On the operative treatment of strabismus / by Freeland Fergus.

  • Fergus, A. Freeland (Andrew Freeland), 1858-1932.
Date:
1900
Catalogue details

Licence: In copyright

Credit: On the operative treatment of strabismus / by Freeland Fergus. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    is that amount, still in others there is not. In fact, not infrequently concomitant squint is found where one eye has even a somewhat low error of refraction, such as 2D of hypermetropic astigmatism, and the other is nearly emme- tropic. I have seen several such cases. It would simply be the height of absurdity to put a pair of -|- 3 D glasses on a case of that kind. A correction, no doubt, should be made, but it ought to be as careful and as accurate as possible; otherwise it is worse than useless. Optical treatment also includes proper exercise by prisms. Where, as a result of efforts to encourage vision in the squint- ing eye, the patient has been made conscious of a diplopia, they are of use in helping the patient to unite the images into one. Under the heading of optical treatment the installation of mydriatics may almost be included. These act oidhoptically by paralysing the power of accommodation, and thus allaying the effort of convergence. In whatever way they act there is no doubt of the clinical fact that, given a case of squint with little difference in the error of refraction and with a fair amount of vision in each eye, a course of mydriatics with correction of I’efraction errors will, without further treatment, often restore binocular fixation. 3. But I wish to-night to dwell especially on the operative treatment; for within the last few years my own opinion, in common with that of man}?- better aide than I to form one, has undergone a radical change. For a considerable time I have operated on all cases of divergent squint by advance- ment. In my earlier days I operated on a few occasions for divergent squint, or for what was called insufficiency of the internal recti, by tenotomy alone. For many years, however, I have, in common with most others, invariably operated on divergent squint, absolute or relative, by advancement of one or both intei’nal recti. For some time back I have operated on convergent squint only by the same method, and have given up tenotomies almost entirely. My endeavour to-night is to justify, if possible, this important change.