Congenital deficiency of abduction, associated with impairment of adduction, retraction movements, contraction of the palpebral fissure, and oblique movements of the eye / by Alexander Duane.

  • Duane, A. (Alexander), 1858-1926.
Date:
1905
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Licence: In copyright

Credit: Congenital deficiency of abduction, associated with impairment of adduction, retraction movements, contraction of the palpebral fissure, and oblique movements of the eye / by Alexander Duane. 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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    true convergence-movement, but really a parallel movement of both eyes to the left, the two eyes converging more and more in doing this, simply because the outward movement of the L eye was arrested. But this view was negatived by the fact that, when the eyes were thus directed to the left and an object in line with the L eye was brought straight in toward the latter, not only did the R eye turn to the left to follow the object, but both pupils contracted, showing that the movement of the R eye was really one of convergence. Such a contraction did not take place when the R was following a distant object that was moved from right to left. TREATMENT. In view of the pathological condition which probably un- derlies most of these cases, advancement by increasing the tension, and hence the retraction, would do more harm than good. So it proved in Case 5. In cases where there is marked inward squint, tenotomy of the internus may help (see Cases 29, 30). In the opposite sort of case, where the eye tends rather to diverge and is hampered by an inextensible band re- placing the externus, an operation for lengthening this band (after the fashion adopted by English operators) might be serviceable. In Case 36,* however, it did no permanent good; nor did tenotomy of the externus in Case 10. Otherwise the proper operation would be that performed in Case 51, viz., tenotomy of the externus of the other eye. In general an operation is not required, and is to be avoided when possible. BIBLIOGRAPHY. 1. 1874, Hirschberg, J., Klin. Beobachtungen aus d. Augeuheilanstalt. Cited by Kunn.’ 2. 1876, PflUger, Klin Monatsbl. f. Augenh., p. 157. Cited by Kunn.’ 3. 1879, Heuck, Klin. Monatsbl f. Augetih., p. 256. Cited by Kunn ’ and Turk.’® 4. 1879, Graefe, a., Graefe-Saemisch Handb. d. ges. Augenh., ist ed. (also 2d ed., 1898). 5. 1887, Stilling, J., Untersuch. a. d. Enstchung d. Kurzsichtigkeii. Cited by TUrk.'® * In which it was associated with tenotomy of the internus.