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7 had had both eyeballs removed
30 had had one eyeball removed
32 had one shrunken eyeball
39 had both eyeballs shrunken

Two cases (0.75 per cent of the 267 cases admitted as blind) were due to consanguinity (i.e., marriages between first cousins). Twenty-five cases were due to congenital disease, and the vast majority of these are undoubtedly syphilitic. Add to this number 42 cases of acquired syphilis, making a total of 67 cases, and we find that this one cause alone is responsible for 25.09 per cent of all the cases of blindness. Fourteen cases were due to ophthalmia neonatorum (gonorrhoea) in the newborn, equal to 5.24 per cent, which is an entirely preventable cause of blindness. There is a law on the statute books making it a misdemeanor, punishable by fine and imprisonment, where a midwife or nurse does not at once call in an oculist where purulent inflammation develops in an infant's eyes within the first few days after birth. The law is honored more in its breach than in its enforcement. Ignorance and neglect exist among the poor, and I feel that if an offender was now and then made to feel the full force of the law, it would arouse the conscience of others. As has been well said, blindness from this cause is a crime against civilization.

Blindness due to the infectious diseases sum up a total of 53 cases = 19.86 per cent; due to scarlet fever, measles, mumps, cerebro-spinal meningitis, typhoid, smallpox, trachoma. School inspection is the greatest safeguard against all of these. No civilized community ought to expose its school children to the ravages of the infections, when regular and systematic examination of all children at school by competent physicians will lead to the early detection of a contagious disease in a child. Where isolation of a case of scarlet fever or measles follows at once, where all the other children in that family, or even living under the same roof, are isolated and not allowed to return to school until the danger of contagion is past, where fumigation of the schoolroom follows every time infection is detected, just to that degree are the dangers of an epidemic averted; and we know only too well that in a certain percentage of serious cases of infectious disease, when death does not ensue, blindness does. Five cases of blindness were due to this cause. Smallpox is entirely preventable by vaccination. Trachoma, a most virulent and practically incurable disease, leads to blindness, and is transmitted by using the same handkerchiefs and towels. Roller towels in schoolrooms or institutions are an abomination. One child with granulated eyelids can infect a whole school, even a community, and spread disaster.

Eleven cases (4.11 per cent) were due to nearsightedness, high degrees of myopia. This condition can likewise be ameliorated by the proper lighting of schoolrooms, seeing that the light falls from the proper direction; the character of the type used in school books, and the proper adjustment of desks and chairs.

Methyl or wood alcohol has been the cause of blindness in three (possibly four cases), as the result of inhalation. Hundreds have died from drinking it. Its sale should be made a felony, since denatured alcohol (which contains but two per cent of wood alcohol) can be used for everything for which wood alcohol is now used, and the dangers are greatly minimized. Lead poison caused four cases of blindness. These two causes are responsible for 2.62 per cent of cases of blindness.

In a total of 154 cases, equal to 57.67 per cent, the causes can justly be considered as preventable. In detail, the preventable causes appear as follows:

The causes put down as not preventable are:

Accidents are placed in the list of non-preventable diseases, and still a study of the causes will disclose many where a little care or forethought could have prevented these frightful results. Man's brutality has not been wanting in at least two cases. The elements, heat, cold, and lightning, are responsible for seven.

In the most liberal sense, fully forty to fifty per cent of all cases of blindness are due to venereal disease, infection poisons, and accident, and ought to be preventable in a very large proportion of cases.

The work demonstrates:
1. That the pension is of inestimable benefit to a large dependent class.
2. That the conditions of the blind, as a whole, are deplorable.
3. That more than half of them are too old to help themselves, or to accommodate themselves to their surroundings.
4. The teaching at the blind school has benefited but few, and of these but a small proportion become self-supporting.
5. That there is need of workshops for the blind in all the large cities in the state.
6. That strict supervision of midwives, some method still to be determined by which the general public may become better informed as regards the dangers of venereal diseases and the part they play in the production of blindness, school inspection -- all will aid greatly in diminishing the number of the blind.