Stenopeic (Pinhole) Glasses - The Evidence

by James E. Lebehsohn, M.D. Ph.D., Chicago

 

Introduction:

Glare protection for eyes dates back to prehistoric time. Some devices were made of bone, wood or hide, and had slits in them to protect the eyes from the glare of the sun, snow or sea water. These were tied round the head with strips of hide. Today a scientific version of the glare interceptor, called by the distributor Stenopeic (multiple-pinhole) spectacles in which 7 rows of pin-holes of specific size and spacing are placed in a plastic opaque material are available. These, after much experiment, were found to be valuable in certain cases of subnormal vision. A few examples follow of the conditions in which they have been used successfully.

Complicated Cases

Recently a case was brought to my attention. It involved a young serviceman whose eyes had been injured by sulfur dioxide gas. Both corneas had been transplanted and his vision, uncorrectable with glasses, was 20/400 in each eye -which meant he was nearly blind.

After studying the case I recommended he be given stenopeic spectacles. With these, vision was improved to 20/70 and he could read 9-point type.

A 70 year old stockbroker had a mature cataract in his left eye and nuclear sclerosis with a small cupuliform opacity in his right crystalline lens. Stenopeic spectacles, by removing the disturbing veiling glare, gave him 20/30 distant vision and permitted 4-point type to be read without difficulty.

Other Complicated Cases

A recent case was most unusual. A 47-year old man had been disturbed for the past two years by seeing distant objects doubled through his only good eye. The other was amblyopic and markedly divergent.

He consulted a qualified ophthalmologist who was puzzled and referred the patient to me. On refracting his seeing eye, I found he had excellent correctable vision, but even with correction he still noted a doubling of the hands on the large clock across the street and the red dots below the numbers on the dial. With stenopeic spectacles he was delighted to see everything sharp and with no doubling.

Excellent Results

A man of 58 had unaided vision of right eye 20/13, left eye 20/300. A diffuse posterior subcapsular cataract was present in his left eye. With pinhole spectacles the vision of this eye was 20/30 though no lens gave any improvement.

An appraiser of 56 had a left mature cataract and a right incipient cuneiform cataract. The right acuity was 20/40, unimproved by lenses. He had been wearing pinhole spectacles successfully for two years, achieving 2030 vision without veiling glare. He can read 4-point type with a hand magnifier.

A man of 46 had bilateral cataracts. On September 23, 1952, with mydriasis, vision was correctable by glasses to right 20/30, left 20/20. On August 1, 1953, his vision with these glasses had diminished to right 20/70, left 20/40. I then recommended pinhole spectacles. With these his distant acuity was 20/25 in both eyes and he could read 4-point type.

 

More Examples of Successful Applications

There are numerous cases in which pinhole vision far exceeds that obtainable by lenses. Usually, excellent pinhole vision is indicative of good operative prognosis, but by utilizing pinhole devices, the imperative necessity for surgery may frequently be delayed. In the past five years I have found the following uses for pinhole spectacles.

 

  1. In irregular astigmatism, conical cornea, discrete corneal opacities and incipient cataract, the pinholes often permitted clarity of vision not obtainable by lenses.
  2. As a temporary expedient the pinholes are valuable for children with high astigmatism until the become sufficiently co-operative for objective refraction.
  3. As the pinholes help both distant and near vision they can be used by those who have broken their glasses while waiting for new lenses.
  4. Following cyclopedia, which induces a temporary paralysis of accommodation, the pinhole provides protection from glare and compensates for the disturbed visual acuity.
  5. In pathologic photophobia-discomfort the pinholes frequently reduce light to a comfortable degree and yet permit effective vision.
  6. In cases of retinal separation the motion of the eyeballs can be controlled adequately by blocking all but the central pinholes.
  7. Used by patients after cataract extraction, before receiving new glasses, the pinhole spectacles add an element of protection besides their own advantages. In none of the cases in which pinhole spectacles were used have I found any adverse effect, and I feel that in time acceptance of this aid will increase among the populace.