A Manual of Clinical Ophthalmology

Cover A Manual of Clinical Ophthalmology
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commenced to fail. At sixty, 2 for far, and + 1-50" for near vision. Patient, age forty-five, requiring 8 O 2 C ax. 1 80 for distance, will wear 5 o 2 r ax. 180 for near. Take, as an example, next, simple myopic astig- matism : 2 C ax. 135 = f, in a patient forty-five years old, MYDRIATICS. 75 the presbyopia correction is -J- I o 2 C ax. 135. At the age of fifty, the correction would be -f 2 O 2. C ax. 135 (= + 2 c ax. 45 ).
Presbyopia in mixed astigmatism : age forty-five, I o -f- 3 ax. 90 = f
.... Add -\- I- f r near, which would give as the presbyopic correction + 3 ax. 90 (+ I added to i = o) ; at fifty, add + 2 D for near, which would equal -f i o -\~ 3 ax. 90.
In all cases of presbyopia the weakest glass which will serve all the purposes demanded should be ordered, for it must be remembered that the ciliary muscle and internal rectus are supplied by the same nerve, and that a strong glass enforces excessive convergence.
MYDRIATICS.
In estimating total hypermetropia or hypermetropic astigmatism, and especially those of minor degree, it will be necessary to paralyze the accommodation in most persons under forty years of age.


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