Vol. 60, 1909 - University of North Carolina at Chapel Hill

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ORIGINAL COMMUNICATIONS. 233
opia, and that the amblyopic eye cannot be such. Results cannot be obtained after the
improved. seventh year.
Le tirange and Moreau in "Archives Herman Cohn, in ( Wachenschrift for
d'Ophtalniologie' ' in 1907, reports his find- Therapie nd Hygiene des Auges, October,
ings of 562 cases of concomitant squint. 6; 1904) outlined his treatment of two thou-
In 81 per cent, refractive error was the chief sand cases of squint, covering a period of
cause, and in 38 per cent, refractive error forty years, in which were 700 operations,
was the sole cause of the strabismus. 43 First: Until the fourth year bandage the
per cent, of the refractive errors were com- better eye for a few hours each day.
plicated; 19 per cent, had uo error of re- Second: In the fifth year he corrects
fraction, and were referred to a strabismus with glasses and stereoscopic exercises,
diathesis. The inheritance is due to the Third: He constantly corrects the total
pathological condition of the nerve centers hj'peropia.
and consequent degeneration of the fusion Fourth: He operates only for strabismus
sense. In 1.50 per cent, it was of muscular of the highest grade in the 6th year, otherorigin,
wise, he waits until the tenth.
A Baker, Cleveland; in the Journal of the Fifth: He promises betterment of posi-
American Medical Association, July. 1907, tion, but never binocular vision,
says that squint comes on slowly; at first it Sixth: In strabismus of high grade he
is intermittent, then alternating, finally per- advances the external retcus.
sistent, with deterioration of the sight in the D. B. St. John Roosa, iu the Medical
deviating eye. He says 75 per cent, of Record, September 1905, reports two cases:
S(iuints develop before the fourth year. Re- one, convergent strabismus followed by
should be corrected at the end of amblyopia exonopsia, cured by the use of
the first year, atropiziiig both eyes at the glasses and the exclusion of the good eye
earliest stage, and in connection with this at intervals and the use of stereoscopic extraining
the fusion faculty. If not correct- ercises.
ed by the tenth year he operates. He con- Second, Case of amblyopia, which had
siders the retinascope the most reliable increased when seen the second time, was
method of refracting young children. afterwards relieved by the exercise of the
Dr. de Schweinitz gives as the cause of eye.
strabismus, Iu stationary convergent strabismus,
iMrst: Disturbance of relation between Foster' in the Colorado Medical Journal,
the accommodation and the convergence by July, 1907, orders glasses the second year,
an error of refraction. or as early as squint is observed, using
Second: Disparity in the length, thick- atropine in the fixing eye and exercises
iiess and tension of opposing muscles. with the Worth's amblyoscope. If this does
liird: Inequality in the vision of the not relieve the condition he operates,
two eyes, or amblyopia of one eye, which
removes the natural stimulus (of diplopia
Froehlich in (in Wiener Mcdizinische
Presse, May 11, 1907,) gives for treatment
to exact convergence). of strabismus, atropine in the fixing eye.
I"ourlh: Disturbance or innervation and
defective development of the fusion facul-
A. .-V. Bradburne, Southport, England,
for over three years with Dr. Worth, who is
ty. conceded authority on squint, in ''Opthal'
I'uchs says the natural development of mology", July, 1908, says there are two
squint is accom])lished by the reduction in varieties of squint, viz: paralytic and conthe
visual acuity of one eye. Strabismus comitant. In concomitant the eye can be
is the result of combined action of two fac- moved freely in every direction; in paralytic
tors: diminution of the visual power of one
eye and preexisting disturbance in the
muscular equilibrium. In strabismus conthe
movement is limited by the paralyzed
muscle. He gives as the causes for squint,
First: A difference in the refraction of
vergeus >4 are hyperopic. In strabismus two eyes.
i-ergens -3 are myopic.
Wendell Reber, in the New York Medi-
Second; Deficiency in the fusion faculty,
and in addition there is nearly always
cal Journal, November 1904, states that found,
squintis likely to appear aboutthethirdyear. Third: Defective vision of one eye.
He believes that amblyopia of the scjuint amounting to the loss of useful vision,
'eye is due to non-use; that it is curative Fourth: Inability to Vjring the deviating
ithout operation if taken before the 5th
»r>i . .1 , 1 . 1 •
year. That the amblyopic eye can be imeye
to bear directly on an object.
Many "'