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Stories from the Clinic

3. Retinitis Pigmentosa

By Emily C. Lierman

I am not a physician, and I know very little about the disease of the
eyes known as retinitis pigmentosa except how to relieve it. I have
been told that in this condition spots of black pigment are deposited
in the retina, that parts of the retina are destroyed, and that the
nerve of sight is diseased. Eye books which describe the disease say
that it usually begins in childhood, and progresses very slowly until
it ends in complete blindness. The field of vision is contracted, and,
because they cannot see objects on either side of them, patients
frequently stumble against such objects. In most cases the vision is
much worse at night than in the daytime. The books say further that no
treatment is known which helps these cases. Nevertheless Dr. Bates
reported, in the New York Medical Journal of February 3, 1917, a case
of retinitis pigmentosa which had been materially benefited by
treatment through relaxation, and by the use of the same methods, I
have been able to greatly improve the sight in several cases of the
same kind.

My first case of retinitis pigmentosa was Pauline, a little girl of
twelve who came to the clinic in October, 1917. At five feet from the
card she could read only the seventy line, and her eyes vibrated
continually from side to side, a condition known as nystagmus. She was
very shy and extremely nervous, and appealed to me pathetically for
glasses so that she could see the blackboard, and the teacher would
not think her stupid and make fun of her. I have noticed that eye
patients often suffer from extreme nervousness; but this poor child
had the worst case of nervse I ever saw, and the slightest agitation
made her sight worse. If, in asking her to read a line on the test
card, I raised my voice and spoke a little peremptorily, her face
would flush, and she would say, "I cannot see anything now." But just
as soon as I lowered my voice and took pains to speak gently, her
sight cleared up.

I began her treatment by telling her to cover her eyes with the palms
of her hands and remember the letters she had seen on the card. This
improved her sight so much that before she left she was able to see
all the fifty line at five feet, and—what thrilled me most of all—the
dreadful movement of her eyes had stopped. She came quite steadily to
the clinic, and every time she came I was able to improve her sight,
so that at last she became able to read the writing on the blackboard
at school.

Then I did not see her again for six months. When she came back she
told me that she had been working in a laundry during the summer
because she hated school. She had also been ill during the summer, and
her mother had taken her to a hospital for treatment. While she was
there an eye specialist looked at her eyes, and this made her so
nervous that they had started to vibrate from side to side. He said to
her:
  "You ought to have your eyes treated; they are very bad."
  "I am having them treated at the Harlem Hospital Clinic," she
answered. "I know how to stop that vibration."
Then she palmed for a while, and when she uncovered and opened her
eyes the doctor looked at them again.
  "Why they seem all right now," he said. "You had better go to that
doctor until you are cured. He can do more for you than I can."

I was very much pleased to find that in spite of having stayed away so
long, she had not forgotten what I had told her, and was able to stop
her nystagmus. I tested her sight, and found that it was no worse than
when I had last seen her. In fact, in some ways, it was better. She
was not so nervous, and she said that her family and friends noticed
that her eyes looked better. She herself was now very enthusiastic and
anxious to have me help her. I told her to palm as usual, and left her
to treat other patients. Five minutes later she read the thirty line
at thirteen feet. I now told her to look first to the right of the
card and then to the left, and to note that it appeared to move in a
direction opposite to the movement of her eyes; then to close her eyes
and remember this movement. She did this, and when she opened her eyes
she read two letters on the twenty line. At a later visit she read the
whole of the twenty line at thirteen feet.

The last patient I treated for this dreadful disease was an old man of
seventy. He came to the clinic on January 14, 1920, and when I first
saw him was standing with many others, waiting patiently for Dr. Bates
to speak to him. Our work has to be done very rapidly, because of the
very short time we have to treat so many patients, and I very seldom
have time to observe individuals as I would like to do. But because of
his unusual appearance, I at once singled out this dear old man from
the crowd. Most men of his age who come to our clinic are unkempt,
dirty and ragged—pitiable objects generally. But this man was well
groomed. His clothes, though worn and old, were well brushed; his
shoes were polished, his collar clean, his tie neatly adjusted. He had
a great abundance of snow-white hair, neatly parted and brushed, and
his skin was like a baby's, "pink and white."

Dr. Bates asked me to treat him with the usual remark, "See what you
can do for this man," and I placed him four feet from the card, asking
him to read what he could.
  "I'm afraid I can't see so well, ma'am," he said; "my eyes bother
me a great deal."
  "I'm going to show you how to rest your eyes so that they won't
bother you," I answered.
The best he could do at this distance was to read the fifty line. I
told him to palm, and in less than five minutes he saw a number of
letters on the forty line. The next time he came I put him nine feet
from the card, and at this distance he read all the letters on the
thirty line. He was so happy and excited over this that I became
excited too. I forgot that I had other patients waiting for me and
encouraged him to talk, a thing which I am seldom able to do with the
patients. I was glad afterward that I did so, for he had a wonderful
story to tell.
  "Do you know, ma'am," he said, "for two nights I palmed and rested
my eyes for a long time before I went to bed—and what do you think?—I
slept all the night through without waking up once. Now I think that's
great, ma'am, because for years I have had insomnia. I would sleep
only a little while; then I would get up and smoke my pipe to pass the
time."

At a later visit I put him twelve feet from the card, and at this
distance also he was able to read the thirty line. When I told him
what he had done he was again greatly pleased and excited.
  "You know I'm so much better," he said, "that I didn't even notice
that I was further away than usual. Thank you, ma'am. God bless you,
ma'am."
During the practice, when he failed to see a letter I was pointing to,
I said:
  "Close your eyes and tell me the color of your grandchild's eyes."
  "Blue, ma'am." he said.
  "Keep your eyes covered, keep remembering the color of baby's
eyes."
He did this, and after a few minutes his sight cleared up and he saw
the letter. After we had finished the practice I again encouraged him
to talk, and he told me more about his insomnia.
  "Do you know, ma'am," he said, "after I had had two night's sleep
without waking up I didn't dare tell any of my family about it, for
fear that it wouldn't last and I would only disappoint them. So I
waited. Now, do you know, ma'am, it is just two weeks that I have
slept the night through without waking up once, and so I told my wife
about it. She is so happy, ma'am, I just can't tell you, for it has
been many years since I was able to do that."

I wish I could have a picture of his face when he is telling of the
improvement in his eyesight and general health. It would be a picture
of love, kindness and gratitude.

Recently he looked up into my face and said: "I am seeing you better
now, ma'am. You look younger."

In two months his vision improved from 10/200 to 10/30. As he made but
eight visits in this time, I feel that this record is remarkable. I
also feel that the statements in the books about the impossibility of
doing anything for patients with retinitis pigmentosa are in need of
modification.

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Better Eyesight
A monthly magazine devoted to the prevention and cure of imperfect
sight without glasses
Copyright, 1920, 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. II - April, 1920 - No. 4
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