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An invariable symptom of all abnormal conditions of the eyes, whether
functional or organic, is the loss of central fixation. When a person
with perfect vision looks at a letter on the Snellen test card he can
always observe that all the other letters in his field of vision are
seen less distinctly. He can also observe that when he looks at the
bottom of even the smallest letters on the card, the top appears less
black and less distinct than the part directly regarded, while the
same is true of a letter of diamond type, or of the smallest letters
that are printed. When a person with imperfect sight looks at the card
he can usually observe that when he can read a line of letters he is
able to look at one letter of a line and see it better than the
others, but the letters of a line he cannot read may look all alike,
or those not directly regarded may even be seen better than the one
fixed.

These conditions are due to the fact that when the sight is normal the
sensitiveness of the fovea is normal, but when the sight is imperfect,
from whatever cause, the sensitiveness of the fovea is lowered, so
that the eye sees equally well, or even better, with other parts of
the retina. Contrary to what is generally believed, the part seen best
when the sight is normal is extremely small. The text-books say that
at twenty feet an area having a diameter of a quarter of an inch can
be seen with maximum vision, but anyone who tries at this distance to
see every part of one of the small letters on the Snellen test card -
the diameter of which is about a quarter of an inch - equally well at
one time will immediately become myopic. The fact is that the nearer
the point of maximum vision approaches a mathematical point, which has
no area, the better the sight.

The cause of this loss of function in the center of sight is mental
strain; and as all abnormal conditions of the eyes, organic as well as
functional, are accompanied by mental strain, all such conditions must
necessarily be accompanied by loss of central fixation. When the mind
is under a strain the eye usually goes more or less blind. The center
of sight goes blind first, and if the strain is great enough the whole
or the greater part of the retina may be involved. When the vision of
the center of sight has been suppressed, partially or completely, the
patient can no longer see the point which he is looking at best, but
sees objects not regarded directly as well, or better, because the
sensitiveness of the reina has now become approximately equal in every
part, or is even better in the outer part than in the center.
Therefore in all cases of defective vision the patient is unable to
see best where he is looking.

This condition is sometimes so extreme that the patient may look as
far away from an object as it is possible to see it and yet see it
just as well as when looking directly at it. In one case it had gone
so far that the patient could see only with the edge of the retina on
the nasal side. In other words, she could not see her fingers in front
of her face, but could see them if she held it at the outer side of
her eye. She had no error of refraction, showing that while every
error of refraction is accompanied by eccentric fixation, the strain
which causes the one condition is different from that which produces
the other. The patient had been examined by specialists in this
country and Europe, who attributed her blindness to disease of the
optic nerve, or brain; but the fact that vision was restored by
relaxation demonstrated that the condition had been due simply to
mentral strain.

Eccentric fixation, even in its lesser degrees, is so unnatural that
great discomfort, or even pain, can be produced in a few seconds by
trying to see every part of an area three or four inches in extent at
twenty feet, or even less, or an area of an inch or less at the near
point, equally well at one time, while at the same time the
retinoscope will demonstrate that an error of refraction has been
produced. This strain, when it is habitual, leads to all sorts of
abnormal conditions and is, in fact, at the bottom of most eye
troubles, functional and organic. The discomfort and pain may be
absent, however, in the chronic condition, and it is an encouraging
symptom when the patient begins to experience them.

When the eye possesses central fixation it not only possesses perfect
sight, but is perfectly at rest and can be used indefinitely without
fatigue. It is open and quiet; no nervous movements are observable;
and when it regards a point at the distance the visual axes are
parallel. In other words, there are no muscular insufficiencies. This
fact is not generally known. The text-books state that muscular
insufficiencies occur in eyes having normal sight, but I have never
seen such a case. The muscles of the face and of the whole body are
also at rest, and when the condition is habitual there are no wrinkles
or dark circles around the eyes.

In most cases of eccentric fixation, on the contrary, the eye quickly
tires, and its appearance, with that of the face, is expressive of
effort or strain. The ophthalmoscope reveals that the eyeball moves at
irregular intervals, from side to side, vertically or in other
directions. These movements are often so extensive as to be manifest
by ordinary inspection, and are sometimes sufficienty marked to
resemble nystagmus. Nervous movements of the eyelids may also be
noted, either by ordinary inspection, or by lightly touching the lid
of one eye while the other regards an object either at the near point
or the distance. The visual axes are never parallel, and the deviation
from the normal may become so marked as to constitute the condition of
squint. Redness of the conjunctiva and of the margins of the lids,
wrinkles around the eyes, dark circles beneath them and tearing are
other symptoms of eccentric fixation.

Eccentric fixation is a symptom of strain, and is relieved by any
method that relieves strain; but in some cases the patient is cured
just as soon as he is able to demonstrate the facts of central
fixation. When he comes to realize, through actual demonstration of
the fact, that he does not see best where he is looking, and that when
he looks a sufficient distance away from a point he can see it worse
than when he looks directly at it, he becomes able, in some way, to
reduce the distance to which he has to look in order to see worse,
until he can look directly at the top of a small letter and see the
bottom worse, or look at the bottom and see the top worse. The smaller
the letter regarded in this way, or the shorter the distance the
patient has to look away from a letter in order to see the opposite
part indistinctly, the greater the relaxation and the better the
sight. When it becomes possible to look at the bottom of a letter and
see the top worse, or to look at the top and see the bottom worse, it
becomes possible to see the letter perfectly black and distinct. At
first such vision may come only in flashes. The letter will come out
distinctly for a moment and then disappear. But gradually, if the
practice is continued, central fixation will become habitual.

Most patients can readily look at the bottom of the big C and see the
top worse; but in some cases it is not only impossible for them to do
this, but impossible for them to let go of the large letters at any
distance at which they can be seen. In these extreme cases it
sometimes requires considerable ingenuity, first to demonstrate to the
patient that he does not see best where he is looking, and then to
help him to see an object worse when he looks away from it than when
he looks directly at it. The use of a strong light as one of the
points of fixation, or of two lights few or ten feet apart, has been
found helpful, the patient when he looks away from the light being
able to see it less bright more readily than he can see a black letter
worse when he looks away from it. It then becomes easier for him to
see the letter wosre when he looks away from it. This method was
successful in the following case:

A patient with vision of 3/200, when she looked at a point a few feet
away from the big C, said she saw the letter better than when she
looked directly at it. Her attention was called to the fact that her
eyes soon became tired and that her vision failed when she saw things
in this way. Then she was directed to look at a bright object about
three feet away from the card, and this attracted her attention to
such an extent that she became able to see the large letter on the
test card worse, after which she was able to look back at it and see
it worse. It was demonstrated to her that she could do one of two
things: look away and see the letter better than she did before, or
look away and see it worse. She then became able to see it worse all
the time when she looked three feet away from it. Next she became able
to shorten the distance successively to two feet, one foot and six
inches, with a constant improvement in vision; and finally she became
able to look at the bottom of the letter and see the top worse, or
look at the top and see the bottom worse. With practice she became
able to look at the smaller letters in the same way, and finally she
became able to read the ten line at twenty feet. By the same method
also she became able to read diamond type, first at twelve inches and
then at three inches. By these simple measures alone she became able,
in short, to see best where she was looking, and her cure was
complete.

The highest degrees of eccentric fixation occur in the high degrees of
myopia, and in these cases, since the sight is best at the near point,
the patient is benefited by practicing seeing worse at this point. The
distance can then be gradually extended until it becomes possible to
do the same thing at twenty feet. One patient with a high degree of
myopia said that the farther away she looked from an electric light
the better she saw it, but by alternately looking at the light at the
near point and looking away from it, she became able, in a short time,
to see it brighter when she looked directly at it than when she looked
away from it. Later she became able to do the same thing at twenty
feet, and then she experienced a wonderful feeling of relief. No
words, she said, could adequately describe it. Every nerve seemed to
be relaxed, and a feeling of comfort and rest permeated her whole
body. Afterward her progress was rapid. She soon became able to look
at one part of the smallest letters on the card and see the rest
worse, and then she became able to read the letters at twenty feet.

On the principle that a burnt child dreads the fire, some patients are
benefited by consciously making their sight worse. When they learn, by
actual demonstration of the facts, just how their visual defects are
produced, they unconsciously avoid the unconscious strain which causes
them. When the degree of eccentric fixation is not too extreme to be
increased, therefore, it is a benefit to patients to teach them how to
increase it. When a patient has consciously lowered his vision and
produced discomfort and even pain by trying to see the big C, or a
whole line of letters, equally well at one time,  he becomes able to
correct the unconscious effort of the eye to see all parts of a
smaller area equally well at one time.

In learning to see best where he is looking it is usually best for the
person to think of the point not directly regarded as being seen less
distinctly than the point he is looking at, instead of thinking of the
point fixed as being seen best, as the latter practice has a tendency,
in most cases, to intensify the strain under which the eye is already
laboring. One part of an object is seen best only when the mind is
content to see the greater part of it indistinctly, and as the degree
of relaxation increases the area of the part seen worse increases
until that seen best becomes merely a point.

The limits of vision depend upon the degree of central fixation. A
person may be able to read a sign half a mile away when he sees the
letters all alike, but when taught to see one letter best he will be
able to read smaller letters that he didn't know were there. The
remarkable vision of savages, who can see with the naked eye objects
for which most civilized persons require a telescope, is a matter of
central fixation. Some people can see the rings of Saturn, or the
moons of Jupiter, with the naked eye. It is not because of any
superiority in the structure of their eyes, but because they have
attained a higher degree of central fixation than most civilized
persons do.

Not only do all errors of refraction and all functional disturbances
of the eye disappear when it sees by central fixation, but many
organic conditions are relieved or cured. I am unable to set any
limits to its possibilities. I would not have ventured to predict that
glaucoma, incipient cataract and syphilitic iritis could be cured by
central fixation; but it is a fact that these conditions have
disappeared when central fixation was attained. Relief was often
obtained in a few minutes, and sometimes this relief was permanent.
Usually, however, a permanent cure required more prolonged treatment.
Inflammatory conditions of all kinds, including inflammation of the
cornea, iris, conjunctiva, the various coats of the eyeball and even
the optic nerve itself, have been beneftied by central fixation after
other methods have failed. Infections, as well as diseases caused by
protein poisoning and the poisons of typhoid fever, influenza,
syphilis and gonorrhoea, have also been benefited by it. Even with a
foreign body in the eye there is no redness and no pain so long as
central fixation is retained.

Since central fixation is impossible without mental control, central
fixation of the eye means central fixation of the mind. It means,
therefore, health in all parts of the body, for all the operations of
the physical mechanism depend upon the mind. Not only the sight, but
all the other senses - touch, taste, hearing and smell - are benefited
by central fixation. All the vital processes - digestion,
assimilation, elimination, etc. - are benefited by it. The symptoms of
functional and organic diseases are relieved. The efficiency of the
mind is enormously increased. The benefits of central fixation already
observed are, in short, so great that the subject merits further
investigation.

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A monthly magazine devoted to the prevention and cure of imperfect
sight without glasses
Copyright, 1919, by the Central Fixation Publishing Company
Editor - W. H. Bates, M.D.
Publisher - Central Fixation Publishing Co.
$2.00 per year, 20 cents per copy
39-45 East 42nd Street, New York, N. Y.
Vol. I - July, 1919 - No. 1
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