Mr. TENEROWICZ. Is there anything else anyone has to offer? Mr. KAUFMAN. Mr. Chairman, I know you want to get rid of this thing as quickly as you can. I hope you will not have a meeting the first week in June as I will not then be in town.

Mr. TENEROWICZ. I am willing to meet next week. We will adjourn and date will be announced for the next meeting.

(Thereupon, at 4 p. m. hearing adjourned to meet at the call of the chairman.)

TO REGULATE THE PRACTICE OF OPTOMETRY IN THE

DISTRICT OF COLUMBIA

TUESDAY, MAY 23, 1939

HOUSE OF REPRESENTATIVES,

COMMITTEE ON THE DISTRICT OF COLUMBIA,

SUBCOMMITTEE ON PUPLIC HEALTH, HOSPITALS, AND CHARITIES,

Washington, D. C. The subcommittee met at 10:30 a. m., Hon. Rudolph G. Tenerowicz (acting chairman) presiding.

STATEMENT OF REX B. SHELEY, OPTOMETRIST, WASHINGTON, D. C.

The CHAIRMAN. Now, the committee will come to order. Doctor, will you give your name to the reporter?

Dr. SHELEY. Rex. B. Sheley.

Dr. MARSHALL. Dr. Sheley is going to give us a little insight into some question that came up in the last day of this hearing concerning the different types of glasses.

The CHAIRMAN. Will you give your name to the stenographer? Dr. MARSHALL. Dr. Marshall.

The CHAIRMAN. Dr. Sheley, what is your address?

Dr. SCHELEY. 1342 F Street, Washington, D. C.

The CHAIRMAN. What is your occupation?

Dr. SHELEY. I am an optometrist.

The CHAIRMAN. You are an optometrist?

Dr. SHELEY. Yes, sir.

The CHAIRMAN. All right, you may proceed.

Dr. MARSHALL. Dr. Sheley, what do you consider to be the cardinal points in the determination of first quality uncut opthalmic lenses? The CHAIRMAN. Just a minute, please, Dr. Marshall. Would it not be better to have the witness first make his statement?

Dr. MARSHALL. I would be glad to proceed in that manner.

The CHAIRMAN. The committee would rather have the doctor make his statement first and then if you have any questions, you may ask them.

Dr. SHELEY. Mr. Chairman, I would say that first-quality opthalmic lenses should be made first out of glass that was free from stria or any internal stresses. I would next say it should be polished to near perfection. In other words, polished to a point of maximum absorption of light; for the transmission of light, possibly that would be better. I should then say that the optical center of the blank or the geometric center of the blank should coincide. That would be important in that there would be no tendency in grinding the lens

for shape to shift it and bring about a prismatic area. The firstquality lenses of American manufacture might differ greatly from the ones of Japanese manufacture. In other words, I do think the American lenses are, in my judgment, far superior to any of the imported lenses. I believe I can say that would answer any question whatsoever. Now, in finishing up a lens, in other words, we get a blank approximately 2 inches square-50 millimeters. We feel that blank should be generally free from chips at the edge and it should be polished right out to the edge. There should be no circle at the edge of overpolish, so that when the blank is cut from the lens it is clear to the edge of the blank. In other words, if you were to cut a blank of 40 millimeters out of a 50-millimeter blank you would have ample room and would get no overpolish. But if you cut a 47-millimeter blank out of a 50-millimeter blank that would be more difficult. So we feel this: A blank should be polished right to the edge. Now, in a bifocal lens there are a good many requisites. Possibly the earliest bifocal lens was the Franklin invention, which was a split lens. In other words, the upper part was a hemisphere and the lower part was a hemisphere. They were bound by a frame together. This type had objections in that the seam between the two was very unsightly and it was very easy to get dirty, and generally it was unsatisfactory from those two points.

The next bifocal lens was known as the Perfection type-a small half-moon was ground in the bottom of a blank. That also had some objections in that they were fit together with a bevel and the two sides of the bevel would collect dirt. And they would chip. That was objectionable from the point of obstructing vision.

Probably the next common bifocal was the so-called cement type. Now, the cement type consisted in adhering a very thin wafer of glass, the focus of which amounting to the difference between the total distance correction and the total reading correction. This wafer was adhered to the bottom of the distance blank by means of, usually, Bolsom cement. This was optically a much better blank, but it also had the objection of having the seam at the top and there was also a certain amount of deterioration between the two layers of glass.

Then, next, was in general use, a Cryptoc blank. This blank is a a fused blank, and it is made by countersinking the distance lens and placing a small button of glass in this countersink and then grinding the common surface to both. Now, because of the fact that this button was of a much higher indexive refraction than the upper lens, the common surface to both permits the lower lens to have a greater refractive power than the upper lens. Now, the Cryptoc probably lends itself to the most protection more readily than any other type of bifocal blank. On the other hand, it has, from an optical standpoint, many very objectionable features. For instance, in fusing those two blanks together, it is very difficult to keep the surface entirely dust free, and because of the lower melting point of the button there is an oxidation which takes place between the two glasses. Now, this produces, in looking through, a rather marked effect. And the light transmission as compared with some better type nbifocal is quite low through a Cryptoc.

Then, possibly, the next type would be the so-called Ultex, or onepiece job. Now, a one-piece bifocal was ground by superimposing

an additional curve to a distance blank. This additional curve was the reading curve. In other words, the Ultex lens is really two curves on the same side of the blank. The Ultex lens has this particular advantage over the fused or Cryptoc: There is no color fringe, or very little color fringe, at the dividing line between the upper and lower part, which was a very common feature of the Cryptoc blank. This color fringe is very objectionable if a person is reading under good illumination. Another particular advantage in the Ultex blanks lay in the fact you could have most any size reading section you might require. Now, that is particularly desirable in considering the occupational use of a bifocal. For instance, a man doing bookkeeping work, an accountant or an architect, might require a very large reading surface. When he leaves his vocation that unusually large reading surface might be quite objectionable on the street. It would be very objectionable on a golf course. So the Ultex lens lends itself to and permits optometrists to give the patient any size reading part that he may require. There has been a great deal of work done on bifocals by some of the major companies. There has been a great deal of research work done.

There are two other types that are commonly used. One is known as the Univis and another is the Penoptic. The Univis is cut in several different shapes. Again it permits the examiner to give the patient, as near as he can judge, the size and shape of the reading section most applicable to the patient's needs.

Then, in any optical lens there is what is known as the prismatic displacement. Now, the prismatic displacement is brought about by the diffrence in thickness in the lens itself. It is objectionable because it has a tendency to make a curbstone look higher or a little further or a little nearer away and one may overreach himself, for example, at table. These newer types of bifocals have a tendency to minimize these displacement factors. They are ground with that in mind. Then that also comes of the fact that they are made out of a different type button or reading portion than the so-called Kryptok. They also minimize the color fringes we have in the Kryptok.

The CHAIRMAN. Doctor, have you read or have you studied the bills, H. R. 278 and 5238?

Dr. SHELEY. Well, sir, I have read them, I can say, Mr. Chairman. To say that I have studied them-possibly I should not use that phrase. I am sure I have gone over them. I have my opinions on them.

The CHAIRMAN. Do you want to state them to the committee?

Dr. SHELEY. Yes. My particular objection to H. R. 5278—am I correct?

The CHAIRMAN. H. R. 5238.

Dr. SHELEY. My particular objection to H. R. 5238 would be that it permitted somebody to come between the examiner and his patient. In other words, I do not believe that any professional man can have any man come between himself and his patient. I also believe that corporate practice generally, generally speaking, possibly would more or less inhibit the refractionist from using that particular form and type of merchandise which in his judgment might be best. I would say those are my particular objections to the bill.

The CHAIRMAN. Are there any questions?

Dr. MARSHALL. Yes.

Dr. Sheley, you mentioned these better types of bifocals. Are they very widely used?

Dr. SHELEY. Well, in the case of practictioners who, I think, are practicing as individuals, I think they are much more widely used than the other practitioners. I have mentioned before, I think that the practitioner who has to account to no one but his patient has a tendency to exercise a little more choice and discretion in the type of bifocal that he uses. And I think the manufacturers of these newer types of bifocals such as the Univis and the Penoptic have endeavored to confine, or they are dispensing to those who are possibly best prepared to use them.

Dr. MARSHALL. Well, how would you choose a bifocal for a particular case?

Dr. SHELEY. Well, as I say, that would again be a matter of the person's occupation. For instance, a bifocal is a very hard thing to fit. A great many factors come into it. What would have to be a bifocal in one occupation would be entirely useless in another. The size of the bifocal is considered in choosing it. And if a man were doing work, for instance, a man doing work in a dye plant, where anything that would disturb color values would be objectionable to him, why, you would have to use blanks which were as near color free as possible. As I say, a golf pro might need a very small lower part. In the case of a marksman the placing of the seams are very important in a blank.

Dr. MARSHALL. Do you have to consider the type of prescription that is to be ground?

Dr. SHELEY. That is very important. The type of blank that might be most applicable to a nearsighted man might be quite objectionable, possibly, to a farsighted man doing the same type of work. This is because, as I have stated, every optical system has prismatic factors in it and the better type of bifocals neutralize this to a much greater extent than the poorer type of bifocal. I particularly mentioned the fused bifocal types and the Kryptok types.

Dr. MARSHALL. Well, in mentioning these better types of bifocals when I ask you if they are widely used, do you mean they are used by a great many people prescribing glasses or that they can be used in a majority of cases?

Dr. SHELEY. Well, I think better type bifocals can be used in all cases. They are very helpful for people who have to wear very strong corrections and, as I say, they are very helpful to folks whose occupation requires careful consideration in the use of bifocals. They are very helpful in that.

Dr. MARSHALL. I understand that the companies putting out this different type of bifocal have done quite a bit of research along that line. What have they done?

Dr. SHELEY. I think there has been a tremendous amount of research given, in my mind. I do not know of any type of lense which we use in which as much research has been put on as has been put on bifocals and their manufacture. For instance, the Penoptic bifocal, which I have seen in the process of manufacture, is manufactured under very exacting conditions. I think it is a very con