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

R. Brooks Simpkins

• Publisher: Youcanprint
• Year: 2016
• ISBN:
  9788892635616
• Topic: Medicine
• Subtopic: Opthalmology & Optometry

The theory that longsight, shortsight, and astigmatism are incurable visual defects, even though they have developed in eyes which were normal at birth, has been maintained for a century — and has been, and still is, the basis upon which glasses are universally prescribed for young and old alike.
Text books in many languages affirm that adjustment of the focus of the eyes depends solely upon the small natural lens inside the eye incessantly altering its strength for near and far vision.
R. Brooks Simpkins has disproved these theories and in this work portrays how refractive errors develop, and also the manner in which the eye actually adjusts its focus for all ranges of vision. 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.

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 flattened approximately in the vertical plane, and in a similar way the curvature will mechanically increase if the opposing traction is subnormal.

The same thing applies to the opposing tractions of the external and internal rectus muscles. Here we find evidence that astigmatism is usually not congenital but, in the absence of trauma, mechanically produced. I have found also that the additional complications of the opposing tensions of the oblique muscles as well as of the rectus indicate the disposition of the axes of cylindrical lenses prescribed to correct astigmatism; but these lenses, unfortunately, also require maintenance of the irregular inter-orbital-muscular tensions.

Again, I am contradicting the acceped bases of ophthalmic and optical practice relating to hypermetropia, myopia and astigmatism, so I will ask my readers to make a primary experiment with the aid of an ordinary pencil.

If any reader is presbyopic and using glasses for reading, or if his eyes are hypermetropic, will he without the aid of his glasses focus on the point of the pencil, moving the point closer and closer to the bridge of his nose. Should he find it difficult to achieve more than 20 degrees of binocular convergence, then the filament of a pen torch as a focal point may be more helpful. He will find that the more degrees of binocular convergence he achieves the more marked is the slight but immediate improvement in his ability to read without glasses. To binocularly converge the eyes, or rotate them inwards towards each other, the oblique muscles have to relax their habitual tension. An observer of this simple little test will see without the aid of any special instrument that the vertical axes of the subject's corneae lengthen slightly in proportion to the binocular convergence achieved.

Any of my readers who are myopic can readily make another experiment with a pencil by holding it out at armslength, or closer if necessary, and without the aid of glasses look at the pencil point, or the pencil itself. As he looks well beyond the pencil the optical illusion of seeing two pencils occurs (normal physiological diplopia). Then in trying to see something, however indistinctly, much further away (beyond fifty yards) he will note that the images of the two pencils appear to move slightly wider apart. Immediately afterwards, if the experiment has been properly performed, there will be some improvement in his distance vision without glasses; moreover, a carefully watching observer will note that the corneal curvature of the experimenter's eyes flattens slightly as the attempt is made to see well beyond the pencil.

As the width between the illusory two pencils increases slightly, the eyes have moved slightly closer together due to increased and combined traction by the oblique muscles, while the visual axes have been maintained in parallel for distance vision. The observer will also see that the horizontal axes of the experimenter's corneae have become slightly longer.

It took me many years to compile charts and diagrams of the complications both of abnormal and subnormal innervation, or activity, of the third, fourth and sixth cranial nerves; and the direct and reflex effects of these mechanical irregularities on the interorbital-muscular tensions. With the aid of these charts the far-reaching effects of a single one of these cranial nerves, of which there are three pairs, can be traced in examining a patient's eyes both as to the muscular balance of each eye and the refractive error which has developed.

For instance, subnormal innervation of the right third cranial nerve may cause subnormal opposing tension between the superior and inferior rectus muscles and hence myopic astigmatism with the axis horizontal, or variably so relative to the reflex disturbance in the opposing traction of the two oblique muscles of the same eye, and their combined traction opposing that of the superior and inferior rectus muscles. Further direct or reflex disturbance may also be found in the tension and activity of the internal and inferior rectus muscles of the Ieft eye. The pupillary contraction of the right eye may also prove to be weak, amidst the other mechanical complications due to a single motor-nerve of the eyes not working properly.

I have not the space adequately or extensively to describe the extensive mechanical complications of irregular activity, or energy, of the pairs of third, fourth and sixth cranial nerves, but those of my readers who are qualified to do so, and who embark upon visible ray therapy* of the eyes will soon observe the response of their patients' motor-nerves both to energising and sedative light rays.

As an example of such observation I will cite a recent case of a woman in her late fifties with early bilateral senile cataract. Previously she had enjoyed good sight, and she still retained 'hazy' unaided binocular 6/9 vision, but some years earlier she had taken to glasses for reading. The cataracts were so developing that in time the central area of both crystalline lenses would be seriously affected, with occlusion of central vision. I found the unaided vision of her right eye to be no more than 6/24, and this eye because of disturbed muscular tension had become both myopic and hypophoric. The ability of binocular convergence had receded. But after 38 visible-ray treatments of twenty-five minutes each the unaided vision of the right eye improved to 6/9, the hypophoria had disappeared, and the binocular convergence had sufficiently improved for her to wear +3.50 spherical lenses for both eyes. The cataractous condition was arrested and indeed substantially diminished.

Even in elderly patients for whom no form of treatment other than visible-ray therapy was desirable, I have often observed improvement in the muscular balance of their eyes, with improved facility of binoculation and more equalised refraction.

The bilateral application of the visible rays, made possible by the design of the instrument employed, corresponds with the bilateral design of the visual mechanism in toto. This is a correspondence of far-reaching importance as regards the optic nerves, the optic tract, the occipital lobes of the brain and the intra-cranial motor-nerves, in conjunction also with the reflexes of the other pairs of cranial nerves.

I am not suggesting that visible-ray treatment of the eyes is a ready cure for all forms of refractive error, muscular imbalance, and strabismus or squint, but since in all these affections the activity of the cranial motor-nerves of the eye muscles is involved, any regulating influence, such as that of the energy of the visible rays, is desirable.

Primary exploration of their use is frequently revealing in the case of young children, and of older patients, who have not yet worn glasses but are developing refractive errors. In many such cases the primary affection is diminished 'tone' due to passing illness or some form of nervous strain. See Visible Ray Therapy of the Eyes, by R. Brooks Simpkins (Health Science Press).

Nervous strain is not confined to adults, and though children are frequently treated just as children, many of them develop some kind of nervous tension when attending school. It has even been shown that a child with 'nervous' myopia when given a test-chart will, when tension is relaxed, in holding its mother's hand, read all the letters normally. Again we have to bear in mind the nervous strain which can arise in children subjected to indirect retinoscopy—the room is strange, also the examiner who may be irritable or at least hurried, and, as we have seen, mydriasis is an added complication of true diagnosis.

When I was given my first pair of glasses more than fifty years ago I found that I could not read with them. According to common practice, I was told that I must get used to them, which, in effect, meant that my eyes must adjust themselves to the design of the lenses. During the last twenty-five years a large number of adults of almost all ages have said they were told they also must get used to the glasses prescribed for them, but have found it difficult to do so.

I am convinced that the visible lays would modify the strength and design of the lenses afterwards prescribed in cases where glasses are unavoidable; moreover, in the course of his treatments, a practitioner is able to understand better the eyes of his patients, so that the glasses he prescribes are not dependent upon a single test.

Individual pairs of eyes do need understanding, as distinct from relatively copybook methods of tests for glasses. If, for instance, the right third cranial nerve is subnormal in activity, primary regulation of the condition by an energising ray, or wavelength of indirect ele...

Table of contents

• TABLE OF CONTENTS
• NOTE
• FOREWORD
• CHAPTER ONE - OCULOPATHY
• CHAPTER TWO - THE ORBITAL TENSION INSTRUMENT
• CHAPTER THREE - THE CILIARY BODY
• CHAPTER FOUR - DETAILED AND DIAGRAMMATICAL DEPICTION OF
• CHAPTER FIVE - DETAILED AND DIAGRAMMATICAL DEPICTION OF IRREGULAR TENSIONS, OR ACTIVITY, OF EACH OF THE THREE PAIRS OF EXTERNAL MUSCLES
• CONCLUSION
• Suggested reading