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ing days they spend looking over the shoulders of each worker. They watch everything—from his posture to the type of work he does; they measure the distance from his eyes to the instrument he uses—be it a lathe or a blueprint.

They evaluate the employees' sight requirements as they relate to the specific task each man has. In addition, they look for ways to prevent eye injuries and accidents that may result from faulty vision. They search for ways to increase production and eliminate waste caused by defective vision.

They cooperate with plant safety experts and perhaps with the medical staff to find and eliminate work and work processes which present eye hazards and to determine protective requirements for workers, including whatever protective eye devices may be needed. They advise foremen as to special and specific visual problems in the plant.

On the basis of their personal, in-the-plant observations, they make their recommendations to management which might include recommendations to control the quality, quantity, and direction of light; using paint which will improve lighting utilization; elimination of certain hazards to vision; wearing of certain types of protective goggles for some men in the plant; etc.

Here is both vision care and preventive vision care. Here is a job of major proportions that needs to be done. Yet we have not, at this moment, the manpower to do it.

H. W. Hofstetter reports in his book, "Industrial Vision," that the total annual incidence of eye injuries alone is about 300,000. I would like this committee to have a copy of Dr. Hofstetter's book.

Anybody in the management field knows that manpower is the most expensive single factor in production costs today. Therefore, it is most important to use personnel at top efficiency. Vision is the key to man's brain, for 85 percent of all he learns comes to him through his eyes. His vision, therefore, is the human element that is the key to production.

Industrial managers are practical businessmen. And it is not difficult for them to establish the effects of a vision program on training time, labor turnover, sickness and absence costs, reduced spoilage, and accident expense. These factors, when eliminated or reduced, mean less production costs and an increase in profit margin.

There are many factors which influence the health level of any business. No claim is made that a vision program will cure, by itself, all the maladies of absenteeism, labor turnover, insurance costs, or the more complicated ailments relating to labor relations. However, a well-conceived continuous vision program properly integrated into personnel, safety, and medical activities of any industry has sufficient influence to validate the effort.

Research in industrial vision has developed a method of vision testing and analysis that will give industry a clear-cut statement of the dollars and cents value of good vision and good seeing, to bring about a realization of the importance of adequate visual attention of industrial employees. Results show that from 20 to 50 percent of the industrial employees need visual help for the jobs to which they are assigned.

The optometrist bas a major role to play in industry, and in the future he will play that role in the best interests of individuals and business organizations.

There are about 90 million Americans who are of great concern to the optometrist. These are the Nation's drivers of private cars and commercial vehicles. We are constantly assailed by horrifying statistics concerning highway accidents and deaths. The optometrist cannot prevent all of them. But he can help to reduce them by making sure that all drivers have vision adequate for modern freeway driving.

Each year about 40,000 people are killed in auto accidents, hundreds of thousands more are involved in nonfatal but often serious accidents. There has been much discussion of the reckless youngster who speeds down streets and highways. A study made in California showed, however, that drivers involved in accidents with other cars were largely people over 65 years old. And the National Safety Council says that the fatality rate climbs rapidly for drivers over 70 who are involved in accidents. Our own motorists' vision and highway safety committee found that 80 percent of drivers 60 years and over have visual problems which make them risks on the highways.

Let's not forget in that connection that by 1975 nearly half the adult population of the United States will be over 65. This is, of course, not an indictment of our elderly drivers. But the fact remains that when you compare mately 10 percent of the school population of America requires special aid because of retardation in reading. A survey conducted by the writer at the Manhattan Children's Court revealed that 84 percent of cases carried by the treatment clinic present the problem of reading retardation in conjunction with personality disorders and antisocial behavior.

Dropouts, délinquency, vision disorders. Five hundred and fifty-five thousand juvenile delinquent cases were tried in court in 1962. These offenders were in the 10 to 17 age group (representing 1.8 percent of all children of that group), this being the group in which the largest number of dropouts obviously occurs.

Now we already know that faulty vision or vision problems if not corrected can in time cause a youngster to be unsuccessful in school and unable to study effectively. Unless his family insists that he remain in school, or unless he has visual care which helps him solve his reading-and-seeing problem, he is a likely dropout candidate. And so, a vicious cycle may well result in adding another delinquent—a boy or girl who might have been saved with the aid of proper, professional visual care.

The growing lack of jobs for young people may then make it impossible for such a youngster to find a job. And if he does apply, his visual difficulties and limited education might make him unsuited for certain types of jobs.

We have thus lost a productive member of the American community. And the cause of that loss may well lie in the field of vision *** in our neglect to help that youngster when help might have made the difference between a useful and nonproductive life.

In American industry the results of lack of vision ability—even where there are no obvious physical defects-can be measured in millions of dollars and thousands of wasted man-hours.

Just as an example, let me use the illustration of one large printing company-R. R. Donnelley & Sons—which found that proofreaders who meet the minimum visual' requirements are 37 percent more accurate than those who failed the minimum visual tests, have 7.9 points higher efficiency, and produce a net productive value of 12 cents per man-hour more than those failing to meet minimum requirements.

Another illustration: In a Washington, D. C., Federal Government office, a vision program, plus improvement in lighting, brought about an increase in worker efficiency, conservatively rated at 5.5 percent. Translated into cash value, it means that the 95 employees in that office, following the vision program and lighting improvements, created a payroll saving of $13,229. Using the same scale, if a business had 1,000 employees, it might save $139,250 over a period of a year. Good, efficient vision pays—in many ways.

And good, efficient vision is obviously a sound business investment—and a sound national investment. Let's remember that our 300,000 industrial plants employ about 16,651,000 people.

Now, let's look at what savings can be had in man-hours based on the figure I mentioned for the printing plant, which as the result of a vision care program found that having good vision produced 12 cents more per man-hour.

Translated into our national industrial plant with its 16.6 million employees, a vision care program would result in savings of about $4 billion annually.

In other words, the $4 billion saved would in effect be added onto the gross national product of $585 billion, instead of being lost to our gross national product, as indeed that $4 billion now is lost.

Well, how do we obtain these savings for industry and for the Nation?

To service the 300,000 industrial plants, we would need about 4,800 optometrists in addition to those now practicing. That sounds like a large order-and at the present moment it is, when we only graduate about 500 students annually from our schools of optometry. But it's a very small number in terms of the real service they could render to industry and nation.

I did not pull that figure out of my hat or even my head. It is based on the fact that the optometrist's actual working time when you deduct such things as weekends, vacations, attendance at postgraduate educational meetings, etc.-amounts to about 250 days. Since there are 300,000 plants, and he needs about 4 days for each plant, that means that optometrists must spend 1,200,000 days a year to service those plants. If you divide the 1.2 million days by 250 days the average optometrist will work, the figure you come up with is 4,800 optometrists.

A number of optometrists work as consultants to industrial organizations. The first day they visit a plant, they obtain an overall idea of plant layout-in particular, they watch for potential dangers to sight and vision. The following days they spend looking over the shoulders of each worker. They watch everything—from his posture to the type of work he does; they measure the distance from his eyes to the instrument he uses—be it a lathe or a blueprint.

They evaluate the employees' sight requirements as they relate to the specific task each man has. In addition, they look for ways to prevent eye injuries and accidents that may result from faulty vision. They search for ways to increase production and eliminate waste caused by defective vision.

They cooperate with plant safety experts and perhaps with the medical staff to find and eliminate work and work processes which present eye hazards and to determine protective requirements for workers, including whatever protective eye devices may be needed. They advise foremen as to special and specific visual problems in the plant.

On the basis of their personal, in-the-plant observations, they make their recommendations to management which might include recommendations to control the quality, quantity, and direction of light; using paint which will improve lighting utilization; elimination of certain hazards to vision; wearing of certain types of protective goggles for some men in the plant; etc.

Here is both vision care and preventive vision care. Here is a job of major proportions that needs to be done. Yet we have not, at this moment, the manpower to do it.

H. W. Hofstetter reports in his book, "Industrial Vision," that the total annual incidence of eye injuries alone is about 300,000. I would like this committee to have a copy of Dr. Hofstetter's book.

Anybody in the management field knows that manpower is the most expensive single factor in production costs today. Therefore, it is most important to use personnel at top efficiency. Vision is the key to man's brain, for 85 percent of all he learns comes to him through his eyes. His vision, therefore, is the human element that is the key to production.

Industrial managers are practical businessmen. And it is not difficult for them to establish the effects of a vision program on training time, labor turnover, sickness and absence costs, reduced spoilage, and accident expense. These factors, when eliminated or reduced, mean less production costs and an increase in profit margin.

There are many factors which influence the health level of any business. No claim is made that a vision program will cure, by itself, all the maladies of absenteeism, labor turnover, insurance costs, or the more complicated ailments relating to labor relations. However, a well-conceived continuous vision program properly integrated into personnel, safety, and medical activities of any industry has sufficient influence to validate the effort.

Research in industrial vision has developed a method of vision testing and analysis that will give industry a clear-cut statement of the dollars and cents value of good vision and good seeing, to bring about a realization of the importance of adequate visual attention of industrial employees. Results show that from 20 to 50 percent of the industrial employees need visual help for the jobs to which they are assigned.

The optometrist has a major role to play in industry, and in the future he will play that role in the best interests of individuals and business organizations.

There are about 90 million Americans who are of great concern to the optometrist. These are the Nation's drivers of private cars and commercial vehicles. We are constantly assailed by horrifying statistics concerning highway accidents and deaths. The optometrist cannot prevent all of them. But he can help to reduce them by making sure that all drivers have vision adequate for modern freeway driving.

Each year about 40,000 people are killed in auto accidents, hundreds of thousands more are involved in nonfatal but often serious accidents. There has been much discussion of the reckless youngster who speeds down streets and hig'lways. A study made in California showed, however, that drivers involved in accidents with other cars were largely people over 65 years old. And the National Safety Council says that the fatality rate climbs rapidly for drivers over 70 who are involved in accidents. Our own motorists' vision and highway safety committee found that 80 percent of drivers 60 years and over have visual problems which make them risks on the highways.

Let's not forget in that connection that by 1975 nearly half the adult population of the United States will be over 65. This is, of course, not an indictment of our elderly drivers. But the fact remains that when you compare involvement in motor vehicle accidents according to age groups, the rate for the older driver is 45 per 100,000 population, while it is only 25 for people of

age 25.

Obviously, more attention must be given to vision care for this group, but not for this group alone. When you remember that about half of our population needs some visual attention, it is obvious that a large group—a group larger than older drivers-among the driving population is in need of such attention. It should be realized, however, that a great many States have a "grandfather clause"-once an individual obtains a driver's license, he can go on driving a car indefinitely without any further examination.

Studies indicate that 90 percent of all driving decisions are based on the ability to see, yet probably about half of today's drivers fall below acceptable vision standards. Yet 40 percent of today's drivers are over 40 years old, when vision defects become more pronounced.

A few States have compulsory driver reexamination. Most do not. As long ago as 1941, New Jersey began a program of reexamination of all drivers over 65 years old who had been in a reportable accident, no matter how minor. As a result, several thousands had their licenses revoked. North Carolina reexamines all drivers—totaling more than half a million-every 4 years. In Illinois, Delaware, Maine, and New Hampshire there is a requirement for the periodic reexamination of senior citizen drivers.

Good vision as far as driving is concerned is not just a question of having 20/20 sight. Driving demands vision that is clear, complete, and quick, each of which is a separate skill of the eye. Good peripheral vision is important-how much you can see on each side without turning your head or eyes. So is depth perception—your ability to judge distances and direction. And night visionyour ability to see under low illumination and your adaptability to darkness. Glare resistance is also important—your ability to see against headlights or sunlight and the rapidity with which you can recover from being blinded by glare.

Good driving vision, then, means many things, all of them important to safe driving.

Optometrists work with many of the State motor vehicle administrations. Quite a few work on a voluntary basis with driver training courses in the Nation's schools. But again, we must come back to the lack of sufficient manpower in this profession.

A population of 191 million people is served by approximately 17,000 practicing optometrists. In other words, the rate is 1 optometrist to every 11,279 per

Even though not every American needs vision care today, this is still an alarming ratio. Plainly speaking, it means that the optometrist simply cannot do all the jobs that need to be done.

Despite such lack of manpower, the optometrists of the Nation have contributed their services to making the highways safer, and are anxious to do more. The American Optometric Association's Committee on Motorists' Vision and Highway Safety has worked closely with numerous organizations, bringing to their programs the necessary professional and technical knowledge of our most precious sense-vision.

“Optometry," in the words of the past chairman of AOA's Committee on Motorists' Vision, Robert C. Sneller, "occupies a unique position in the field of highway safety and can make a substantial contribution to the fund of knowledge necessary to many remedial programs. Almost all actions and decisions of a driver are dependent upon what he sees. Thus, almost all factors relating to movement and control of the motor vehicle are at least in part within the scope of optometry. The optometrist, as a professional man and responsible citizen, is anxious to lend his efforts to the further reduction of fatalities, injuries, and loss of property due to auto accidents." I would like to leave with this committee a copy of Dr. Sneller's book, titled "Vision and Driving."

I am also leaving with the committee a pamphlet entitled "The Optometrist and Safe Driving," which spells out the role of the optometrist in this area.

On the highway, in the school, in industry, and the office the optometrist's help is needed—and critically needed. And there are yet other areas of our national community where his services would be a personal as well as an economic advantage to many of our citizens. As part of the war on poverty, a good many men will have to be retrained, and this is a big job. For the individual to be retrained, it will not be an easy thing. It will become very much harder for a man without good, efficient vision. And a good many of these men will be in middle

sons.

and upper age brackets. The visual part of the entire retraining program will be of great importance.

Since the Department of Health, Education, and Welfare will be principally concerned with this campaign, optometrists should be on the Department's staff to evaluate programs and plans, to supervise the carrying out of plans—all in the interest of vision care.

Optometry occupies a unique position in the health care field. It renders visual care in the physical sense through the measurement of the refractive powers of the eye, and the visual training to develop a high level of visual performance skills for accurate perception of objects in space. But it also gives advice regarding environmental factors which may affect visual efficiency. This is certainly true in office and industrial work which the optometrist undertakes.

Optometrists also work with the near blind, including near-blind children. Time was when educators believed that students with limited vision would damage their eyes further if they used them for classroom work. Today it is realized that some children, at least, who have limited vision, should be working in the classroom for all or part of their educational process. This is the result largely of the renewed interest in exact refractions and in the use of low vision optical aids.

There is a recognition today that not all who are classified as legally blind are in effect completely unable to see. The optometrist has developed many effective aids for the partially blind, and it is no longer uncommon for the legally blind persons, some of whom are on blind pensions, to have their vision restored sufficiently to read or watch television. Optometrists have led the way in improving telescopic spectacles. They are a boon to children and to the aging whose number is rapidly growing.

The new philosophy here is to keep the partially seeing child in a normal school environment as much as possible. Thus, he can lead a normal school life. He can learn and play with his normally seeing classmates and not feel set apart from them. Thus, he is better prepared for life than if he had been kept apart from the "normal" child of his own age, and learns at an early age how to live with his handicap and how to make the most of his total abilities in a normal environment.

Such an approach to the problem of the child with limited vision was possible only when the idea that one had to conserve the child's vision was recognized as being faulty. The fact is, that properly supervised and guided, a partially seeing child does not wear out his limited vision. Rather, he enhances and develops it, and thereby his own role in life as well.

Optometry believes in dynamic progress, and not in just making the best of what is available. Thus, to improve a partially seeing child's vision, it can give him specialized vision aids—including telescopic and microscopic types of eyeglasses which often enable him to read even the smallest type. But again, this is not enough. The optometric profession has evolved a program and a concept of low-vision rehabilitation which, in the main, makes these points: that the child or adult patient utilize rather than "conserve” his vision; that he shun the sheltered life and instead take an active part in it and in the edu cation he needs for life.

In such ways does the optometrist help to raise the visual efficiency of America. But more, much more, needs to be done; and to do it we need more optometrists.

This means that more students and prospective students of optometry should receive the financial assistance that will enable them to obtain or continue their education. Medical and dental students have available thousands of loan dollars for every loan dollar available to optometry students.

Under these circumstances it would seem self-evident that optometry students be accorded the same privilege of borrowing and paying interest on student loans as the medical, dental, and osteopathic students. If you vote favorably on these amendments, and I urge you gentlemen to do so, the money you will be lending these students will be a pittance compared to that now being provided to the other health professions.

Failure to act favorably will result in a reduction of the number of students who will study optometry in the years to come; it will mean a reduction in the number of qualified optometrists when the country needs more, many more, to perform the vital services which only optometry can perform. It will mean that the profession would have to abandon some of the areas it is investigating and developing, or at least greatly reduce some of its work in those areas.

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