anything to ask. She tugged at the hand of her daughter. “Come on, Anna. Let’s see what they are giving away.”
The man manning the front desk was wearing glasses just like the ones on the sign. She approached him. “What are the ‘free examinations,’ please?”
“The optician does a few simple tests to determine if you need glasses or if there is some other problem with your eyes that needs to be addressed.”
Juliane glanced down at her daughter. Surely her eyes shouldn’t be turning in like that. “Could I have one for my daughter, please.”
“Of course. The optician is in. I’ll give her a ring.”
Behind one of the doors was the gentle tinkle of a bell in response to the cord the receptionist pulled. The door opened and…a very young female came out. Juliane swung round to question the receptionist, but didn’t get the chance before he spoke.
“Fraulein Sprug, this lady would like you to examine her daughter.”
“Of course. Would you please come this way?”
Ursula studied the woman and child as they approached. Their dress suggested “poor but proud.” The daughter’s clothes looked like they’d been made out of material from her mother’s old clothes. The mother’s clothes had few obvious repairs, but they were heavy wear for the current weather. If she had to guess, Ursula didn’t think she’d be able to afford the full cost for glasses.
“What’s the patient’s name?” she asked the mother.
“Anna.”
Ursula wrote that down. “And how old is Anna?”
“She’ll be four in August.”
Ursula added the age to her notes, then pulled out the booster seat that would raise the child to a comfortable working height and placed it on the examination chair. “If you’ll just seat Anna, I’ll be right with you.”
While Juliane lifted Anna onto the booster seat Ursula took her first really good look at the little girl. She had to bite her tongue to stop herself crying out. Both eyes were turning in. She’d seen this condition in patients during her apprenticeship back in Grantville, but not this bad. She took a small paddle from her work table and did a simple cover-uncover test. She knew young Anna had a definite problem when her eyes swung back and forth. Fortunately, the condition had been caught early enough that it should still be treatable…if the family could afford it.
Ursula selected the special child’s eye chart and proceeded to do the best she could to determine whether there was more wrong than just the eyes turning in. She started by pointing to the largest picture on the chart. “Can you tell me what that is, Anna?”
“A horsie?”
“Very good.” It was actually a man on a horse, but at least Anna could make out the horse. Ursula pointed to an image on the next line down, a hand. “Now, how about this one?” Anna shook her head. Ursula pointed to the next picture on the same line. “What about this?” Anna shook her head again.
Ursula repeated the procedure with Anna’s left eye, regularly glancing at Anna’s eyes. They didn’t turn in as much when Anna was looking at the chart. Ursula added that snippet of information to Anna’s notes. Finally she turned to the mother.
“Anna has a definite problem, but it is treatable. Unfortunately, the condition that is causing her eyes to turn in is beyond my current ability to assess. She really needs to see Dr. Shipley in Grantville.”
“Grantville! We can’t afford to go there. And a Grantville doctor? We can’t afford the kind of fees they charge.”
Ursula nodded in silent sympathy. She knew all about the fees Dr. Shipley charged. “I believe Dr. Shipley intends coming to Magdeburg for Fourth of July Arts Week. I can probably get him to examine Anna free of charge then.”
“Why would you do that?” Juliane demanded.
“So I can learn how to do the examination myself.” Ursula was proud of that statement. It even contained a grain of truth. It would be a useful learning experience, but she’d probably have to pay Dr. Shipley’s fee herself.
Ursula watched the woman wrap her arms protectively around Anna, and tried to reassure her. “The examination won’t cost you anything, I promise. However, Anna does need prescription glasses, and they could be expensive.”
“How expensive?”
Ursula mentally compared what she could afford to subsidize with how much a new pair of glasses cost. “About three hundred dollars.”
“Three hundred dollars? For glasses for a child? You can buy a pair from a peddler for a fraction of that.”
“Yes, you can buy a cheap pair of glasses from a peddler, but Anna’s problem won’t be helped by them. And if you don’t do something soon, her vision could be permanently damaged.”
“Permanently? You mean Anna could go blind?”
Ursula hastily shook her head. “Not blind, just beyond our ability to correct. Come on, let’s get Thomas to take down some contact details and I’ll be in touch as soon as I hear back from Dr. Shipley.”
July 1635, Magdeburg
It usually took about half an hour for the atropine eye drops to stabilize a child’s eyes enough for him to examine, so Dr. Ezra Shipley spent the time explaining the importance of good eye health to the mother. Eventually he was happy with the dilation of Anna’s eyes and turned his attention to his patient.
“Anna, I’m not going to do anything that will hurt you. I’m just going to shine a light in your eye and put some lenses in front of it, like this.” He knew that a demonstration helped calm any apprehension a child might have. It even worked on some of his more highly-strung adult patients.
He selected a lens and held it in front of Anna’s eye and shone the light from the hand held retinoscope through it. The reflection of the retina still showed movement, so he tried another lens.
“Ursula, come try this. I want you to see how when I move the beam from the retinoscope across the pupil the reflex moves the same way as the light and how it moves faster at the forty-five degree angle than the hundred thirty-five degree angle. It’s really easy to see here, because the difference is so great.”
He gently coached Ursula through the steps to neutralize the refractive error in the right eye, and after checking for himself, fitted the selected lens into the trial frame before repeating the process on the left eye. With two lenses selected, he passed the loaded trial frame to Ursula and crouched down so he was at Anna’s level.
“Now Fraulein Sprug is going to hold this funny-looking thing in front of your eyes. It’s called a trial frame. And we’re going to try some more lenses.”
With Ursula holding the trial frame, which was too big to fit Anna comfortably, Ezra used cylindrical lenses to correct both eyes for the other meridian with the same method.
“There. Now that wasn’t so bad, was it? Let’s see what you can see on the chart.”
In a few minutes Ezra finished measuring Anna’s vision through the trial lenses. She was now seeing 20/30. Or more correctly, she was reporting 20/30. Young children had an unfortunate tendency not to want to reply when the pictures got very small. Not great, but probably the best they could do with purely objective measurement. In a couple of years’ time, when Anna was old enough to give reliable subjective feedback, Ursula could refine the prescription closer to 20/20. However, there was still the matter of convincing the mother to purchase glasses she might not really be able to afford. He glanced over at Anna. She was a sweet little girl. She didn’t deserve to be condemned to a world permanently out of focus just because of a few dollars.
“Frau Lortz, your daughter needs a high prescription. As Miss Sprug has already told you, if we don’t correct her vision now she will have blurred vision later in her life that we will be unable to treat. It is imperative that we fit her with glasses as soon as possible. Now, you’re probably worried about how much they’ll cost. Because they’re for a child we can make them up for…” He glanced at Juliane’s worried face. Ursula had warned him about the price she’d quoted and why. He might have gone lower, but Ursula had also commented on the poor but proud appearance. “Three hundred dollars.”
The mother reached out a hand to run it gently over her daughter’s head. She looked at the eye chart and back to Ezra. Then she reached under her jacket and pulled out a crumbled piece of paper, which she handed
