The anomalies of the ocular muscles / by George T. Stevens.

  • Stevens, George T. (George Thomas), 1832-1921.
Date:
[1889?]
Catalogue details

Licence: Public Domain Mark

Credit: The anomalies of the ocular muscles / by George T. Stevens. Source: Wellcome Collection.

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    from the necessity of a most difificult and perplexing ocular adjustment. With this release came relief from the whole train of nervous symptoms. Treatment of Hyperphoria. The treatment of hyperphoria is tenotomy. If the pa- tient is unwilling to submit to a radical relief, or if the sur- geon hesitates to perform the operation, if complicating circumstances render such an operation inadvisable, other means may be resorted to. The use of a prism, with its base up or down, is indicated under such circumstances. Let it be remembered that while glasses are of inestimable value, they are still inconvenient and often extremely so ; that with the best art of the optician, glasses detract from the symmetry and expression of the face, a fact of much importance to females at least ; and finally, that in the con- ditions of muscular deviations, they neither cure nor afford as complete temporary relief as a removal of the actual defect. Indeed, it is not uncommon for one having hyper- phoria of 1° or 2° to suffer much pain in or about the eyes while wearing a correcting prism, but to experience almost immediate and complete relief from all the symptoms caused by the mal-adjustment of the eyes, as soon as ten- otomy is performed. Glasses are like crutches, desirable when defects which render them useful cannot be removed. A special disadvantage of a very weak prismatic glass is the fact that it reflects a false image of every strongly illu- minated object, seen at some distance, just above or just below the true image. This false image is often extremely annoying. The daily exercise, continued through two or three weeks, of overcoming prisms placed vertically before the eyes alternately, with the bases in the same direction or before the same eye with the prism reversed, may tend to give the muscles greater vigor, and hence to enhance their ability to endure the difficulty. The duration of the exercise should not exceed three to five minutes at a time. If tenotomy is performed, the surgeon must choose be- tween relieving the tension of the superior rectus of one or if