptoms were relieved by this treatment, it was found with the aid of the retinoscope that the astigmatism had disappeared.

Compound Myopic Astigmatism

Another patient was a girl, aged fifteen. The vision of the right eye was one-third of the normal, while that of the left eye was one-fifth of the normal. She was wearing glasses for the correction of compound myopic astigmatism, in which the astigmatism in each eye was less than one diopter. With the aid of paining, swinging, and the use of her imagination, her vision became normal in each eye and the astigmatism disappeared.
This patient had but one treatment and obtained a quick cure, which is very unusual.

Simple Hypermetropic Astigmatism

On June 1, 1924, a man, thirty years old, became a patient. The vision of his right eye was 10/70, while that of the left eye was 3/200. For the correction of astigmatism, he was wearing a convex 5.00 D.C. in the right eye and convex 5.50 D.C. in the left eye. His glasses were not satisfactory, and he suffered from double vision. He could not remember mental pictures or read fine print.
After palming, swaying, flashing and blinking, his vision was temporarily improved and the double vision disappeared. He obtained a considerable amount of rest from the drifting swing. The universal swing was also a great benefit. His ability to read was improved by having him imagine the white spaces between the lines of black letters to be whiter than they really were. It helped when he imagined that he was painting the white spaces with white paint, alternately with his eyes closed and with his eyes open. His vision was very much improved by the imagination of the white centers of most letters to be whiter than they really are.
His visits were irregular. Nevertheless, on October 22nd, the, vision of the right eye had improved to the normal, while the vision of the left eye had improved to 15/70. With the aid of the retinoscope, it was demonstrated that the astigmatism of the right eye had entirely disappeared, while that of the left eye was very much reduced.
The histories of these cases indicate the possibilities of relieving all degrees of astigmatism without the use of glasses.

Emily C. Lierman and W. H. Bates, M.D., take this opportunity of wishing you a Merry Christmas and a Happy New Year.
They desire to thank you for your interest and hope that the Better Eyesight Magazine will be improved upon in the New Year.

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