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June 1927

Demonstrate – Astigmatism - Definitions, Occurrence, Symptoms, Cause, Treatment, Favorable Conditions, Central Fixation, Shifting, Memory and Imagination, Case Report-I, Case Report-II, Conical Cornea – Stories From The Clinic: 88. Astigmatism by Emily C. Lierman – Announcement – Questions and Answers


BETTER EYESIGHT

A MONTHLY MAGAZINE DEVOTED TO THE PREVENTION AND CURE OF IMPERFECT SIGHT WITHOUT GLASSES

JUNE, 1927

Demonstrate

(Walking, Movement and Oppositional Movement)

That the eyes can be used correctly or incorrectly when walking.
Many people have complained that after walking a short distance slowly, easily and without any special effort, they become nervous, tired and their eyes feel the symptoms and consequences of strain. When they were taught the correct way to use their eyes while walking, the symptoms of fatigue or strain disappeared.
The facts can be demonstrated with the aid of a straight line on the floor or the seam in the carpet.
Wrong Way
Stand with the right foot to the right of the line and the left foot to the left of the line. Now put your right foot forward and look to the left of the line. Then put your left foot forward and look to the right of the line. When you walk forward, look to the left of the line, when your right foot moves forward. Look to the right of the line when your left foot moves forward. Note that it is difficult to do this longer than a few seconds without uncertainty, discomfort, pain, headache, dizziness or nausea.
Right Way
Now practice the right method of walking and using the eyes. When the right foot moves forward, look to the right; and when the left foot moves forward look to the left. Note that the straight line seems to sway in the direction opposite to the movement of the eyes and foot, i.e., when the eyes and foot move to the right, the line seems to move to the left. When the eyes and foot move to the left, the line seems to move to the right. Note that this is done easily, without any hesitation or discomfort.
When you walk, you can imagine that you are looking at the right foot as you step forward with that foot. When you step forward with the left foot, you can imagine that you are looking at your left foot. This can be done in a slow walk or quite rapidly while running straight ahead or in a circle.

Astigmatism

By W. H. Bates, M.D.

The study of astigmatism is important because of its frequency and because so many serious diseases of the eye are preceded by astigmatism.

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 angels 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 angels 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 eyes, 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 it. This form of astigmatism is usually caused by the contraction of scar tissue, which has formed on the cornea after the healing of a corneal ulcer.

Occurrence

Astigmatism occurs frequently and is usually combined with hypermetropia or myopia.
I have investigated the facts of the occurrence of astigmatism in new-born children. For the past one hundred years or more, atropine has been used to assist in measuring the astigmatism of the eye. It dilates the pupil and is supposed to paralyze the muscles which change the focus of the eyeball. While young babies were under observation, atropine, of sufficient strength to produce a maximum dilatation of the pupil, was accordingly used. Although the pupils became widely dilated, the ability of the eye to change its focus was not prevented by the atropine. With the aid of the retinoscope, it was found that the form of the eyeball changed from hour to hour or from day to day. My observations showed that the children were born with normal eyes and had no astigmatism, but it was very commonly found to be present as early as a half-hour after birth. The degree and kind of astigmatism varied within very wide limits.
These cases were kept under observation and examined at intervals. In nearly all cases, the eyes were normal and there was no astigmatism present, when they had reached the age of about six years. After attending school a few years, astigmatism was frequently acquired. When those children, who wore glasses for the correction of astigmatism, were examined at the age of twelve years or older, it was found to be still present and increased as they grew older, necessitating stronger glasses. Those children who wore no glasses for the correction of astigmatism, did not have it when they reached the age of twelve or older, which, of course, suggested treatment. Whenever it was possible to remove the glasses of young children, the astigmatism invariably became less or disappeared altogether.

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. This is, however, not a reliable test because patients with normal vision do not always see vertical or horizontal lines equally well.
Many patients with astigmatism complain of headaches and pain in various parts of the head and eyes. Some patients have said that when their eyes became tired or felt uncomfortable in any way, they could rest them by removing their glasses.
One elderly lady obtained a pair of glasses from an optician for the relief of astigmatism. After wearing them for a few days, she returned complaining that every morning, when she put her glasses on, the pain in her head increased very much, and that, after wearing her glasses for a few hours, the pain was occasionally only partially relieved. The optician remonstrated and told her that she needed to wear her glasses several weeks before her eyes could get used to them. The patient then told him that she had come to have glasses fitted to her eyes, and not her eyes fitted to glasses.
An optician was wearing window-pane glasses for the relief of headaches, and said that glasses were a great help to him. His wife, however, informed her friends that his headaches were much more frequent while wearing the glasses than when he did not use them.
 

Cause

Astigmatism is caused by a mental strain or an effort to see, either consciously or unconsciously. Patients have demonstrated that astigmatism can be produced by staring or straining to see.
The normal eye with normal sight, normal memory or normal imagination has no astigmatism, but when the normal eye remembers or imagines imperfectly, the retinoscope demonstrates the presence of astigmatism.
Pain in the eyes and head can always be produced in the normal eye by straining or making an effort to see. Such headaches disappear promptly when relaxation methods are employed.


Treatment - Astigmatism cures

Astigmatism is caused by a mental strain and can only be cured by complete relief of the strain. Glasses should not be prescribed because they increase mental strain, which is accompanied by an increase in the degree of astigmatism.
To relieve astigmatism, it is necessary for the patient to practice those methods which rest the mind and eyes. Children, when asleep, may acquire in an hour or less a high degree of astigmatism, and the muscles of the face may show a great deal of tension or strain. If this manifest tension can be relieved or corrected altogether, the retinoscope demonstrates that the astigmatism has become less or has disappeared entirely. When astigmatism is present in young babies, it can be lessened by relaxation methods. The mother can rest the child by swinging it in her arms with a slow, short, easy swing. In children twelve years of age, and older, astigmatism is often acquired, and can be corrected very promptly by palming or swinging.
Sway, Blink, Shift, Central Fixation.
Adults suffering from various forms of astigmatism are benefited by practicing central fixation, by improving their memory and imagination and by other methods which secure relaxation.

Favorable Conditions

For the correction of astigmatism, we should consider favorable conditions, which promote the best vision. Some patients with astigmatism, perhaps the majority, prefer the illumination to be bright. They can see better in the strong sunlight and the astigmatism becomes less than when the light is dim. Other patients with astigmatism see better, and the astigmatism becomes less or disappears, in a dim light, while it may be very much increased in a bright light.
The distance of the Snellen test card from the eyes is also important. A patient may, at twenty feet, read the card with normal vision, when the astigmatism is not so great. The same patient may read the Snellen test card at ten feet with normal vision and the astigmatism may become worse. Some of these cases are difficult to understand. One patient became worse when the eyes were tested at three feet, but when tested at fifteen feet, the patient read the last line of the Snellen test card and the astigmatism disappeared. Each individual case, in order to obtain the best results from relaxation methods should be tested at a distance which is favorable.

Central Fixation

The normal eye with normal sight sees with central fixation, i.e., it sees best where it is looking and not so clearly where it is not looking. The astigmatic eye sees with eccentric fixation, i.e., it sees best where it is not looking. It is important, therefore, that patients with astigmatism consciously practice central fixation until it becomes an unconscious habit. (Correct Vision Habit)
For example, one may look at the notch at the top of the large letter “C” of the Snellen test card and observe that the notch is seen best, while all other parts of the letter are seen worse. When one looks at the bottom of the large letter and sees that part best, the top is not seen so clearly. With the use of the retinoscope, it can be observed that the astigmatism has become less or disappeared altogether when this is done correctly.
One may look at the lower left hand corner of a white pillow and see that corner best, while the other corners are not seen so well. The patient should then look at the upper left hand corner of the pillow and see that best and the other corners worse. By looking at each corner of the white pillow in turn, the corner regarded will be seen best while the other corners are not seen so clearly and the vision of the whole pillow will be improved. Not only is the form seen better, but the whiteness is also improved by using central fixation. With the eyes open or closed, the memory of the pillow is also improved. Shift part to part on any area of the pillow – left and right, top and bottom, corner to corner, middle…

Shifting

The normal eye with normal sight is constantly shifting from one point to another and does not hold one point longer than a second. It may shift only a short distance, a quarter of an inch or less, and then back again to the point previously regarded. Patients with astigmatism stare or make an effort to see. When a letter or other object is regarded, they attempt to see the whole letter or object at once, they may concentrate on one point for a continuous period of time, thereby increasing the astigmatism.

Memory and Imagination

The normal eye has no astigmatism when the memory and imagination are perfect. The memory of a perfect letter “O”, with a white center imagined whiter than it really is, can be accomplished easily, promptly, continuously, without effort, pain, or fatigue. The memory of the same letter, with the white center covered over by a gray cloud which blurs it, requires a stare or a strain to see or to remember, and astigmatism is manifest. A letter may be remembered imperfectly for a few seconds, but this is difficult or impossible to do for an appreciable length of time. The gray blur constantly changes and always becomes worse or more blurred when the effort to see or remember increases.
A perfect memory can only be obtained when the sight is perfect. A large area of white (white area of the page) can usually be remembered perfectly because it is seen perfectly. By regarding a white area alternately with the eyes open and closed, the memory is improved and the astigmatism is lessened.
When the memory is improved, the imagination usually improves. Since we can only imagine what we remember, in order to imagine letters or other objects clearly or perfectly, a good memory is necessary.

Case Report - I

A man, aged sixty, was treated some years ago. At his first visit, he was asked to regard a white pillow resting on a table. He was told to close his eyes and remember it. When he did this, he remembered a black pillow instead of a white pillow, which surprised him very much. By having him see each corner of the pillow in turn, with his eyes open, his vision for the white pillow was improved, and when he closed his eyes he was able to remember a white pillow.


Case Report – II

A girl, eight years old, had a high degree of astigmatism in each eye. The vision of the right eye was 5/200, one fortieth of normal, while that of the left eye was only 3/200 or one sixty-sixth of normal. The left eye habitually turned in,—internal squint. The child was very bright and seemed to realize the value of central fixation almost from the beginning. By practicing central fixation and regarding the Snellen test card first at ten feet and later at twenty feet, the vision of each eye improved, so that in about a week the vision was normal in each eye and the left eye became straight permanently.
The patient’s near vision was also tested. At ten inches, the usual reading distance for the normal eye, the patient by practice became able to imagine one part best of capital letters and, later on, of smaller letters. In about two weeks, she read diamond type at six inches by central fixation. The retinoscope indicated no astigmatism and no malformation, of any kind, of the eyeball. This young child acquired what may be called microscopic vision. In three weeks she became able to read very fine print with the paper in contact with the eyelashes of either eye, and very small objects were seen close to her eyes with the same clearness as they were seen with the aid of a microscope. For example, she could describe red blood corpuscles and white blood corpuscles mounted on a glass slide when held in contact with the eyelashes of either eye. The child was benefited or cured by the practice of central fixation. Although the results were very gratifying, the child received so much attention by exhibiting her ability to see, that I was very much relieved when the family left New York for a distant city taking the prodigy along with them.


Conical Cornea

The question has often been asked if relaxation treatment benefits conical cornea with its large amount of irregular astigmatism. The contraction of the superior and inferior oblique muscles (when tense, functioning abnormally) squeezes the eyeball and increases the length of the optic axis. As a result of this pressure, the back part of the eyeball becomes thinner and bulges backwards with the production of irregular astigmatism. The scientific name for this bulging of the back of the eye is “Posterior Staphyloma.” Less frequently, the front part of the eye, the cornea, may bulge in the form of a conical mass and is accordingly termed “conical cornea.”
Since a strain causes the bulging of the back part or the front part of the eyeball, rest or relaxation of the strain should be and is followed by relief.
Conical cornea is a very painful, complicated disease of the eyes. The vision is always lowered and usually continues to grow worse from year to year. In the beginning, simple astigmatism with a clear cornea can usually be demonstrated in these cases. The amount of the astigmatism may be two diopters or less, and the impaired vision may be improved to the normal with a weak astigmatic glass. The bulging of the cornea increases slowly or rapidly and an ulcer appears near the center of the cornea where the parts are more severely Inflamed. The astigmatism becomes the irregular type, in which glasses are not able to improve the poor vision to the normal.
A school teacher had been suffering from conical cornea in both eyes. Her vision was only 10/200 in each eye. With strong glasses for compound myopic astigmatism, her vision was improved to 10/50. For a number of years, she had worn glasses which had been made stronger from year to year. Each time that she was tested, stronger glasses were prescribed for the loss of vision during the preceding year. She suffered great pain which was not relieved by the strong glasses. By practicing palming, the variable and universal swings, the pain was completely relieved, and the vision improved to 10/40 without the use of glasses. The relaxation treatment improved her condition, so that she became able to see without glasses better than she had been able to see with them. It is important to realize that the relief from pain was accomplished in about half an hour of treatment and that the benefit was obtained after other methods had failed while she wore glasses.
The stare or strain to see has been demonstrated to be associated with all diseases of the eyes, and is the cause of all imperfect sight. When relaxation is obtained, the eyeball may at once become normal in form with normal sight. Anything that is done with an effort to improve the vision is wrong and always fails. The benefit is only temporary when the stare is only relieved temporarily, but it is always a permanent benefit when the eyestrain is continuously relieved.
Shifting, central fixation, relaxation causes the eye muscles to relax, the eye returns to normal shape, conical cornea, astigmatism… are removed.

Astigmatism

By Emily C. Lierman

During the holidays, a woman came to me for treatment and brought her prescription for glasses with her. She told me frankly that she was doubtful that I could cure the mixed astigmatism with which she had been troubled for so many years and which was getting worse from day to day. She was seventy years old and had worn glasses for reading and for distance for about twenty years. During the past few years she had suffered considerable pain in the back of her eyes. The pain was more intense on bright, sunshiny days, and because of the pain and discomfort caused by the light, she always wore a large hat as a protection from the sun and she frequently wore dark glasses.
The copy of her prescription for glasses showed that she had hypermetropia and mixed astigmatism. The vision of her right eye was better than that of the left for the distance, namely 10/50, but all the letters of the card were blurred. The vision of her left eye was 10/70. When she looked at me, she had no wrinkles in her forehead and her eyes were open in a natural way. When she looked at the test card, there immediately appeared more than a half dozen wrinkles in her forehead and her mouth became distorted as she tried to read the letters for me.
I directed her to palm her closed eyes and, instead of telling her to remember a letter of the test card, which is something I usually direct the patient to do while the eyes are closed and covered, I asked her if she had a flower garden. She answered, “Yes.” I noticed how nervous she was and promptly proceeded to make her more comfortable by giving her a foot-stool, and a pillow to rest her elbows while palming. She said that she could easily remember the different flowers which she had planted herself and that it was always a pleasure to spend a great deal of her time in the garden watching the flowers grow. I asked her to name the different flowers and also to mention their colors.
We spent about five minutes’ time in this way. Then I removed the footstool and cushion and had her stand as I taught her the universal swing. Swaying to the left, she got a glimpse of the tops of buildings from my office window. When she swayed to the right, she was told to glance at the test card on the wall ten feet away and to keep up the universal swing all the time. Her vision improved in less than ten minutes to 10/30. By reading one line of letters and then another, as I directed her to do, swinging and blinking with each sway of the body, the vision of both eyes improved to 10/10. After one hour’s treatment, the pain in her eyes had disappeared also.
She complained that she might not be able to do as well by herself at home, and was also doubtful whether her astigmatism could actually be cured. I then proceeded to make her sight worse by having her stare as she looked directly at one letter and then another. She soon complained that the pain in her eyes had returned. I felt sorry to think that under my direction she should be so punished. Many times I have heard Dr. Bates say, “If you know how to make your sight worse, you will then know how to improve it”. It has always been a disagreeable task for me to have the patient demonstrate this, as I am sensitive to the pain and discomfort that the patient feels. It is only when a patient complains that she is not receiving much help or that she does not understand how her particular case can be cured, that I cause the patient to make her sight worse by doing the wrong thing.
My patient soon discovered that staring and straining caused the pain to return and that it lowered her vision for the distance as well as for the near point.

Oppositional Movement
I placed her by a window and directed her to swing with me as my body moved from right to left. Printed signs on the upper parts of buildings in the distance seemed blurred to her before she began to swing. By noticing that the buildings in the distance moved slightly with her, while the window and curtains up close moved rapidly opposite to the movement of her body, her pain and discomfort disappeared. She noticed also that her desire to see things better, which made her forget to blink, prevented her from improving her vision for the test card. Then she conscientiously kept up the blinking as she kept time with the sway of her body. This pleased her and she was satisfied with the treatment.
Ten days later her vision for the test card had improved to 15/10 with each eye, and the black letters on the white card were clear and distinct. I gave her a small Fundamental card to hold in her hand. Immediately, she held the card off as far as her arm would reach. It was interesting to notice how the strain disappeared from her face when she drew the card further away from her eyes. She was told to close her eyes and then draw the fine print card up to about six inches from her eyes. Then, when she opened her eyes and looked at the card, I held her hand in place so that she could not move it further away. In an instant, she drew her head as far back as she could from the card. She said that looking at the letters of the card when it was held so close caused an instant pain in back of her eyes and made her feel nauseated.
I told her to quickly close her eyes and drop the card in her lap and forget about it. In trying so hard to please me, she had produced a terrible strain which made me almost as uncomfortable as it did her. I palmed with her as she again described her garden to me. While her eyes were closed, I placed a test card which was fastened on a stand, five feet from where she was sitting. This card was black with white letters. When all else fails to improve the sight of the patient, this card is my greatest help.
I then told her to follow my finger as I pointed to the first letter of each line down to the bottom of the card. I pointed a half-inch below each letter and told her to look in the direction of my finger tip and not at the letter.
Modern teachers state to look directly at the letters to see them clear. Shift on the letters, relax, blink. Occasionally, take a break and look at, shift on the white spaces to relax the eyes, (without trying to see the letters), then look directly at the letters to see, read them. Reading each letter clearly at five feet produced no strain whatever. As she mentioned each letter, she closed her eyes and remembered it.
Following my directions in this way, she became able to look at the white spaces of the small Fundamental card which she again held in her hand at six inches from her eyes. By shifting and blinking from the small letter “o” of the test card at five feet to the white spaces of the small Fundamental card, she read straight down to the finest print of the Fundamental card, line number fifteen. The change in her face was good to see because all signs of strain had cleared away. When reading the letters on the card, look directly at them, shift, use central fixation. Look at the white area of the card only when resting the eyes, not reading the letters.
She practiced at home for several weeks and then came to me again to hear what I had to say about her good sight. She was able to do without her glasses all the time and did not use them again. She wanted to take more treatment if I thought it was necessary.
I tested her eyes and at fifteen feet she read a strange card, which has small letters to be read with the normal eye at nine feet. This card she read with each eye separately and without any effort or strain.
She told me that she had practiced faithfully every day for more than two hours altogether, and had done as I told her to, which was not to put her glasses on again. She practiced the universal swing almost an hour a day. She said that she enjoyed the universal swing so much that instead of counting to one hundred, which I told her was necessary to do in order to know that she was swinging enough for the improvement of her vision and the relief of strain, she practiced for twenty minutes at a time.
It only took me ten minutes to find out that she no longer needed help from me. I told her, however, that she could be sure of a relapse if at any time she punished her eyes by staring or by not blinking enough.
Palming and the universal swing helped her to rest her eyes and to see things moving all the time.
This swing, with the help of the memory of the flowers in her garden, cured my patient.

Announcement

Dr. Bates is pleased to announce that Mrs. E. Reid and Mr. Ian Jardine of Johannesburg, South Africa, have completed a course of instruction under his personal supervision and are qualified to teach the Bates Method of improving imperfect sight without the use of glasses. Their interest in the Bates method was originally inspired by the benefit Mr. Jardine received in his own case, which led them to travel eleven thousand miles from Johannesburg to New York to study under Dr. Bates personally in order that they might help others who have defective vision.
In the next issue of Better Eyesight will appear Mr. Jardine’s account of his case.



Questions and Answers

Q – Should one practice with fine print by holding it where it can be seen best or at the normal distance?
A – Hold the print at the distance from your eyes at which you see best. Remember not to look directly at the letters,
until the eyes have looked at the white spaces first, relaxed, then; look directly at the letters to read them.
If done without strain, no squinting: reading fine print closer, at a blurry distance improves the sight.

Q – Is age a factor in the cure of imperfect sight without glasses?
A – Age is not a factor. I have cured hundreds of patients past sixty.

Q – What method is best to relieve the tension in the back of the neck?
A – The variable swing. This is described in the September, 1926, number of the Better Eyesight Magazine. See Demonstrate article paragraph 2.

Q – Is the swing apt to cause nystagmus?
A – No, the swing relieves strain, whereas nystagmus is caused by eyestrain.
Q – When taking Dr. Bates’ treatment, could one wear glasses for a few hours each day for close work?
A – No, each time you put on your glasses, your progress is retarded.

Q – What causes the lids of the eyes to itch and sometimes become scaly?
A – This is due to strain. Practice relaxation methods all day long, - shifting, blinking and central fixation. Get as much sun treatment as possible.

Q- What causes my vision to improve for a day or two, and then relapse?
A – This is caused by lack of practice and by straining your eyes. When the vision is good, you are relaxed.

Q – In palming, should one close the eyes tightly?
A – No, easily, lazily and naturally at all times.

Q – Why is my vision worse on a rainy or cloudy day than in broad daylight?
A – Because you strain to see on a dark day.

Also: the pupil is larger in dimmer light – the pinhole effect of bright light is not available. If the vision is imperfect, imperfectly focused light rays in the eye and the larger pupil in dimmer light lets in more light rays; more imperfectly focused light rays are on the retina and blur is increased. Practice Natural Eyesight Improvement, Correct Vision Habits - shifting, central fixation, relaxation, switching, memory and imagination at night for clear night vision and vision will be clear in all levels of light.