A contribution to the surgery of divergent squint / by C.R. Agnew.

  • Agnew, Cornelius Rea, 1830-1888.
Date:
[between 1800 and 1899]
Catalogue details

Licence: Public Domain Mark

Credit: A contribution to the surgery of divergent squint / by C.R. Agnew. Source: Wellcome Collection.

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    A CONTRIBUTION <? TO THE By C. R. AGNEW, M. D., New York. We are commonly asked to operate in cases ot divergent squint, either to remove the deformity or relieve the dragging pain and weari¬ ness, which the loss of muscular co-ordination seems to induce. While we may certainly remove the deformity and the asthenopia, we must not expect, in the majority of cases, to restore binocular vision. The danger from inflammation is slight it the surgeon is gentle in his manipulations, and handles the parts involved with due skill. We must first determine, in a given case, whether the divergence can be cor¬ rected by a contemporaneous tenotomy of both external recti muscles, without an advancement of one or both internal recti. When an externus is successfully cut, it slips backward and adheres to the sclerotic at a point posterior to its natural insertion, and this practically increases the adductive power of the interims. Such a procedure may be successful in case's of weakness of the intend, in which the sharpness of vision in both eyes is nearly the same, but it cannot be depended upon in cases of divergent squint resulting from a tenotomy of one or both interni for previous convergent squint, nor in any case in which binocular vision has been long disturbed, and in which there is a permanent and visible divergence, however small. In such cases the faulty interims must be shortened or its line of insertion planted in the sclerotic, as close to the coi lieal edge as practicable and additional adductive power also given by tenotomy of the opposing extend. We will, after these few preliminary remarks, describe a method ot operating which may be made to meet any 01 all of the indications, and the performance of which does not involve extra¬ ordinary skill, or subject the eye to the danger of grave inflammation.