BLINDNESS, the condition of being blind (a common Teutonic word), i.e. devoid of sight (see also [Vision]; and [Eye]: Diseases). The data furnished in various countries by the census of 1901 showed generally a decrease in blindness, due to the progress in medical science, use of antiseptics, better sanitation, control of infectious diseases, and better protection in shops and factories. Blindness is much more common in hot countries than in temperate and cold regions, but Finland and Iceland are exceptions to the general rule.[1] In hot countries the eyes are affected by the glaring sunlight, the dust and the dryness of the air. From statistics in Italy, France and Belgium, localities on the coast seem to have more blind persons than those at a distance from the sea.
The following table gives the number of blind persons as reported in the census of each country. Unless otherwise stated, it refers to the statistics of 1900.
| Country. | Total Number. | Number per Million of Population. |
| Austria | 14,582 | 540 |
| Belgium | 3448 | 487 |
| Canada | 3279 | 610 |
| Denmark | 1047 | 427 |
| England | 25,317 | 778 |
| France | 27,174 | 698 |
| Finland[2] | 3229 | 1191 |
| Germany | 34,334 | 609 |
| Hungary | 19,377 | 1006 |
| Ireland | 4263 | 954 |
| Italy | 38,160 | 1175 |
| Holland (1890) | 2114 | 414 |
| Norway | 1879 | 838 |
| Portugal | 5650 | 1040 |
| Sweden | 3413 | 664 |
| Switzerland (1895) | 2107 | 722 |
| Scotland | 3253 | 727 |
| Spain (1877) | 24,608 | 1006 |
| Russia | · · | about 2000 |
| United States (corrected census) | 85,662 | 1125 |
Causes and Prevention
There are many cases of complete or partial blindness which might have been prevented, and a knowledge of the best methods of prevention and cure should be spread as widely as possible. Magnus, Bremer, Steffen and Rössler are of opinion that 40% of the cases of blindness might have been prevented. Hayes gives 33.35% as positively avoidable, 38.75% possibly avoidable, and 46.27% as a conservative estimate. Cohn regards blindness as certainly preventable in 33%, as probably preventable in 43%, and as quite unpreventable in only 24%. If we take the lowest of these figures, and assume that 400 out of every 1000 blind persons might have been saved from such a calamity, we realize the importance of preventative measures. For the physiology and pathology of the eye generally, see [Vision] and [Eye].
The great majority of these cases are due to infantile purulent ophthalmia. This arises from inoculation of the eyes with hurtful material at time of birth. If the contagious discharges are allowed to remain, violent inflammation Ophthalmia. is set up which usually ends in the loss of sight. It depends on the presence of a microbe, and the effective application of a weak solution of nitrate of silver is curative, if made in a proper manner at an early period of the case. In Germany, midwives are expressly prohibited by law from treating any affection of the eyes or eyelids of infants, however slight. On the appearance of the first symptoms, they are required to represent to the parents, or others in charge, that medical assistance is urgently needed, or, if necessary, they are themselves to report to the local authorities and the district doctor. Neglect of these regulations entails liability to punishment. Eleven of the United States of America have enacted laws requiring that, if one or both eyes of an infant should become inflamed, swollen or reddened at any time within two weeks of its birth, it shall be the duty of the midwife or nurse having charge of such infant to report in writing within six hours, to the health officer or some legally qualified physician, the fact that such inflammation, swelling or redness exists. The penalty for failure to comply is fine or imprisonment.
The following weighty words, from a paper prepared by Dr Park Lewis, of Buffalo, N.Y., for the American Medical Association, show that laws are not sufficient to prevent evil, unless supported by strong public sentiment:—
“When an enlightened, civilized and progressive nation quietly and passively, year after year, permits a multitude of its people unnecessarily to become blind, and more especially when one-quarter of these are infants, the reason for such a startling condition of affairs demands explanation. That such is the fact, practically all reliable ophthalmologists agree.
“From a summary of carefully tabulated statistics it has been demonstrated that at least four-tenths of all existing blindness might have been avoided had proper preventative or curative measures been employed, while one-quarter of this, or one-tenth of the whole, is due to ophthalmia neonatorum, an infectious, preventable and almost absolutely curable disease. Perhaps this statement will take on a new meaning when it is added that there are in the state of New York alone more than 6000, and in the United States more than 50,000 blind people; of these 600 in the one state, and 5000 in the country, would have been saved from lives of darkness and unhappiness, in having lost all the joys that come through sight, and of more or less complete dependence—for no individual can be as self-sufficient without as with eyes—if a simple, safe and easily applied precautionary measure had been taken at the right time and in the right way to prevent this affliction. The following three vital facts are not questioned, but are universally accepted by those qualified to know:—