Blind women in Victorian fiction are habitually excluded from marriage plots (in this database, see Dickens's The Cricket on the Hearth) and assiduously prevented from bearing children, undoubtedly because of Victorian anxieties about hereditary transmission of blindness. Given this cultural context, Collins's novel is remarkable.

Poor Miss Finch represents the most normalized of Collins's many representations of physical disability (in this database, see Hide and Seek and The Moonstone; see also The Law and the Lady and The Guilty River). At the same time, Lucilla's assertive sexuality separates her from the typical non-disabled heroine, for whom sexual expression usually precipitates a quick descent to prostitution and/or death. The bizarre plot which brings Lucilla to her domesticated ending also marks this novel's distance from other "domestic stories."

Because Collins wanted this novel to challenge the sentimentality of existing modes of representing blindness, he gave Lucilla's experience a philosophical and clinical context, drawing on Diderot and Thomas Burke as authorities and giving enough details of cataract surgery to irritate Victorian critics, who wanted their blindness fanciful rather than clinical. Collins may have drawn on his own experiences with the eye surgeon George Critchett as well; he records himself as suffering from chronic "eye gout."

Poor Miss Finch's attempts to produce clinical realism, however, are a resounding and entertaining failure, perhaps because Collins's affinity for the subversive and outrageous is always stronger than his desire for mimesis. For example, the use of silver nitrate to treat Lucilla's fiance's epilepsy is consistent with medical practices of 1872; the treatment's potential to darken the skin is also recorded in contemporary medical journals. For Collins the sensation novelist, however, it was probably impossible to resist pushing this detail to a suspenseful extreme by adding in Lucilla's aversion, her renewed sight, and (for good measure) an evil twin.