Absolute Near Tests

Abstract

The term "absolute" is used not to dogmatize but to emphasize the point we hope to make, namely: That too strict adherence to the conventional technique of correlating near findings with distance findings hampers the development of technique better designed to cope with near vision problems.Half-measures are frequently wholly ineffective and near tests which dare not divorce themselves absolutely from distance tests are half-measures which cannot be expected to meet the exigencies of present-day optometric practice.The hold which the correlation concept has upon the practice of optometry is the result of chance rather than of deliberate control. And this chance conception has been accepted so uncritically over so long a period as to make any attempt to dislodge it an arduous undertaking. None the less, we shall undertake to do so.The discovery of radium enabled the physicists to gauge geologic time and estimate that mammals first made their appearance 65 million years ago. Thus the type of eye we are interested in has been in the process of development a long, long time. But the important factor for us to note is that this development was confined almost exclusively to a distance-vision organ.T h e chief value of the sense of sight was the means it afforded its owner of seeing an enemy a t a distance. The greater the distance at which a stronger opponent could be sighted the better the chances for survival of the weaker animal. T h e senses of touch, taste, smell and hearing might meet the near problems; but without sight, and superior distance sight, the forebears of man would not have survived to pave the way for his evolution.According to the most conservative estimate of Osborn, the human binocular organism has been developing over one million and a half years, with the trend constantly toward improvement of a distance-seeing means.Yet go back but a few hundred, even a few score, years and still distanceseeing played the dominant part in all but a relatively insignificant portion of his activities.Result : The human binocular organism developed on the basis of distanceseeing needs.Paralleling this biological development went the scientific development of optometric procedure. Vision was appraised upon its distance accomplishments. Visual acuity standards were distance standards. Test-letter charts were designed for testing distance visual acuity.Astigmatic test charts were designed for distance use. Objective test findings (ophthalmoscopic, ophthalmometric, and retinoscopic) were interpreted in terms of distance needs.Result : Optometric procedure developed, and crystallised, on the basis of distance-seeing needs.Million-year-old biologic habits and hundred-year-old optometric habits do not lend themselves readily to change. They may be expected to form the basis of a strong opposition to change. They are fulfilling that expectancy. But change they must because the distance concept they nurtured no longer fits the radically changed living and working conditions of to-day.From arboreal, to pastoral, to agricul...