Pointing to the Letters 169
this is a distraction. When the method is found success ful one can proceed as follows:
(a) Place the tip of the finger three or four inches
below the letter. Let the patient regard the letter, and shift to the tip of the finger, see ing the letter worse.
(b) Reduce the distance between the finger and
the letter, first to two or three inches, then to one or two, and finally to half an inch, proceeding each time as in (a).
If successful, the patient will become able to look from the top to the bottom of the letter, seeing each worse alternately, and producing the illusion of swing ing. It will then be possible to see the letter contin uously.
When the vision is imperfect it often happens that, when the patient looks at a small letter, some of the larger letters on the upper lines, or the big C at the top, look blacker than the letter regarded. This makes it impossible to see the smaller letters perfectly. To cor rect this eccentric fixation regard the letter which is seen best, and shift to the smaller letter. If successful, the small letter, after a few movements, will appear blacker than the larger one. If not successful after a few trials, rest the eyes by closing and palming, and try again. One may also shift from the large letter to a point some distance below the small letter, gradually approaching the latter as the vision improves.
Shifting from a card at three or five feet to one at ten or twenty feet often proves helpful as the unconscious