In the middle of 1920’s, the so called “Eighteen Point” optometric examination was developer by “Skeffington and Associates”, Later (about 1930) the “blur points” were added by Associates Louis Jaques and George Crow, and the OEP routine became known as the “21 Point Examination.” Syndromes for analyzing the “case”.
In 1933, Saul Lesser, who was the primary author of the “Little Black Book” at least until the mid 1970s, published a second edition of Fundamentals in Procedure and Analysis in Optometric Examination. The #19, #20. & #21 were not yet part of the analysis. Similarly, in 1932, in the Proceedings of the New York Optometric Society do not consider those findings either.