. The refraction of the eye; including a complete treatise on ophthalmometry; . glasses for the last six years. Thevision blurs after reading for a few moments, and she has tostop and rub the eyes before she can continue. Ophthalmometer.—Astigmatism with the rule, D.,axis 90° + or 180° - right eye; D., axis 105° + or 15° -left eye. Test cards and trial lenses. — ^ ^ = 2% : I* W. + 4 D. + .75 D. cyl., 90°.R. L. = 2V0 • -I* W. + 4 D. + .75 D. cyl., 105°. Reads Jaeger No. 1 at 7|- inches. Ophthalmoscope. — H. 4 D. at 90° and 5 D. at 180° righteye; H. 4 D. at 105° and 5 D. at 15° left ey
. The refraction of the eye; including a complete treatise on ophthalmometry; . glasses for the last six years. Thevision blurs after reading for a few moments, and she has tostop and rub the eyes before she can continue. Ophthalmometer.—Astigmatism with the rule, D.,axis 90° + or 180° - right eye; D., axis 105° + or 15° -left eye. Test cards and trial lenses. — ^ ^ = 2% : I* W. + 4 D. + .75 D. cyl., 90°.R. L. = 2V0 • -I* W. + 4 D. + .75 D. cyl., 105°. Reads Jaeger No. 1 at 7|- inches. Ophthalmoscope. — H. 4 D. at 90° and 5 D. at 180° righteye; H. 4 D. at 105° and 5 D. at 15° left eye. 88 THE REFRACTION OF THE EYE A second test resulted in the patient accepting exactlythe same glass as at the first test, and it was ordered. Theyhave been worn four years, with entire relief of asthenopiasymptoms. The point of interest in this case, as far as fitting theglasses is concerned, is the order of sequence in which theglasses should be placed in the trial frames during the is, if cylindrical glasses should be tried first, or spherical. B. E. L. E, Fig. 45. glasses. In an article on the Technics of the Trial Case,^ I havestated it as a rule to be generally followed, that in cases ofcompound astigmatism it is always best to correct the astig-matism first, unless there is a large amount of spherical errorpresent, — a hypermetropia of 6 D. or more, a myopia of8 D. or more, with only a small amount of astigmatismpresent. Perhaps in that statement I gave the amount ofthe spherical error too large in cases where it is necessaryfirst to correct part of the spherical error before correcting 1 iVeic York Med. Jour., June 20, 1896. ILLUSTRATIVE CASES 89 the astigmatism; for I have sometimes found it necessary incases of hypermetropia of only 4 D., and in myopia of only6 D., with a small amount of astigmatism present, to correctpart of the spherical error before the patient could appreciatethe effect of a weak cylindrical glass when placed in fron
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