ASTIGMATISM. 
Illustrative Cases from Clinical Memoranda. 
READ BEFORE THE OHIO STATE MEDICAL SOCIETY, 
JUNE 18, 1875. 
BY 
J. H. BUCKNER, M.D., 
CINCINNATI, OHIO. 
CINCINNATI, O. 
ROBERT CLARKE & CO., PRINT. * 
1875- ASTIGMATISM. 
Illustrative Cases from Clinical Memoranda. 
READ BEFORE THE OHIO STATE MEDICAL SOCIETY, 
JUNE 18, 1875. 
BY 
J. H. BUCKNER, M.D., 
CINCINNATI, OHIO. 
The term astigmatism “ is a compound Greekword, derived from 
<r, and stigma from stigo, and signifies that rays divided from 
one point do not again unite into one point.”* The subject has 
been divided into regular and irregular astigmatism. When the 
acuteness of vision is not materially diminished by astigmatism, 
it is said to be normal, and abnormal when vision is much dis- 
torted by it. Regular astigmatism exists, to some degree, in 
almost all normal eyes. This fact any one may determine by 
noting the farthest point at which fine vertical lines and hori- 
♦Mackenzie: A Practical Treatise on Diseases of the Eye, 1854, p. 927. 2 
Buckner. 
zontal lines may be acutely seen. The majority of persons hav- 
ing normal eyes, will find that they can plainly discern vertical 
lines at a greater distance than horizontal lines. Dondersf ex- 
plains this by stating that rays emanating from vertical lines, which 
strike the vertical meridian of the eye, are more speedily brought to 
a focus than those of equal divergence situated in a horizontal plane. 
He further says, that the cause of regular astigmatism is to be 
sought partly in the cornea. “Humorous experiments have shown 
that the cornea, in its several meridians, has a different radius of 
curvature. It is thus established in the first place, that the 
cornea, on account of its form, produces astigmatism ; in the sec- 
ond place, that even if the crystalline lens has an influence, the 
direction given to it by the cornea, in general preponderates.” 
Irregular Astigmatism.—Irregular astigmatism has been also di- 
vided into normal and abnormal. 
The normal form has been proved to be due to the structure of 
the crystalline lens, by the fact that when the lens is absent from 
the eye, all phenomena of irregular astigmatism are removed. 
The abnormal degrees, on the contrary, which considerably dis- 
turb the power of vision, may depend upon irregularities of the 
cornea as well as upon those of the lens. 
We can not precisely draw the line of demarcation between nor- 
mal and abnormal astigmatism, but may consider it abnormal when- 
ever the disturbance of vision is sufficient to attract the atten- 
tion of the person affected, or whenever upon trial,The patient, 
from this cause, is unable to read Ho. 20 of Snellen’s test type at 
twenty feet. Donders had fixed the standard for the commence- 
ment of abnormal astigmatism whenever the degree was one- 
fortieth ; he, however, found that a cylindrical glass of one-eightieth, 
held before his own eyes, materially improved the distinctness of 
images. 
The importance of this subject may be better appreciated when 
it is understood that, according to the most eminent authority, “in 
every forty or fifty eyes, one is, in consequence of astigmatism, 
disturbed in its functions” (Donders). And in high degrees of 
the affection, vision, unless assisted by proper glasses, may become 
comparatively useless for all the practical duties of life. It is no 
less remarkable than humiliating to us, as specialists, when we 
consider the number of eyes that were either maltreated or left in 
tDonders upon Accommodation and Refraction of the Eye. Astigmatism. 
3 
partial darkness, without treatment at all, through the many long 
years which intervened from the first discovery of this anomaly 
of refraction and its full and complete discription, practical de- 
monstration, and general recognition by several of the eminent 
oculists of Europe more particularly by the eminent scientist, phys- 
iologist, and oculist, Prof. Donders, of Utrecht. In this connec- 
tion it may not be uninteresting to this society to briefly trace the 
history of astigmatism. It is a curious fact that while we are so 
largely indebted to the Dutch and German oculists for the thorough 
and exhaustive investigations into the cause of astigmatism, the 
honor of its discovery is due to Thomas Young,*M.R.F.C.S., who 
first observed the defect in his own eye, and described it in his 
“ Philosophical Transactions for 1793.” He communicated his dis- 
covery to the optician Cary, who stated that he often found that 
near-sighted people distinguish objects much more acutely when 
the glasses suited to them were held in a particularly oblique di- 
rection before the eye ; by this means a part of the astigmatism 
may be corrected. Young sought the source of the astigmatism in 
the crystalline lens, and from experiments supposed it to be due to 
an oblique position of the lens* 
The next case of astigmatism recorded, was by Airy, in 1827, 
thirty-four years after Young. He detected a high degree of my- 
opic astigmatism in his own eye; he also determined the proper 
glass for its correction. 
Next came Stokes, who invented an astigmatic lens for deter- 
mining the degree of astigmatism, 
*The brilliant discovery of Dr. Young will, I hope, excuse some slight 
sketch of his life at this point. He was a remarkable man ; from youth un- 
til his death he was a devoted student of natural philosophy. He was born 
in 1773; studied medicine in 1792; in 1800 he became a member of the Col- 
lege of Physicians, and settled in London, where he began to practice. In 
1801 he was appointed a professor of natural philosophy in the Roval Institu- 
tion. He was not popular as a lecturer; his style being too condensed, and 
the matter of his lectures unsuited to the miscellaneous audiences of the Royal 
Institute. He was not more fortunate in pleasing patients; for it is re- 
corded of him that his efforts to secure them were a failure. (Patients then, as 
now, were often misled by the showy allurements of quacks and pretenders.) 
His most valuable paper was probable upon the discovery of the law of inter- 
ference of light. He was elected a fellow of the College of Physicians, also 
physician to St. George’s Hospital. “ He was the first to suggest the mode of 
investigation, by which the received interpretation of hieroglyphics has been 
arrived at.”—Circle of the Sciences. 4 
Buckner. 
In 1847 a case was reported by Hamilton, and in 1848 a few 
cases were published by Hr. Goode. 
Three cases of this anomaly are reported by Hays in his edition 
of Lawrence on Diseases of the Eye, 1854, page 669. 
Donders quotes the above cases in detail, and says that only one 
more had been recorded (up to that time), which was observed upon 
the Continent of Europe. It was described by Pastor Schneider, 
of Switzerland, Canton of Lucerne, who discovered this anomaly 
in his own person. He was near-sighted for vertical, and far-sighted 
for horizontal lines; he used bi-convex cylindrical glasses combined 
with bi-concave spherical, for correction. Up to this time, the 
source of this defect in normal refraction had not been determined. 
“Young presumed it to be in the lens ; Airy did not publish any 
opinion as to its seat.” Wharton Jones, in his second American 
edition of Ophthalmic Medicine and Surgery, under the head ot the 
cylindrical eye, mentions Airy’s case as an exaggerated degree of 
the natural form of the cornea, so as to disturb vision. 
Wilde, of Dublin, is quoted by Donders as having attributed the 
cause of astigmatism to be due to the form of the cornea, and he 
supposed that both Jones and Wilde obtained their information 
from a small work upon the form of the cornea, published by 
Gearson, at Gottengen, in 1810. 
This brings the history of this anomaly of refraction up to the 
time of the investigations of Listing and Helmholtz, upon the phys- 
iology of vision, but to Prof. Donders is due the honor of calling 
general attention to the subject, among the eye-specialists of Europe 
and America. His masterly work upon the accommodation and 
refraction of the eye, was translated into English, in 1864, by re- 
quest of the New Sydenham Society. To this work I am indebted 
mainly for the facts contained in this brief sketch of the history 
of astigmatism, which I have taken the liberty of introducing into 
this paper, believing that it would interest this society as it has me 
to trace the gradual development of our knowledge of the source 
of one of the most important defects in normal vision. 
Astigmatism is frequently congenital, but slight degrees of it 
may not disturb vision sufficiently to be remarked, until the person 
affected reaches the age of thirty or forty years. When the power 
of the eye to accommodate itself to near and distant points becomes 
weakened, then the astigmatic begins to observe a diminution of 
clearness of vision, and to notice that the eye becomes easily fa- 
digued by reading or writing. This is markedly the case if such Astigmatism. 
5 
work is done by a bad light. Good illumination I have found to 
be a great relief to such persons. 
If the astigmatism be of high degree, it manifests disturbance 
of vision, and distortion of objects at an early age. If sex has 
any influence, the preponderance of this defect is to be found in 
males. 
All cases of astigmatism have, in one or both of the chief meri- 
dians of the eye affected, either myopia (near-sight)—i. e. rays from 
distant objects (parallel rays) are focused in front of the retina— 
or hypermetropia (far-sight), i. e. divergent rays (rays from near 
objects), if projected, would come to a focus behind the retina. If 
the refractive power in one meridian only is abnormal, we have a 
case of simple astigmatism, which will require for correction a 
concave cylindrical glass, if the abnormal refraction be myopic, or 
a convex cylindrical lens if it be hypermetropic. If it be a case 
of compound astigmatism, it requires a spherical and a cylindrical 
lens combined, and these glasses will be either negative (concave), 
or positive (convex), accordingly as the astigmatism is either myopic 
or hypermetropic. 
In the treatment of mixed astigmatism, a convex and a concave 
cylindrical lens are combined, their axis being at right angles. 
A cylindrical lens differs from the ordinary spherical glasses in 
this way: The former is a segment of a cylinder, and refracts the 
rays of light which pass through it in a plane at right angles 
to the axis of the glass, and those rays which pass through its 
axis are not bent, but pass on in straight lines to the eye, while 
the spherical glasses refract equally the rays which strike any part 
of its surface. 
For holding the trial glasses when testing for astigmatism, per- 
haps Nachet spectacle frames are best; but as they are only suited 
for glasses with frames, and moreover are not easily procured in 
this country, I have had constructed by the skillful surgical 
instrument-maker, Mr. Autenrieth, No. 71 West Sixth street, Cincin- 
nati, an apparatus to which anj' of the glasses contained in- trial 
cases can be easily adapted. As only one eye can be tested at a time, 
it is intended to be held by its handle, either by the patient or 
physician; by this means much greater facility in changing the 
lenses is obtained over Nachet or the German frames which have 
to be removed from the head in changing the glasses. With my 
apparatus, also, the patient is not disturbed by the weight and dis- 
comfort of which many patients, particularly ladies, complain in 6 
Buckner. 
wearing theNachet frames. Another point 
of advantage is the marking of the degrees, 
the inner numbers correspond with those 
upon the Naehet frame, while the outer 
mark the angle when at the vertical point 
at which the axis of the glass must be 
set in spectacle frames by the optician. 
As in the Naehet apparatus, the cylindrical 
glass may be turned before the eye to any 
angle, the inner circle may hold at the 
same time a spherical glass. It is impor- 
tant before taking the angle, that the 
handle of the instrument be perpendic- 
ular to the horizontal meridian of the 
eye. 
Methods of determining astigmatism.— 
These are too numerous to mention in 
detail hero; but for practical purposes, 
the plates of Becker or Snellen are suffi- 
cient. The former consist of short bars 
or stripes, arranged three in a group, 
in a circle, having three horizontal bars 
in the center. See Snellen’s plate, which must be placed at a dis- 
tance of fifteen to twenty feet from the eye for testing purposes. 
Dr. Green’s plates* are recommended by Solberg Wells. They 
embrace the principle given in the plates of Becker and Snellen. 
Either of these plates have numbers at the top of each bar or stripe 
which marks the angle. If all the lines are distinct and sharply 
defined, the eye is not astigmatic; but if one or more lines in one 
meridian are distinct, and the other dim, astigmatism is proved, 
and the direction of the line most distinct corresponds to the me- 
ridian of the highest refraction. Furnished with a case of trial 
glasses, we find the weakest concave or strongest convex cylin- 
drical lens which causes all the stripes to be equally bright and 
distinct. This is generally the correct glass. In compound as- 
tigmatism the excess of myopia or hypermetropia must first be 
neutralized by the proper spherical glass, before adjusting the 
cylindrical lens. 
1. Cylindrical lens. 
2. Scale for marking angle, 
3. Groove for spherical glass. 
4. Spring for holding glasses. 
* Dr. Green, of St. Louis, Mo. Test-circle, for determining the direction of the principal meridians of astigmatism; the maximum and minimum of curvature. (Snellen.)) 
vertical. 8 
Buckner. 
Ordinarily, this method is sufficient to arrive at the degree of as- 
tigmatism, and the proper angle at which the glass must be set for 
correction. But many patients can not determine with sufficient 
exactness the most distinct line, even when the accommodation is 
paralyzed, and then it becomes necessary for the physician to resort 
to other methods or to note the angle (by repeated trial), as marked 
on the graduated scale attached to the frame which gives the 
sharpest vision for distance. The slightest variation from the cor- 
rect angle in high degrees of astigmatism will considerably affect 
the sharpness of vision. 
Case I. Simple astigmatism. 
ILLUSTRATIVE CASES FROM CLINICAL MEMORANDA. 
T. W\, a law student, aged 22, called upon me (June 2d) ten 
days ago. History: Had trouble with his eyes for two or three 
years past, pain on reading any length of time, and dimness of 
vision. At first this was noticed only at night, and afterward 
both day and night. This gentleman visited me in September, 
1873, on his way to college. He complained of weak eyes, and 
thought I might give him something to strengthen them. The 
eyes were not inflamed, and I at once suspected an error of refrac- 
tion. Upon trial, we found that neither weak concave nor convex 
spherical glasses improved his vision ; weak cylindrical glasses were 
but little better. I suggested an examination with the ophthal- 
moscope. He was, however, in a great hurry and left without fur- 
ther examination, promising to return the same day, if his engage- 
ments would permit. 
He did not return, as he was anxious to have the company 
of a young friend to college, who could not wait. During the 
succeeding year he suffered considerably with his eyes, and his 
studies were on this account much interrupted. He finally con- 
sulted an oculist, who suspected astigmatism and made the at- 
tempt to prove the degree, but owing to the fact that both weak 
and strong spherical glasses did not materially improve vision even 
when held in front of a stenopseic slit, the physician concluded 
that rest and blue or smoked glasses would be the proper treat- 
ment for him. Under his advice Mr. W. refrained from resuming 
his place at college for the next session. For tho past year he has 
faithfully obeyed instructions, abstaining from reading as much as 
it was possible for him to he has been having a friend to read 
to him daily in order to save his eyes. He still has considerable ir- 9 
Astigmatism. 
ritability in both eyes, and they are very sensitive to strong light, 
although not inflamed. 
With this brief history we will proceed to give from the notes of 
this case our plan of investigation. At 15' (feet) the vertical bars and 
those at a slight angle from the vertical, upon Becker’s plate, were 
distinct, while those perpendicular to them were dim. At 20' he 
reads with the left eye the fourth line from the bottom of Snellen’s 
test types. The letters, however, are distorted. In the left eye we 
therefore record S. (sight) = = 2-5ths, being considered 
normal vision. 
At the same distance, he reads with the right eye, the third line 
from the bottom. Therefore, of this eye S. = Concave 
and convex spherical glasses were now tried before each eye. A 
concave lens of 36" focus improved vision slightly, but stronger 
concaves diminished it; with convex glasses he could see nothing. 
The steneopeeic apparatus was now tried with the slit in the dia- 
phragm horizontal; he could now read the second line from the 
bottom of the test type. With the slit vertical, his sight was not 
nearly so good as without it; —36" was given him to hold in front 
of the slit, and he was requested to turn them together slowly be- 
fore the eye until the best point was found. This, at the proper 
angle, improved vision, but stronger glasses revolved in the same 
way made no improvement. Our patient now complained of fa- 
tigue of that eye, and proposed to change the examination to the 
other. From the extreme sensitiveness of this eye, we feared a 
complication with disease of the retina or optic nerve, and decided 
before going further with our test-glasses to make an ophthalmoscopic 
examination. By this means we found that the optic discs of both 
eyes were hyperannic; the left much more so than the right. By 
the erect image the blood-vessels running vertically were distinct, 
the horizontal vessels small and not easily discerned. The optic 
disc was elongated vertically. I may say here that I am aware 
that “ Dr. Hays shows that this is not uniformly true,” and has 
demonstrated that the elongations of the optic disc in the vertical 
or horizontal direction is not a proof of astigmatism, but is the 
result of the distance at which the object lens is held from the 
eye.* 
I am prepared to admit the truth of the latter part of the above 
statement; but in cases of astigmatism I have observed a distortion 
* Transactions American Ophthalmological Society, 1870, p. 86. 10 
Buckner 
of the disc when the field was accurately in focus, and that this is 
not due to slight regular astigmatism in my own eyes, is proved by 
the fact that no such distortion is observed in the examination of 
normal eyes, provided the field is plainly in focus. But to return 
to our patient. The ophthalmoscopic examination did not reveal 
anjT sufficient cause for amblyopia, but confirmed the correctness of 
my diagnosis, that the source of the defect in vision was due to 
astigmatism. In order to get rid of any error which might have 
been produced by the active accommodation of the eye, we dilated 
the pupil with a strong solution of atropia sul. The stenopmic 
slit was now held horizontally before the left eye, and his vision rose 
to %% = A concave lens of 12-inch focus was held in front of the 
vertical slit, which greatly improved his sight. He could now read 
the second line from the bottom, S. = With a concave glass of 
7" focus his vision was best. This glass, axis nearly horizontal, 
corrected the astigmatism. All the bars upon Becker’s plate were 
equalty bright, and he read with ease No. 30 of the test tj’pe at 
twenty feet; — S. added, made the type blacker, butdid not ena- 
ble him to read the lowest line; — S. was better. We had now 
proved a high degree of myopia in the vertical meridian of the left 
eye, with so small amount in the horizontal meridian as to make it 
practically of little account. The examination of the right eye 
was now simplified, as we found that with the same glass—7" C. 
axes horizontal, his vision rose to -f£ nearly. Spherical minus 
and plus glasses added were no improvement. We therefore re- 
corded myopia in the vertical meridian of the right eye = j-, and in 
the horizontal meridian, emetropia (i. e. normal refraction.) 
Concave cylindrical glasses of 7" focus were ordered for both 
eyes. With these he sees in good illumination No. 20 of Snellen’s 
type at 20' (feet), and can read with the same glasses Snellen 
at 12 inches. He was, of course, delighted that he had found a 
remedy for his trouble, and that he could resume his studies with- 
out the fear of doing serious injury to his eyes. 
The above may be considered an illustrative case for thousands 
of others. 
Case II. Compound myopic astigmatism. June 2d, the same 
day as the case just mentioned, Dr. L. B. consulted me for a defect 
in the vision of both eyes. History : Age 38, married; seven or 
eight years ago first noticed trouble with my eyes; was not able to 
see small objects distinctly; noticed that letters were distorted, and Astigmatism. 
11 
straight vertical lines were curved; lamps were sometimes seen 
double, and the outlines of small objects were hazy; the left eye 
often became inflamed and painful; some five or six years since he 
consulted an eye-specialist, who made several examinations, but did 
not suggest a remedy for his trouble. 
Astigmatism in this case was probably overlooked by the doctor, 
as it has been frequently by other reputable men. 
Upon an examination, we found for the left eye in the horizontal 
meridian myopia of ; in the vertical meridian, myopia of We 
therefore had, for the whole eye, myophia = ¥o -|- A. M. In the 
right eye, we found myophia of -|- A. M. -fa. For the left eye, 
with a concave cylindrical lens of -Jg-", combined with a spherical 
concave glass h'8 sight for distance was (normal version). 
For the right eye, — ¥V' C. and — S. combined,gave him normal 
sight. For reading at twelve to eighteen inches, he could see best 
with C. glasses, uncombined. As he did not wish to get two pair, 
we ordered the latter for both purposes. We have in the above 
case the evidence that even slight degrees of astigmatism often 
seriously disturbs vision. This gentleman was enthusiastic over 
the benefits derived by the glasses, and was impatient at the delay 
necessary to have the glasses ground and set in frames by the 
optician. He said that the proper diagnosis of his case had re- 
moved the apprehension of future blindness—a calamity great 
enough in itself, but the more fearful to him on account of his large 
family, who were entirely dependent upon him for support. 
Case III. Simple hypermetropic astigmatism. (Hypermetropia 
in one meridian, and emetropia—normal vision—in the other.) J. 
J. applied to me in June, 1874; his history was not taken, but my 
notes show that his vision for both eyes was = f, and with con- 
vex cylindrical glasses of 36" focus, sight in each eye rose to normal 
vision. 
We have heretofore stated in this paper that astigmatism was 
generally congenital; it is also often hereditary, and may occur in 
several members of the same family. 
Case IV. In July, 1874, Mr. E. B., editor, applied to me for 
advice about his eyes ; had suffered with them from boyhood ; he 
could not read long without closing one eye; the right was his 
best eye ; had tried a variety of spectacles without benefit. An 
examination revealed simple myopic astigmatism in the right eye, 
and compound myopic astigmatism in the left. In this case, as in 12 
Buckner. 
several others, we found that fitting both eyes with piano-cylindri- 
cal glasses was preferable to giving one eye this sort of glass for 
correction of the simple astigmatism, and a spherico-cylindrical 
glass for the other eye affected with the compound form. With his 
reading-glasses, which we prescribed, he could read the smallest 
type of Snellen at twelve inches, and could see also very well with 
the same glasses for distance. 
Case Y. Astigmatism complicated with lamellar cataracts. Mr. 
C. B., brother of the gentleman whose case we have just given 
above, visited me in July, 1874. He had been informed that he 
would be blind in a few months, and that there was no help for 
him, to use his own language. He was consequently much de- 
jected, and came in fear and trembling to ask my opinion of his 
case. He had made up his mind to submit with what resignation 
he could to his fate. When his brother had been fitted with glasses, 
he concluded to seek further advice. He was a type-setter in the 
office of his brother, but had been compelled to give up work on 
account of his failing vision. History: At ten years of age he had 
convulsions, and since that time his vision has been imperfect. He 
often had a sense of fatigue about the eyes. The outlines of ob- 
jects were hazy and indistinct. F6r the last six months his sight 
had failed considerably, and for the last month he has not been able 
to set fine type. The eyes were not inflamed; and, as he was still a 
young man (about twenty-four years of age), I did not suspect cat- 
aract, but thought the case to be either an error of refraction or 
amblyopia. Convex and concave spherical glasses made the sight 
worse. He reads two and a half Snellen at six inches, and three 
and a half at eighteen inches ; the near point for the same type 
was five inches. 
With the stenopseic apparatus, armed with convex spherical 
glasses, we found in the vertical principal meridian, hypermetropia 
of -Jg-; in the horizontal principal meridian II. of This would 
give us H. -f- A. H. nearly. The degree was about the 
same in each eye; and he should have received ordinarily a 
convex spherical glass of combined with a 0" C. In fact, 
howTever, he could see best with each eye when armed wfith -A/' C. 
glasses. We now examined the eye with the ophthalmoscope, and 
then discovered the lamellar or zonular opacity in the crystalline 
lens of both eyes. The fundus of the eye could be plainly dis- 
cerned, and its details quite accurately made out. Without glasses, Astigmatism. 
13 
hia sight for distance was = £ for each eye. With the cylindrical 
glasses, his sight was f jj or lie was furnished with these glasses, 
and informed that as long as the opacity did not extend toward the 
periphery of the lens, his sight would remain good in all proba- 
bility by the aid of his glasses, but we could give him no positive 
assurance that the cataracts might not be further developed, thereby 
shutting off all practical vision. In the above case, abnormal 
regular, as well as iri*egular astigmatism, caused by a change in the 
structure of the crystalline lens, probably exceeded regular astig- 
matism of the cornea. As lamellar cataracts are either stationary 
or slowly progressive, it will be a great benefit conferred upon per- 
sons thus afflicted if we can even for a few months restore useful 
vision, before resorting to iridectomy, iridodesis, or an operation 
for the extraction of the cataracts. While many, provided it be 
found that abnormal astigmatism generally exists in these cases, 
may be able to wear the glasses with benefit for a lifetime. As far 
as I can find, the experiment of using cylindrical glasses for the 
improvement of vision in cases having lamellar or zonular cataracts, 
is entirely new. 
Mixed, Astigmatism.—In this form we have myopia in one prin- 
cipal meridian and hypermetropia in the other. 
Case VI. M. B., a sister of charity, was .fitted by me some 
three or four years ago with cylindrical glasses, which at the time 
vastly improved her vision. Owing to some accident to the glasses, 
she came to be refitted in August, 1874. From my notes, I find that 
she had often had much trouble with her eyes before she got her 
glasses ; her eyes at times had been inflamed, and she had from 
childhood great difficulty in seeing clearly. In reading, the letters 
run together, and she had acquired the habit of holding the book 
very close to get rid of the diffuse and hazy outlines of the letters. 
By methods already stated, we found in the left eye, in the vertical 
principal meridian, myopia of J-0, and in the horizontal meridian, 
hypermetropia of Tlg-, and for the right eye, myopia in the vertical 
of J0, and in the horizontal, hypermetropia of Bi-cylindrical 
glasses were therefore ordered, the axis of the concave cylinder to 
correspond with the hypermetropic meridian, and the axis of the con- 
vex cylindrical lens to be in the plane of the vertical or myophic 
meridian, the axis of both glasses to be set at right angles. Without 
the glasses for R. E., S. =%%= $ ; and in the L. E., S. = 
Now this eye was evidently amblyopic. With the crossed C. lenses 14 
Buckner. 
forR. E., S. = f£ nearly; for L. E., S. = f ° =%. She could also read 
the finest of Snellen’s test type, at twelve inches, using both eyes. 
If I have been somewhat tedious to the in my 
relation of cases, I hope that the object of my paper—viz., to call 
attention to this important and interesting subject, and to induce 
among the general profession further investigation and increased 
knowledge of an anomaly in refraction, which can not be relieved 
by the glasses ordinarily to be found at opticians—will excuse what 
may otherwise appear as unnecessary minuteness of detail. 
Any lover of art who has visited the national gallery at London, 
must have been astonished with the difference between the earlier 
paintings of Turner, the great English landscape painter, and those 
executed by him later in life. The latter have the appearance of 
having been done in a hurry, presenting a vagueness in outline, and 
a confusion of detail inexplicable to all who do not understand the 
secret of this wonderful decline in conception or skill in execution 
of the works of the great artist. Some persons have attributed the 
change to the effects of a diseased mental and physical condition, 
and others not so charitable, said the eminent painter had become 
avaricious and used both cheap paints and indiscreet haste in his 
work. But Liebreich, the distinguished oculist to St. Thomas’ 
Hospital, London, stated in a lecture, at which I was present, that 
it was quite evident to him that Turner’s eyes had become im- 
paired in vision by reason of astigmatism. Had the discovery of 
Dr. Young been properly appreciated, the lustre of Turner’s fame 
might have remained untarnished, and probably his last efforts 
would have been his greatest and best works. 
Within the last two centuries, the improvements made in astro- 
nomical instruments have enabled astronomers to discover new 
worlds, to fix the orbits of planets—nay, more, to look into those 
worlds, see mountains, and by means of spectrum analysis to ascer- 
tain even the composition of their atmospheres. Yet for ages, the 
wonderful organ which enabled us to learn something of the 
planetary system located in space millions of miles from our earth, 
was comparatively little understood. When Galileo at Padua, in 
1609, constructed his first telescope “with a lead tube and two 
spectacle glasses,” he in triumph hurried with it to Venice, where 
the “ magical toy ” excited the greatest enthusiasm. At the request 
of the doge, he presented his extraordinary instrument to the 
senate, who rewarded him by “ conferring upon him for life his 
professorship at Padua, and generously raising his salary from 520 Astigmatism. 
15 
to 1,000 florins.”* The discovery and practical demonstration of the 
anomaly in refraction since called astigmatism, conferred as great 
a boon upon mankind in my opinion as the invention of a telescope 
by Galileo. Parliament did not vote Dr. Young an annnuity, how- 
ever, nor even give recognition to his brilliant discovery.