AVIATORS’ EYES 
    
By W. H. Bates, M.D.

AVIATION is becoming more popular than ever before. The writer has treated many aviators who had, within a few months, acquired trouble with their eyes which made it dangerous for them to continue to fly. During the war a Major, an Aviator in the Army, consulted me about his eyes. His principle trouble was dizziness. He was wearing glasses for the correction of a slight astigmatism. The glasses did not relieve the dizziness. At this time a large number of aviators had been killed by falls. The history of this aviator was very interesting and valuable. He was positive that a number of years previously when he began to practice flying that his sight was normal - 20/20 with each eye or with both. After a few years he noticed that his sight was impaired and that he had attacks of dizziness which did not last long in the beginning. These attacks of dizziness would come without warning while he was flying about one thousand or more feet above the ground. While he was conscious of the dizziness, he noted that his machine (plane) started to fall and continued falling until the dizziness stopped. It was some months before he realized that with every attack of dizziness the machine fell a greater distance, and he feared that these spells would ultimately cause his death. Like most Army and Navy men, the Major did as he was told and was cured by me. This is the way it was done. I tested his eyes with the ophthalmoscope and retinoscope and found no disease of his eyes. The retinoscope revealed a small amount of astigmatism in each eye. His vision for the test card was 20/30. When he closed his eyes and rested them, the astigmatism became less and his sight for the test card became normal - 20/20. This was accomplished in about an hour. The improvement was only temporary, however, and he was given advice for treatment at home. A large test card was given him with directions to read it with each eye separately at twenty feet. He was directed to rest his eyes often by closing them. It was suggested to him that he look at one letter which he remembered better with his eyes closed than he imagined or saw it with his eyes open. By repetition, his vision for the known letter improved and his sight for unknown letters and other objects improved until his vision became 25/10. He was under treatment for about a month and he was seen at irregular intervals during that time. Since that time I have not heard from him personally. Other aviators have been benefited by the same treatment. There is a right way and there is a wrong way to use the eyes when controlling a flying machine. The time required to do the wrong thing is just as long as the time required to do the right thing. The aviator can also demonstrate that an imperfect memory, imagination or sight is more difficult than a perfect memory, imagination or sight. For example, a small letter "o" can be remembered imperfectly on one of the lines of small letters of the Snellen test card, but a stare or strain to see it with a white center as white as snow may require much effort, time and trouble. The imperfect whiteness of the letter soon disappears while its blackness turns to a shade of dark or light gray, all covered by a blurred cloud. The concentration, the effort to see, brings on discomfort, fatigue, pain, dizziness and other nervous symptoms which are all difficult to remember, imagine or feel. The memory, imagination or sight can only be demonstrated easily when exercised without strain. The successful pilot when at his best is always doing the right thing. When riding in a fast moving train, the telegraph poles, although fastened to the ground, appear to move in the opposite direction. But any effort to stop this movement brings on a strain which may cause much pain, dizziness, fatigue or other nervous discomfort. The Major, who recognized the bad effects of dizziness from imperfect sight, believed that the dizziness, if sufficient, could cause fatal accidents when flying. He became able consciously to produce dizziness by eyestrain or by an effort to improve his vision. He was taught to imagine the floor to be moving when he walked about his rooms. Swaying his head and eyes from side to side enabled him to imagine the floor to be always moving. When he steered his plane to the right, all objects seen appeared to move to the left. When he moved to the left all objects seen appeared to move to the right. He was able to lengthen the apparent movement of stationary objects. The wider the movement, the less was the sight improved, while a shorter movement of the eyes or head was followed by a greater improvement. It was difficult for him to demonstrate that perfect sight can only be obtained by rest and prevented by an effort. But when he had learned that it was a truth without an exception he soon became able to demonstrate the facts. He was encouraged to improve his vision by using various or all parts of his machine as objects for testing and improving his sight. The more successful he was in improving his memory for objects, the better was the vision. We can only remember perfectly what we see perfectly; we can only imagine perfectly what we remember perfectly; we can only see perfectly what we imagine perfectly. The time required for a cure varies with individuals. The eyes of some aviators may be under a greater strain than that of others. The aviator should demonstrate that shifting the eyes or moving the eyes from one small part of his plane to other objects is restful and that his sight is always improved by resting his eyes. Blinking or closing the eyes and opening them quickly is also a rest. He should also demonstrate that closing the eyes for a few seconds or longer and then opening them for a shorter time is a benefit to the sight. Palming or covering the closed eyes with the palm of one or both hands when done right always improves the vision. Blinking, shifting, or palming can be practiced before entering the plane and so accidents may often be avoided. While attacks of dizziness are a frequent cause of accidents, many of them fatal, there are numerous other causes which are just as serious or important. Many fliers of airplanes seldom have accidents. What is the secret of their success? It is due to their control at all times in all places. Control of what? The answer is: Control of the mind, control of the eyes and of all the nerves generally. When the efficiency of the mind is at its maximum, it is at rest. Nothing is done consciously or unconsciously. It was a shock to the writer to discover with the aid of the retinoscope that the greatest strain of the body occurred during sleep. Strain is always accompanied by a loss of mental control when things go wrong. Accidents, fatal accidents, always mean a loss of mental control. The fact should be demonstrated. It should also be demonstrated that it is more difficult to fail than to succeed. "Lindy" (Charles Lindbergh – Pilot – see pictures on right) could not have crossed the Atlantic Ocean, a 3,000 mile journey, by making a constant effort to obtain nervous control. The effort would have caused fatigue, and no man can have control of his nerves by using some form of effort. Dizziness is caused by prolonged effort and no man could fly very far when dizzy. The eyesight of even the best of us would become imperfect in a few minutes or less. Now let me ask how many of the best aviators could be efficient if their sight should become imperfect? Control is necessary. How can it be obtained? Very easily. First demonstrate that doing the wrong thing - like staring, straining or making an effort to remember, imagine or see - requires an effort, while resting the eyes or mind is easy and requires no effort. It is a common experience for many people to fail to remember a person’s name. An effort to remember it always fails but if they rest their minds by thinking of something else the name comes to them without their volition. A perfect memory can be obtained by practice. Perfect mental control comes or is manifest when the memory is perfect. Practice is important and very necessary. One may see and remember familiar or well known objects with the eyes open but better with the eyes closed. By alternating, the memory with the eyes open improves until it becomes as good as with the eyes closed. This means mental control of the mind, eyes, and all the nerves of the body. The imagination can also be improved by practice. For example, if a well known or familiar letter of a sign or print on a card can be imagined more clearly than it really is, the vision of all parts of the letter is improved as well as the vision for other objects which were not seen before. Imagining the letter alternately with the eyes open and closed is a benefit to the imagination and the memory as well as to the sight. The aviator can improve his control by improving his memory, imagination, and sight, while flying. It is not necessary for him to practice on letters or other objects several miles away. He can practice successfully, more or less continuously, on the face of his compass or some other part of his machine. Finally he should remember that perfect control can only be obtained by rest and not by any effort whatever.